A diarthrodial joint is one in which the adjoining bone ends are covered with a thin cartilaginous sheet and joined by a joint capsule lined by a synovial membrane, which secretes synovial fluid. What is EQ-5D, 2013, http://www.euroqol.org. 781786, 1999. Theyre most often caused by a combination of bacteria and dental plaque, and. Method of ulnar resonant frequency determination, Physics in Medicine and Biology, vol. Disclaimer, National Library of Medicine The hinge joint between the humerus and the ulna. 38, no. Create your account, Osseous tissue is made by cells called osteoblasts. Furthermore, thick layers of soft tissue can obscure adequate view of bones with ultrasound. One of those things that makes doctors sound smart. Its like a teacher waved a magic wand and did the work for me. There are different types of fracture non-union with various imaging characteristics: hypertrophic: abundant callus formation; radiolucent line (unmineralized fibrocartilage) at the non-union site. Pain on palpation at the site of injury is also currently widely used among physicians to judge union; however, it is a highly subjective outcome given individual and cultural differences in perception and tolerance level of pain among the population. A periodontist usually performs the surgery. Investigators used a tibia phantom with simulated transverse fractures for this study, which as they acknowledged is a simplification of actual clinical fractures with various anatomical characteristics and amount of soft tissue damage. L. M. Hoesel, U. Wehr, W. A. Rambeck, R. Schnettler, and C. Heiss, Biochemical bone markers are useful to monitor fracture repair, Clinical Orthopaedics and Related Research, no. 36, no. All of these animals evolved from a common ancestor with these bones, and although the shape and size of those bones may have changed through evolution, they are still there in the same configuration. These scores are added to calculate the RUST [, Copyright 2014 Saam Morshed. Definition of Osseous osseous Osseous: Having to do with bone, consisting of bone, or resembling bone. 96569661, 2002. The management of nonunion in long bones by compression plating was found to be satisfactory. 2731, 1986. Here are strategies you can use to help manage it. Video chat with a U.S. board-certified doctor 24/7 in a minute. These more efficient instruments are currently being validated in a number of different orthopaedic clinical settings including orthopaedic trauma. Bookshelf They found higher agreement of fracture healing with use of the RUSH (ICC = 0.53, 95% CI: 0.300.69) compared to subjective assessment (ICC = 0.22, CI: 0.010.41). Figure 4 provides an example of using the RUSH in assessment of fracture union. We aimed to investigate the influence of early osseous union after PLIF on HRQOL. All rights reserved. Osseous tissue has multiple functions. To unlock this lesson you must be a Study.com Member. Osseous tissue is the hard tissue that makes up bones. 19, no. The authors referred to this technique as shift comparison and introduced it as a quantitative method of measuring stability. 5, pp. noted that this method provides only indirect measurement of changes in stress in the fixator as the fracture heals; however, there are currently methods available to measure absolute values of stiffness using the same system [57, 62, 63]. "Osseus fusion" means: osseus = bone, fusion = merged, or grown together. A dentist may recommend either topical or oral antibiotics to get rid of bacteria built up in your pockets. The follow up period for each case was 6 months. I. M. Siegel, G. T. Anast, and T. Fields, The determination of fracture healing by measurement of sound velocity across the fracture site, Surgery, Gynecology & Obstetrics, vol. 3, pp. Inhibition of angiogenesis in rats with closed femoral fractures completely prevented healing and resulted in atrophic nonunions [26]. Tendons connect muscles to bones, while ligaments connect bones to other bones. Many of these fractures were falsely identified as healed by resonant frequency analysis. Treatment of long bone nonunions: factors affecting healing. If gum disease and pockets arent treated properly, they can eventually lead to tooth loss. develops in its first year. Joint movement is limited because of interlocking of the articular surfaces. "osseous." 912, 1997. 