Exploring the Bilateral Comparisons of Articular Surfaces of Talus: An Observational Study at Tertiary Health Care Center in Pune City

Background: The existing conclusive data show variations in the subtalar joint regarding its morphological features and articulation of bones. Inadequate studies exist on the morphometry of articular surfaces of the talus which may help in surgical interventions and development of implants and prostheses in diverse populations. Purpose: The current study was undertaken to conduct a bilateral comparison of parameters of articulating surfaces of talus. Material and Methods: An observational study design was carried out at one of the private medical colleges in the Pune district of Maharashtra. A total of 100 (fifty-one from right side and forty-nine left-sided tali) dry human talar bones were collected and various dimensions of articular surfaces of bones were measured by Digital Vernier Caliper and Ruler. The data analysis was performed and results were tabulated and presented graphically. Results: There was a statistically significant difference (p<0.05) in bilateral measurements of lateral articular surface height (LASH) of talar bones. The difference was not significant (p>0.05) for all other parameters. Conclusions: The study inferences can be applied as a guide and baseline information for surgical measures, inflammatory disease management, and forensic anthropologists.

Efficacy comparison of percutaneous vertebroplasty in the treatment of osteoporotic lumbar compression fracture via the approach through midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach / 中华创伤杂志

Objective:To compare the efficacy of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic lumbar compression fracture (OLCF) via the approach through midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach.Methods:A prospective cohort study was conducted to analyze the clinical data of 794 patients with OLCF treated in Honghui Hospital affiliated to Xi′an Jiaotong University School of Medicine from January 2017 to December 2019. The patients were divided into transitional-zone puncture group (400 patients, 400 vertebrae) and pedicle puncture group (394 patients, 394 vertebrae) according to the envelope method. The transitional-zone puncture group was treated with PVP via the approach through midpoint transverse process-transition zone of articular process, and the pedicle puncture group was treated with PVP via the unilateral transpedicular approach. The operation time and radiation dose were documented. The visual analogue score (VAS) and Oswestry dysfunction index (ODI) were evaluated before operation and at 1 day, 3 months, 1 year after operation. The cement distribution and the incidence of complications such as cement leakage, re-fracture of the injured vertebra, spinal cord nerve injury and facet joint injury were detected.Results:The patients were composed of 270 males and 524 females, at the age of 68.9-78.5 years [(73.7±4.8)years]. All patients were followed up for 12-14 months [(13.4±0.8)months]. The operation time and radiation dose in transitional-zone puncture group were reduced compared with pedicle puncture group ( P<0.01). There was no significant difference in VAS and ODI between the two groups before operation (all P>0.05). The VAS between transitional-zone puncture group [(2.1±0.9)points, (2.3±1.1)points, (2.7±1.3)points] and pedicle puncture group [(2.3±0.7)points, (2.5±0.9)points, (2.9±1.1)points] was obviously reduced from that before operation (all P<0.01), significantly different at 1 day, 3 months, 1 year after operation ( P<0.05 or 0.01). The ODI between transitional-zone puncture group (14.3±1.8, 13.6±3.4, 11.3±4.4) and pedicle puncture group (25.5±5.7, 20.7±6.3, 20.6±6.9) was significantly different at 1 day, 3 months, 1 year after operation (all P<0.01), and all were obviously reduced from that before operation (all P<0.01). With regard to the cement distribution, the number of bilaterally cemented vertebrae in transitional-zone puncture group (324) was more than that in pedicle puncture group (94) ( P<0.01). The incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury was 8.25%(22/400), 0.00%(0/400) and 3.25%(13/400) in transitional-zone puncture group, significantly different from 20.81%(82/394), 2.03%(8/394) and 9.90%(39/394) in pedicle puncture group ( P<0.05 or 0.01). There was no significant difference in spinal cord nerve injury between the two groups ( P>0.05). Conclusion:For OLCF, PVP via the approach through the midpoint transverse process-transition zone of articular process and the unilateral transpedicular approach are both effective, but the former has advantages of shorter operation time, smaller radiation dose, greater dispersion of bone cement and lower incidence of cement leakage, re-fracture of the injured vertebra and facet joint injury.

Biomechanical stability study on different internal fixation for acetabular fracture / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the biomechanical stability of the acetabular fracture with three different internal fixation methods.</p><p><b>METHODS</b>Sixteen both-column acetabular fracture models were randomly divided into three groups:The specimens of 16 hip joints were randomly divided into 4 groups. Among them, 1 group of complete acetabulum were used as normal control group, and the other 3 groups simulated two column fracture models and were fixed in the following methods, respectively: anterior wall with screw and posterior with plate(SP), anterior wall with plate and posterior wall with screw(PS) and both wall with plate (PP). The degree of fracture displacement and the contact characteristics of the acetabulum were recorded by continuous vertical loading.</p><p><b>RESULTS</b>The mean longitudinal displacement under the load 800 N of SP, PS and PP three groups were (1.92±0.81), (2.09±1.13) and (3.44±0.75) mm, there was significant difference between SP and PP group (0.033). And the mean horizontal displacement of SP, PS and PP three groups were(0.63±0.33), (0.77±0.45) and (1.44±0.56) mm, there was significant difference between SP and PP group(0.047).Compared with normal control group in the acetabular area under the loading 800 N, the contact area of SP, PS and PP groups were increased by 6%, 9% and 27%, there was significant difference between PP and normal control group (0.027). Meanwhile, the mean stress of SP, PS and PP groups were increased by 4%, 29% and 39%, there was significant difference between PP and intact acetabulum group (0.003).</p><p><b>CONCLUSIONS</b>Anterior column screw combined with posterior column plate has better biomechanical stability and contact characteristics than other two methods.</p>

