ABSTRACT
Objective:To explore the characteristics and clinical values of preoperative imaging signs and intraoperative stress test in the surgery of the Weber type B fracture without medial malleolar fracture.Methods:The data of 52 patients were reviewed who had been treated at Orthopaedic Trauma Department, Beijing Jishuitan Hospital for Weber type B ankle fracture without medial malleolar fracture from January 2018 to December 2021.They were assigned into 2 groups depending on their results of intraoperative stress test. In the positive group of 21 cases showing a positive intraoperative stress test, there were 19 males and 2 females with an age of (34.4±10.2) years; in the negative group of 31 cases showing a negative intra operative stress test, there were 22 males and 9 females with an age of (39.5±14.8) years. The 2 groups were compared in terms of the medial clear space, tibiofibular clear space and vertical length of the fibular fracture on the preoperative X-ray film, as well as the relative size of the posterior malleolar fracture fragment on the preoperative CT. The imaging characteristics of intraoperative stress tests were also observed.Results:There was no significant difference between the 2 groups in the preoperative general data, showing comparability between groups ( P>0.05). The medial clear space (7.2±2.5) mm and the vertical length of the fibular fracture [49.2 (33.7, 58.7) mm] in the positive group were significantly larger than those in the negative group [(4.5±1.7) mm and 29.6 (24.7, 36.0) mm] ( P<0.05). There was no significant difference between the 2 groups in the lower tibiofibular space [(6.0±1.9) mm versus (5.2 ± 1.4) mm] or in the relative size of posterior malleolar fracture measured by CT [15.8% (6.9%, 19.1%) versus 12.7% (0%, 18.9%)] ( P>0.05). The intraoperative stress test imaging data of a total of 22 cases were collected from the 2 groups (11 cases from each of the 2 groups). During the stress test, only the medial clear space was widened with no widening of the inferior tibiofibular space was found in 7 cases (5 cases in the positive group and 2 cases in the negative group). Conclusions:A routine stress test is recommended for Weber B ankle fracture without medial malleolus fracture, because instability sometimes exists after fibular fixation. Patients with a wider medial clear space and a longer fibular fracture line on X-ray after injury are more likely to be afflicted by instability after fibular fixation. In the patients with a widened medial clear space but without a widened inferior tibiofibular clear space during an intraoperative stress test, it calls for further study whether it is necessary to fix the inferior tibiofibular joint.
ABSTRACT
Cleft lip and palate (CLP) is one of common congenital malformations. The evaluation of upper airway morphology using two-dimensional (2D) and three-dimensional (3D) imaging data for CLP patients has important clinical significance. Studies have adopted various measurement methods,in which different anatomical landmarks and reference planes are used in 2D cephalometric measurement. Shooting positioning for cone beam computed tomography (CBCT), measurement software, reference plane, landmark selection, and measurement method in 3D studiesare also different. Currently,comparison is unable to be performed across different studies due to various measurement methods and measurement standards. This article reviews studies on upper airway morphology measurement in CLP patients.
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Objective:To explore the imaging measurement and clinical significance of the angle between the axis ofpedicle and the plane of lamina in lower cervical vertebra.Methods:Three dimensional reconstruction of CT scan was performed in 30 patients with cervical deformity,and the angle between the axis ofpedicle and the plane of lamina was measured with the specific reconstructed CT image of C3-C7.Results:1) The left and right transverse angle of C3-C7 between the axis of pedicle and the ipsilateral plane oflamina were 98.3°±6.3°,98.0°±5.1°,97.5°±6.9°,95.1°±5.0°,85.8°±5.4°and 96.7°±8.2°,98.7°±7.1°,97.8°±3.6°,93.2° ±6.2°,86.8° ±5.7°,respectively,which showed a gradual decreasing trend.Meanwhile the angle ofC3-C6 was more than 90 degrees and C7 was less than 90 degrees.In addition to C6 with C3 and C7 with other segments,the rest of the differences between the sections was not statistically significant (all P＞0.05).2) The left and right transverse angle of C3-C7 between the axis of pedicle and the pedicle of vertebral arch of lamina were 0.2°±4.5°,1.2°±7.2°,-0.8° ±6.8°,-3.3°±5.4°,-14.7° ±4.0° and-1.6°±5.4°,1.9°±4.6°,-0.5° ±6.0°,-4.6° ±5.3°,-13.7°±3.4°,respectively,which showed a first increasing and then reducing trend.Meanwhile the angle of C4 was maximum angle.In addition to C6 with C3;C6 with C4,and C7 with other segments,the differences between the sections was not statistically significant (all P＞0.05).3) The left and right sagittal angle of C3-C7 between the axis of pedicle and the ipsilateral plane of lamina were 77.7°±7.6°,77.0°±7.1°,85.3° ±8.4°,94.1°±2.2°,94.9°±3.8° and 78.5° ±7.1°,76.2° ±6.2°,86.4°±6.4°,94.0°±2.7°,95.6°±3.8°,respectively,which showed a gradual increasing trend.The angle of C3-C4 was less than 90 degrees.Cs showed large variation and C6-C7 was more than 90 degrees.In addition to C3 with C4 and C6 with C7,the differences between the sections was statistically significant (all P＜0.05).There was no significant difference between the two sides of the above indexes (all P＞0.05).Conclusion:In low cervical vertebra,there is a certain angle relationship between the axis of pedicle and the plane of lamina,which can provide reference for the clinical determination of angle of pedicle screw insertion.
ABSTRACT
Objective To explore the uncinate-transverse hole spacing developmental patterns and aging characteristics by means of studying the teenagers aging from 6~20 years old,and provide the basis for image analysis of the treatment and prevention of cervical spondy-losis. Method the 66 adolescents without trauma nor problems of nervous system were selected to do thin spiral CT scan(0. 625 ~1. 25 mm) ,the range was C1 ~T1 . The original data in the form of DICOM are analyzed according to gender and age. Results There was no sig-nificant difference in gender and different sides. Overall,the physical development of human increases gradually with age and has some signifi-cant differences. Conclusion There exists a close relationship between cervical hook-transverse process and the incidence of vertebral artery type and nerve root type cervical spondylosis.