ABSTRACT
Purpose@#This study morphologically compared and analyzed various measurements from initial radiograph and computed tomography scans of posterior malleolar fractures (PMFs) in tibial spiral fractures and ankle fractures. @*Materials and Methods@#The measurements of PMFs in 31 TSFs and 53 AFs were analyzed. PMFs were classified using Bartoníček’s classification. The initial displacement (ID), cross angle (CA), fragment length ratio (FLR), fragment width ratio (FWR), fragment height ratio (FHR), fragment height (FH), sagittal angle (SA), articular step-off (AS), and inter-fragment distance (IFD) were measured. The presence of intercalary fragments and articular incongruity were identified. @*Results@#Bartoníček types 2 and 3 in the AF group, type 3 in the supination-external rotation (SER) group, type 2 in the pronation-external rotation (PER) group, and type 4 in the TSF group accounted for the largest proportion. In the TSF group, the mean ID, FWR, SA, AS, and IFD were significantly smaller than in the AF group (p<0.001, p=0.003, p<0.001, p<0.001, and p<0.001, respectively). The CA, FLR, FH, and FHR were significantly larger than the AF group (p<0.001, p=0.019, p<0.001, and p<0.001, respectively). @*Conclusion@#In TSFs, posterior malleolar fragments tend to have longer anteroposterior lengths and heights, but shorter horizontal lengths than AFs. Most have minimal displacement, congruous joint, and no intercalary fragments. Understanding these morphological differences is necessary for the clinical approach to PMFs in TSFs and AFs.
ABSTRACT
Sleeve fractures are an unusual type of patella fracture that usually occurs in children or skeletally immature adolescents. Most sleeve fractures occur at the inferior pole of the patella, whereas sleeve fractures of the superior pole are quite rare. Only a few cases have been reported thus far. Operative treatment is recommended for sleeve fractures of the patella due to the poor clinical outcome of conservative treatment. Stable fixation is difficult because of the thin sleeve fragment. Because of its rarity, the choice of operative method is based mainly on the surgeon’s preference. This paper reports a rare case of sleeve fracture of the patella superior pole and describes an operative technique using a modified transosseous vertical suture technique combined with a suture bridging technique to achieve stable fixation of the sleeve fragment.
ABSTRACT
We reported a case of subchorionic placental cyst with maternal floor infarction in 32-year-old multigravida. In this case the infant without growth retardation was delivered at fuU term by repeat cesarean section. A 5.8*5cm placental cyst detected prenatally by ultrasound was shown subsequentty to be a subchorionic cyst without thrombohematoma. The cyst was unilocular and attached near the cord insertion, and it contained straw-colored fluid. There was no other placental abnormalities except placental inFarction on matemal floor with fibrin deposition. It is necessary to differentiate placental cystic lesions by ultrasonographic and pathologic examination because placental abnormalities could be associated with perinatal complications.