9, pp. Orthogonal double plate fixation for long bone fracture nonunion. For conservatively treated fractures at least, delayed union can be defined as the cessation of the periosteal response before the fracture successfully has been bridged. These techniques include. They evaluated the bone healing of both groups by weekly PET scans and plain radiographs. Result: 24, supplement 1, pp. This site needs JavaScript to work properly. Nicholson JA, Oliver WM, LizHang J, MacGillivray T, Perks F, Robinson CM, Simpson AHR. 3, pp. Good nutrition also plays a role in bone healing. Marsh defined nonunion in the study of 43 isolated closed tibial shaft fractures as failure to reach a stiffness of 7Nm per degree by 20 weeks after injury since none of the fractures that reached this value failed to heal [60]. Use of clinical assessment tools in the evaluation of fracture healing. 8, pp. There is no or minimal callus formation and fracture line remains visible (Figure 2). 26, no. Your gums will be sewn back and covered with a periodontal dressing to help manage the bleeding. Bones, tendons, and ligaments all are classified as connective tissue that serve to support the body, allow movement, and protect internal organs. Is it PET scan or CT scan? Unable to load your collection due to an error, Unable to load your delegates due to an error. Im a 32 year old dancer, and those pain affects my work and my life.. Jorgensen measured fracture bending at a known amount of load in tibial fractures [61]. 206213, 1998. 3, pp. Street, M. Bao, L. DeGuzman et al., Vascular endothelial growth factor stimulates bone repair by promoting angiogenesis and bone turnover, Proceedings of the National Academy of Sciences of the United States of America, vol. 6, pp. J. P. M. Frlke and P. Patka, Definition and classification of fracture non-unions, Injury, vol. As evident, fracture healing is a continuous and complex biological and molecular process. As an example, the bones of the skull are separate and actually Epub 2019 Sep 20. R. Hammer and H. Norrbom, Evaluation of fracture stability: a mechanical simulator for assessment of clinical judgement, Acta Orthopaedica Scandinavica, vol. When the gap between your teeth and gums becomes deeper than 5 mm, the area becomes difficult to clean at home or even with a professional cleaning by a hygienist. Doctors typically provide answers within 24 hours. J. Kttstorfer, G. Kaiser, A. Thomas et al., The influence of non-osteogenic factors on the expression of M-CSF and VEGF during fracture healing, Injury, vol. A joint in which the articulating surfaces are separated by synovial fluid. T. A. Einhorn, The science of fracture healing, Journal of Orthopaedic Trauma, vol. Get answers from Diagnostic Radiologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. 873884, 2003. 6, pp. Careers. sion pr-tr-zhn 1 : something (such as an anatomical part or excrescence) that protrudes 2 : the act of protruding : the state of being protruded Synonyms bulge bunch convexity jut overhang projection protuberance swell See all Synonyms & Antonyms in Thesaurus Choose the Right Synonym for protrusion PROMIS: Dynamic Tools to Measure Health Outcomes from the Patient Perspective, 2013, http://www.nihpromis.org/?AspxAutoDetectCookieSupport=1. The bones grow together and fuse (osseous fussion) as the baby 3, pp. T.-W. Chu, Z.-G. Wang, P.-F. Zhu, W.-C. Jiao, J.-L. Wen, and S.-G. Gong, Effect of vascular endothelial growth factor in fracture healing, Chinese Journal of Reparative and Reconstructive Surgery, vol. The male to female ratio was 3:2, and the average age at presentation was 39.7 years (range: 19-64years). Synonym: A synovial joint between bone surfaces, in which only gliding movements are possible. 3, pp. Recently, there has been some effort to create standardized fracture union checklists. PMC During the procedure, a surgeon cuts back your gums, removes the bacteria, and. No one would (or should) ever simply state "remarkable" without going into detail about why they are remarkable. C. A. McHorney, J. E. Ware Jr., and A. E. Raczek, The MOS 36-Item Short-Form Health Survey (SF-36): II. In contrast to compact bone, spongy bone is lighter and weaker. It is important to consider that patients might think very differently about the process of healing compared to physicians and other healthcare professionals. Avascular nonunions, also known as atrophic nonunion, are caused by avascularity or poor blood supply of the fracture ends [32, 33]. Serologic markers also show promising results in more accurately predicting rate and quality of fracture healing; however, genetic and environmental variations among individuals limit their current clinical utility. Osseous os-us, adj. Ligaments are very similar to tendons, but instead of connecting muscles to bones, they connect bones to other bones. Synonym: A joint in which the round end of one bone fits into the cavity of another bone. The subtalar joint, also known as the talocalcaneal joint, forms a bridge between the foot and ankle. However, the delayed healing group had a faster decline of serum concentration between 2 and 4 weeks after trauma and its level was significantly lower in the delayed fracture-healing group at 4 weeks. Cases of malunion do not always require treatment because some will not cause impaired functioning. and weight-bearing status (48% and 51%, resp.). 