ABSTRACT
Objective@#To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.@*Methods@#From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.@*Results@#All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion.@*Conclusion@#Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
Objective To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.Methods From January 2015 to January 2019,16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery,The Second Affiliated Hospital to Inner Mongolia Medical University.They were 14 men and 2 women with a mean age of 38.4 years (range,from 20 to 55 years).All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy.The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.Results All patients were followed up for a mean time of 12.6 months (range,from 6 to 30 months).The mean operation time was 68.4 minutes (range,from 52 to 96 minutes);the mean amount of hemorrhage during operation was 96.8 mL (range,from 48 to 122 mL);the mean period of bone union was 4.8 months (range,from 3 to 8 months).The postoperative mean AOFAS score was 75.3 points (range,from 43 to 91 points).Complications occurred in 4 cases,including one case of talus ischemic necrosis,one case of partial talus ischemic necrosis accompanied by tibial arthritis,one case of subtalar arthritis,and one case of combined tibial,talar and subtalar arthritis.All incisions obtained primary healing,with no complications like infection,screw breakage,delayed union or nonunion.Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
ABSTRACT
BACKGROUND:The therapeutic effectiveness on tendon injury is closely related to the material of tendon suture. OBJECTIVE: To review the progress of tendon suture materials and tendon biomechnics in recent years. METHODS:A computer-based search of CNKI (January 1999 to December 2014), and PubMed (January 1950 to December 2014) was performed for relevant articles using the keywords of “tendon, suture materials, biomechanics” in Chinese and English, respectively. RESULTS AND CONCLUSION:Ideal tendon repair refers to the restoration of the continuity of its anatomical structure, tensile strength and sliding function in physiology, which is influenced by many factors. Suture technique and choice of suture materials are two steps that cannot be ignored. With the development of surgical tendon suture technique, in order to improve the quality of tendon healing, ideal tendon suture is first to have sufficient strength to avoid an early tensile fracture; secondly, the elasticity cannot be too large that can cause a gap between suturing ends and affect tendon healing, and time for protecting the tendon strength is as long as possible. Therefore, the optimal choice of tendon suture materials should be based on suture methods and biomechanical characteristics of suture lines, thereby to promote tendon healing.