ABSTRACT
Objective To investigate the guidance of a new intraoperative classification of distal tibiofibular syndesmosis injury in the selection of internal fixation for ankle fractures.Methods Between January 2010 and January 2015 our department treated 116 patients with displaced closed ankle fracture (Weber type B or C).They were 60 men and 56 women,aged from 18 to 78 years (average,45.6 years).After reduction and fixation of the fibular fracture,we assessed the syndesmosis stability using the fibular hook traction test and radiological findings.We classified the distal tibiofibular syndesmosis injury into 3 grades (grade Ⅰ:＜ 4 mm displacement;grade Ⅱ:4-7 mm displacement;grade Ⅲ:＞ 7 mm displacement).Selection of proper screwing was determined by our new classification.Results Of the 116 cases,82 (70.7％) demonstrated distal tibiofibular syndesmosis injury.Screwing of the distal tibiofibular syndesmosis was not conducted for 30 (25.9％) of them who were of stable grade Ⅰ.52 (44.8％) cases were of unstable grades Ⅱ and Ⅲ.Of the 48 cases of grade Ⅱ,44 were fixated with one screw and the rest 4 became stable grade Ⅰ after Volkmann block fixation and received no screwing.Fixation of the distal tibiofibular syndesmosis with 2 screws was conducted for the 4 cases of unstable grade Ⅲ.All the patients were followed up for 12 to 60 months.No non-union,screw breakage,or syndesmosis separation after screw removal occurred.The American Orthopaedic Foot and Ankle Society ankle-hindfoot scoring showed a good/excellent rate of 93.1％ (108/116).Conclusion Our new intraoperative classification can provide correct judgment of the severity of distal tibiofibular syndesmosis injury,thus guiding the selection of proper screw fixation to enhance the outcomes of ankle fractures.
ABSTRACT
Objective To investigate the guidance of a new intraoperative classification of distal tibiofibular syndesmosis injury in the selection of internal fixation for ankle fractures.Methods Between January 2010 and January 2015 our department treated 116 patients with displaced closed ankle fracture (Weber type B or C).They were 60 men and 56 women,aged from 18 to 78 years (average,45.6 years).After reduction and fixation of the fibular fracture,we assessed the syndesmosis stability using the fibular hook traction test and radiological findings.We classified the distal tibiofibular syndesmosis injury into 3 grades (grade Ⅰ:＜ 4 mm displacement;grade Ⅱ:4-7 mm displacement;grade Ⅲ:＞ 7 mm displacement).Selection of proper screwing was determined by our new classification.Results Of the 116 cases,82 (70.7％) demonstrated distal tibiofibular syndesmosis injury.Screwing of the distal tibiofibular syndesmosis was not conducted for 30 (25.9％) of them who were of stable grade Ⅰ.52 (44.8％) cases were of unstable grades Ⅱ and Ⅲ.Of the 48 cases of grade Ⅱ,44 were fixated with one screw and the rest 4 became stable grade Ⅰ after Volkmann block fixation and received no screwing.Fixation of the distal tibiofibular syndesmosis with 2 screws was conducted for the 4 cases of unstable grade Ⅲ.All the patients were followed up for 12 to 60 months.No non-union,screw breakage,or syndesmosis separation after screw removal occurred.The American Orthopaedic Foot and Ankle Society ankle-hindfoot scoring showed a good/excellent rate of 93.1％ (108/116).Conclusion Our new intraoperative classification can provide correct judgment of the severity of distal tibiofibular syndesmosis injury,thus guiding the selection of proper screw fixation to enhance the outcomes of ankle fractures.
ABSTRACT
Objective To explore the role of body fat distribution in the pathogenesis of obesity-related asthma.Methods Totally 125 patients with stable asthma were recruited and were divided into non-obese group (n =51),peripheral obesity group (n =34) and central obesity group (n =40) according to body mass index and waist circumference.The FEV1％,FVC,FEV1/FVC ratio,IL-6,and hs-CRP levels in peripheral blood,eosinophil and neutrophil percentage in induced sputum,as well as exhaled NO levels were determined,and asthma control test (ACT) scores were calculated.Both one-way analysis of variance and analysis of covariance were used for statistical analysis.Results The values of FVC in the central obesity group and the non-obese group were [3.98 (3.99) ±0.99] L and [4.51 (4.51) ±1.00] L,while the levels of IL-6 and hs-CRP in peripheral circulation and the percentage of neutrophils in induced sputum were [33.63 (33.28) ± 14.04] ng/L and [21.22 (21.33)±11.23] ng/L,[2.12 (2.15) ±0.73] mg/L and [0.92 (0.91) ±0.61] mg/L,52.58 (52.81) ± 14.14 and 45.41 (45.34) ± 12.84,respectively (all P ＜ 0.05).After adjusting for inhaled corticosteroids (ICS) doses,the ACT scores were also significantly higher in central obesity group (22.10 ± 1.68 vs.23.01 ± 1.62) (P ＜ 0.05).Only the hs-CRP level was found significantly higher in peripheral obesity group than in non-obese group [(1.54±0.68) mg/Lvs.(0.91 ±0.61) mg/L] (P＜0.05).Conclusion Central obesity may play the leading role in the pathogenesis of obesity-related asthma.