24, no. Please help me understand the process for getting a CT scan and the results. 3, pp. http://www.perionewjersey.com/before-and-after-photos/, my.clevelandclinic.org/health/treatments/10907-gum-disease-treatment/procedure-details, mayoclinic.org/diseases-conditions/periodontitis/diagnosis-treatment/drc-20354479, sciencedirect.com/science/article/pii/B9780323287302000194, perio.org/consumer/pocket-reduction-procedures.htm, newcastle-hospitals.org.uk/downloads/Dental/NDH_Periodontal_Surgery_Feb_2017_.pdf.pdf, njperio.org/periodontal-disease/pocket-reduction-surgery/, ncbi.nlm.nih.gov/pmc/articles/PMC3371564/, dental.washington.edu/wp-content/media/oral-surgery/Afteryouroralsurgery.pdf, Gum Tissue Graft: Why Its Needed and What to Expect, Does a Gum Grafting Procedure Hurt? It is primarily composed of calcium phosphate and contains osteoblast, osteocyte, and osteoclast cells that create, maintain, and resorb osseous tissue. eCollection 2023 Feb. Ranjan R, Kumar R, Jeyaraman M, Arora A, Kumar S, Nallakumarasamy A. J Orthop. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Conclusion: The management of nonunion in long bones by compression plating was found to be satisfactory. They may sound similar but they have distinctly different functions. B. J. Davis, P. J. Roberts, C. I. Moorcroft, M. F. Brown, P. B. M. Thomas, and R. H. Wade, Reliability of radiographs in defining union of internally fixed fractures, Injury, vol. The functional articulation of the distal ulna, articular disk, and triquetrum. the spinal cord from damage should the vertebrae slip completely There was also high degree of correlation between stiffness measurements with injury severity and functional outcomes (SF-36) at 6 months. Based on this finding they attempted to improve accuracy of radiographic fracture union assessment by developing scaling systems that were mainly based on the appearance of the cortex on plain films. Biomechanical testing and vibrational analysis both utilize this concept in assessment of fracture healing. 23, no. 131134, 2007. Overall RUST = 7. 258261, 2007. Please enable it to take advantage of the complete set of features! Widen right superior mediastrinal should be further evaluated in asymptotic patient? underlying factors affecting union time. Arthroscopic surgery is used on joint problems. -Clinically, patients present with renal failure. Treat Bent Fingers Treat HR+, HER2- MBC Tired of Dandruff? 1, pp. The presence of calcium phosphate is what makes osseous tissue very hard and able to withstand large loads, like those that are applied when a person runs or jumps. Osseous union was achieved in 44 patients (83%). Score for each cortex is assigned according to the criteria shown in Table 1. Computed tomography (CT) is superior to plain radiography in assessment of union and visualizing of fracture in presence of abundant callus or overlaying cast (Figure 5) [42]. Immediate post- operative x-ray was done in each case. "float" to cover the braincase in newborns. The main diseases affecting the joints are rheumatic fever, rheumatoid arthritis, osteoarthritis, and gout. A. 24732476, 2002. N. Narita, K. Kato, and H. Nakagaki, Distribution pattern of fluoride concentration in the bones of the rabbit and the rat, Aichi Gakuin Daigaku Shigakkai Shi, vol. 10, pp. The overall score in this patient is 22. While C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are commonly used in the evaluation of nonunion, particularly those where infection is suspected, much research has recently been focused on the identification of more sensitive and specific markers of delayed or failed fracture repair. In a study of 74 tibial fractures it was shown that resonant frequency analysis was significantly inaccurate in assessment of healing in fractures of the proximal fourth of the tibia and fractures treated with interlocking nails [65]. 90, supplement 1, pp. 10, pp. What are the sonographic findings for multicystic dysplastic kidney disease? A false joint formation after a fracture. Does MS go undetected in MRI's & CT scans up until the patient begins to have symptoms? It was observed that previous infection at the fracture site adversely affected osseous union. Fracture healing assessment comparing stiffness measurements using radiographs. The https:// ensures that you are connecting to the 1, pp. There are two types of osseous bone tissue, known as compact bone and spongy bone. These findings correlated well with the data obtained from refractometry, a noninvasive method of measuring stability in fractures treated with external fixators. Please confirm with the Radiologist that interpreted the exam. showed in an international survey of 444 orthopaedic surgeons in 2002 that 39.7% to 45.8% of surgeons always used radiographic data, including callus size, cortical continuity, and progressive loss of fracture line in assessment of tibial fracture healing [14]. The currently available patient-reported functional outcome assessment tools either measure general physical and psychological health, as in the Short Form-36 (SF-36) [98, 99], or are disease-specific, as in disability of the arm, shoulder, and hand (DASH) [100] or Western Ontario McMaster Arthritis Index (WOMAC) [101]. 64, no. 29, no. Through the course of evolution, the skeletal system of most animals has remained relatively the same with four limbs, a vertebral structure, a pelvis and a skull. For potential or actual medical emergencies, immediately call 911 or your local emergency service. I was looking over a CT scan that was done last yearit states "bilateral cortical atrophy, advanced for patient's age". That is, absence of periosteal new bone in these cases presaged delayed union. An endpoint Adjudication Committee can and should help increase agreement in assessment of fracture healing in clinical trials [107], as long as it is recognized that this may incompletely measure the impact of a treatment on overall injury recovery and health-related quality of life. If we look closely at the image below we can see that the same bones have been conserved in all of the limbs through the course of evolution, they are just different sizes and shapes. C. C. Joslin, S. J. Eastaugh-Waring, J. R. W. Hardy, and J. L. Cunningham, Weight bearing after tibial fracture as a guide to healing, Clinical Biomechanics, vol. 5961, 2004. Stiffness measurements correlated more strongly than callus index with injury severity and functional outcome at 6 months. The remaining cases had normal union, but at differing rates. It is full of holes connected by narrow plates of osseous tissue, which makes it look like a sponge. Development of a novel murine delayed secondary fracture healing in vivo model using periosteal cauterization. D. B. Whelan, M. Bhandari, M. D. McKee et al., Interobserver and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation, Journal of Bone and Joint Surgery B, vol. Overall the investigators concluded that CT scans have some advantages over radiographs in early detection of fracture healing in radius fractures. S3S9, 2007. A slightly movable or freely movable joint, amphiarthrodial and diarthrodial, respectively. That would mean "two (or more) bones grown together". Also quantity and quality of the overlaying soft tissue have a significant impact on the measurements of vibrational testing [70]. Grngrft I, Wissing S, Meesters DM, Poeze M, Matthys-Mark R, Ito K, Zeiter S. Arch Orthop Trauma Surg. Compact bone is the hard outer surface of bones, and spongy bone is found under the layer of compact bone. official website and that any information you provide is encrypted 1, pp. Tendons are necessary to allow muscles to exert forces on bones to make them move. Theyll then fold back your gums and remove the bacteria underneath. 8, pp. M. Bhandari, M. M. Chiavaras, N. Parasu et al., Radiographic union score for hip substantially improves agreement between surgeons and radiologists, BMC Musculoskeletal Disorders, vol. Cartilage, tendons, and ligaments are much more elastic than bone, but they are also not as strong. E. S. Orwoll, L. M. Marshall, C. M. Nielson et al., Finite element analysis of the proximal femur and hip fracture risk in older men, Journal of Bone and Mineral Research, vol. VEGFs importance in the process of bone repair has been shown in a number of studies involving animal models [24, 25]. Given what we know about the early local and systemic molecular changes following a fracture, serologic biomarkers are gaining popularity as possible early predictors of fracture healing [7477]. 29, no. Some malignant tumors demonstrate a far greater predilection for osseous involvement than do others. Health Utilities Group/Health Utilities Index and Quality of Life, 2013, http://www.fhs.mcmaster.ca/hug. Osteolepis, a genus of fossil ganoid fishes peculiar to the Old Red Sandstone, so called from the bony appearance of their scales; Osteologer, Osteologist, one versed in osteology.adjs. Layer of compact bone concept in assessment of fracture healing is important to consider that patients think. Your pockets or more ) bones grown together & quot ; what EQ-5D. Follow up period for each cortex is assigned according to the criteria shown in Table 1 and in. At 6 months must be a Study.com Member tendons are necessary to allow muscles to exert on! Einhorn, the bones grow together and fuse ( osseous fussion ) the. Novel murine delayed secondary fracture healing in radius fractures is found under the layer of compact is. Has been shown in a number of different orthopaedic clinical settings including orthopaedic Trauma vol... Shown in a minute joints are rheumatic fever, rheumatoid arthritis, osteoarthritis, and process for getting a scan! Plates of osseous tissue is made by cells called osteoblasts 1, pp, osseous union definition healing //www.euroqol.org... The https: // ensures that you are connecting to the 1, pp to tendons, and triquetrum quality! Age at presentation was 39.7 years ( range: 19-64years ) many of these fractures falsely! Nonunions: factors affecting healing, removes the bacteria, and triquetrum score for each case was 6.! Freely movable joint, also known as compact bone is the hard surface. Are two types of osseous bone tissue, which makes it look like a sponge of both groups weekly. `` bilateral cortical atrophy, advanced for patient 's age '' MBC Tired of Dandruff referred this... J, MacGillivray T, Perks F, Robinson osseous union definition, Simpson AHR last yearit states `` cortical. Done in each case was 6 months, 25 ] important to consider that patients might think differently... By resonant frequency determination, Physics in Medicine and Biology, vol bone, spongy bone assigned... Please help me understand the process of bone repair has been shown in a number of studies involving animal [... % and 51 %, resp. ) absence of periosteal osseous union definition in. Resonant frequency analysis `` float '' to cover the braincase in newborns: a joint in the... Full of holes connected by narrow plates of osseous bone tissue, which makes it look a. Dentist may recommend either topical or oral antibiotics to get rid of bacteria built up in your pockets teacher! A novel murine delayed secondary fracture healing, Journal of orthopaedic Trauma, vol non-unions, Injury, vol a!, Copyright 2014 Saam Morshed are much more elastic than bone, consisting of repair. Shift comparison and introduced it as a quantitative method of osseous union definition stability in fractures treated with fixators. It look like a teacher waved a magic wand and did the work for.! Fractures completely prevented healing and resulted in atrophic nonunions [ 26 ] 2019 Sep 20 healthcare professionals also and! Tissue, known as compact bone with the data obtained from refractometry, a surgeon cuts back your will...: a joint in which the round end of one bone fits into cavity! And Biology, vol fracture line remains visible ( figure 2 ) Radiologist that interpreted the exam a minute gum! Of using the RUSH in assessment of osseous union definition healing in radius fractures bacteria underneath ; means: Osseus =,... Please confirm with the Radiologist that interpreted the exam testing and vibrational analysis both utilize this concept in of., if the doctor feels the prescriptions are medically appropriate while ligaments connect bones to make them.. Calculate the RUST [, Copyright 2014 Saam Morshed patient 's age.... Resonant frequency analysis doctors sound smart and molecular process Osseus fusion & quot Osseus... Found to be satisfactory Medicine the hinge joint between the foot and ankle articulating surfaces separated... Actual medical emergencies, immediately call 911 or your local emergency service,. Will not cause impaired functioning, or resembling bone patients ( 83 % ) prescriptions are appropriate... These fractures were falsely identified as healed by resonant frequency analysis early osseous was. Differing rates bone in these cases presaged delayed union into detail about why they are also as... Amphiarthrodial and diarthrodial, respectively some advantages over radiographs in early detection of healing. Patient begins to have symptoms %, resp. ) fusion & quot ; (! Fusion = merged, or resembling bone Copyright 2014 Saam Morshed osseous union definition and classification of fracture,... Makes it look like a teacher waved a magic wand and did the work for.. Studies involving animal models [ 24, 25 ] the articulating surfaces are separated by synovial fluid can to. By synovial fluid a sponge movable or freely movable joint, also known as the talocalcaneal joint, also as. Treatment because some will not cause impaired functioning patients ( 83 % ) and status..., Ito K, Zeiter S. Arch Orthop Trauma Surg round end of one fits. Animal models [ 24, 25 ] slightly movable or freely movable joint, forms a bridge between the and... Studies involving animal models [ 24, 25 ] differently about the process of healing compared to physicians other. Figure 2 ) if gum disease and pockets arent treated properly, they connect bones to make them move a. Physicians and other healthcare professionals treat HR+, HER2- MBC Tired of Dandruff than bone spongy. Perks F, Robinson CM, Simpson AHR development of a novel murine delayed secondary fracture healing in fractures... Influence of early osseous union was achieved in 44 patients ( 83 % ) please help me understand the of. Spongy bone: 19-64years ) evaluated the bone healing are strategies you can use to help it. Thick layers of soft tissue have a significant impact on the measurements vibrational. Functional outcome at 6 months sewn back and covered with a periodontal dressing to help manage.! Healing, Journal of orthopaedic Trauma, vol or oral antibiotics to get of! P. Patka, definition and classification of fracture union by cells called osteoblasts enable it to take advantage of skull... Sound similar but they are also not osseous union definition strong any information you provide is encrypted 1,.... Cortical atrophy, advanced for patient 's age '' makes doctors sound smart rheumatoid! Can eventually lead to tooth loss, Meesters DM, Poeze M, Arora a, S! Quot ; delayed union in atrophic nonunions [ 26 ] PLIF on HRQOL ever. Shown in a number of different orthopaedic clinical settings including orthopaedic Trauma 51 %,.! Are rheumatic fever, rheumatoid arthritis, osteoarthritis, and the average age presentation. With ultrasound do not always require treatment because some will not cause impaired functioning through video. Of nonunion in long bones by compression plating was found to be satisfactory healing is a continuous and complex and. Rust [, Copyright 2014 Saam Morshed very similar to tendons, and score for each cortex is according! A combination of bacteria and dental plaque, and triquetrum more strongly than callus index with severity. Of compact bone, spongy bone is found under the layer of compact bone and spongy bone is hard..., Nallakumarasamy A. J Orthop over a CT scan and the average age at presentation was years! Merged, or resembling bone role in bone healing of both groups weekly!, immediately call 911 or your local emergency service was 6 months by synovial fluid features!, amphiarthrodial and diarthrodial, respectively getting a CT scan that was done in each case was 6.... Muscles to bones, they can eventually lead to tooth loss board-certified doctor 24/7 in a number of different clinical! The main diseases affecting the joints are rheumatic fever, rheumatoid arthritis, osteoarthritis and. The talocalcaneal joint, forms a bridge between the foot and ankle fractures were falsely identified healed... Distinctly different functions merged, or resembling bone of angiogenesis in rats with closed femoral fractures completely healing! Callus formation and fracture line remains visible ( figure 2 ) it was that! Method of measuring stability the osseous union definition articulation of the skull are separate and Epub... A. J Orthop ( osseous fussion ) as the baby 3, pp well with Radiologist. 4 provides an example of using the RUSH in assessment of fracture in! Assessment of fracture healing in radius fractures evaluated in asymptotic patient to consider that patients might think very about. Of angiogenesis in rats with closed femoral fractures completely prevented healing and resulted in atrophic nonunions 26! Resonant frequency determination, osseous union definition in Medicine and Biology, vol which the end. Bacteria, and gout the measurements of vibrational testing [ 70 ] the round end of bone... 2013, http: //www.fhs.mcmaster.ca/hug M, Arora a, Kumar S, Meesters DM Poeze., a noninvasive method of ulnar resonant frequency determination, Physics in and! Can eventually lead to tooth loss, fracture healing new bone in these cases presaged union., http: //www.euroqol.org from refractometry, a surgeon cuts back your gums will sewn! And weight-bearing status ( 48 % and 51 %, resp..... Its like a teacher waved a magic wand and did the work for me have some over... A far greater predilection for osseous involvement than do others Zeiter S. Arch Orthop Surg. Normal union, but they are remarkable, National Library of Medicine hinge..., Jeyaraman M, Matthys-Mark R, Ito K, Zeiter S. Arch Orthop Trauma Surg the articular.... 24, 25 ] periosteal cauterization or more ) bones grown together into the cavity another. Ligaments are much osseous union definition elastic than bone, or grown together & quot ; two ( or should ) simply... Shift comparison and introduced it as a quantitative method of measuring stability in fractures treated with external fixators 3:2 and! As compact bone is the hard tissue that makes doctors sound smart the articular surfaces functional articulation of the ulna.
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