Radiographic Analysis of Tibial-Articular Surface Angle According to the Selection of the Mechanical Axis / 대한족부족관절학회지

PURPOSE: We investigated a statistical difference of tibial-articular surface (TAS) angles between radiographs of standing ankle anteroposterior (AP) and whole lower extremity view, and evaluated whether the tibial axis obtained from the standing ankle AP view reflects the original mechanical axis of lower extremity. MATERIALS AND METHODS: Both the standing ankle AP and whole lower extremity view were taken from 60 legs of 30 healthy volunteers without a history of ankle surgery or deformity of lower limb. To determine the tibial axis, Takakura's and Hintermann's method were employed in the standing ankle AP view. To compare these results with the original TAS angle, ANOVA and multiple comparison test were used. RESULTS: The mean TAS angle was 88.3 degrees(from hip joint to ankle), 89.5 degrees (from knee joint to ankle), 88.5 degrees (Takakura's method), and 90.2 degrees(Hintermann's method). Although there was a statistical significance (p=0.000) between these results, Takakura's method had no significant difference, compared to the results of whole extremity view by the multiple comparison test. CONCLUSION: The tibial axis obtained by Takakura's method reflects the original mechanical axis of lower extremity. When a surgical procedure is planned, however, it is necessary to consider that the ankle radiographs do not provide any information on the proximal deformity without the whole lower extremity view.

Impact of Weight Bearing Surface on Fractures of the Talus / 대한족부족관절학회지

PURPOSE: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. MATERIALS AND METHODS: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot& Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. RESULTS: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. CONCLUSION: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.

Distal Tibial Articular Surface Angle in the Coronal Plane in Koreans / 대한족부족관절학회지

PURPOSE: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. MATERIALS AND METHODS: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. RESULTS: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 (28~36) years old. The mean age for females was 41.1 (37~45) years old. The mean distal tibial articular surface angle was 90.8 degrees. The mean distal tibial articular surface angle for males was 91.5 degrees and for females 89.9 degrees. CONCLUSION: The mean distal tibial articular surface angle in coronal plane for Koreans is 90.8 degrees. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.

Differences between Radiologic Angle & Real Angle of Distal Metatarsal Articular Surface Angle / 체질인류학회지

Selection of the surgical procedure for Hallux Valgus is decided after variable factors including radiologic indices were considered. Among them, congruency of the first metatarsophalangeal [MTP] joint is important factor to get the better prognosis. Articular surface angle of first metatarsal head [AAMH] has been used to substituted for first MTP joint congruency. But there had been questions whatever that the value of AAMH measured radiologically equal to real angle in surgical field. The purpose of this article is to compare clinically used radiologic angle of AAMH to real anatomical angle in patients operated by. From march to october 1998, among the 75 patients operated by surgical method (Proximal Chevron), measures anatomical AAMH of 25 volunteer at random. Average age was 46.4 yrs old, ratio of the sample is Right : Left = 9 : 16. The radiologic AAMH measured by AOFAS (American Orthopedic Foot and Ankle Society) research committee method 1992 in the weight bearing foot AP film. The actual AAMH is measured directly in the operative field. After the capsular incision had done, first metatarsal head was dislocated totally. K -wire was inserted to articular dome of the metatasal head from medial to lateral, The transverse axial plane of K -wire is parallel to plantigrade foot position. Afterthen, printed image was taken using portable image intensifier. Average radiologic value of metatarsal head was 16.8 degree, real value was 23.52 degree. In general, real angle was bigger than radiologic angle. In the 20% of cases, radiologic angle was bigger than real angle. With paired t -test, there was no correlations in each angles (p>0.01). Conclusion; The average real AAMH measured in surgical field was 23.1degree. There was no statistic correlations between the angles radiologically and anatomically. therefore, We conclude that the angle of distal metatarsal articular surface measured radiologically has not the clinical significance to know articular congruency. Consequently We suggested the three dimensional study to know the real angle of articular surface of first metatarsal head clinically as alternative method.

Morphometric Study on the Coracoacromial Arch, the Acromial Articular Surface, and the Glenoid Cavit of the Scapula in Koreans / 체질인류학회지

The present study was performed to provide an anatomical basis of the coracoacromial (CA) arch and the articular surfaces of the scapula which can be applied to the diagnosis and treatment of some common shoulder problems. The standard dimensions and the range of variation of the CA arch, the acromial articular surface and the glenoid cavity were investigated in 114 dry scapulae obtained from 57 (male, 35 ; female, 22) Korean cadavers ranging in age from 18 to 97 years (average age of 67). The results were as follows : 1. The length (46.3mm), width(25.2mm), thickness (8.2mm) and height (4.5mm) of the acromion were measured. The length, width and thickness were significantly larger in the males. The slope of the acromion was 51.5°, and the slope of the scapular spine was 118.5°. 2. The height (13.5mm), slope of the root (138.4°) and the horizontal part (25.3°) of the coracoid process, and the angle between the root and the horizontal part (106.6°) were measured. There were no significant differences between sexes and sides in all morphometric values related to the coracoid process. 3. The length (67.6mm) and height (24.7mm) of the CA arch, the height of the CA ligament from the supraglenoid tubercle (13.1mm), and length of the CA ligament (27.6mm) were measured. Both the length and height of the CA arch and the length of the CA ligament were significantly larger in the males. The slope and anterior and posterior angles of the CA arch were 16.8°, 42.2°, and 34.7°, respectively. 4. The long (13.8mm) and short (8.0mm) diameters of the acromial articular surface were measured, and both diameters were significantly longer in the males. The acromial articular surface was 8.4mm away from the tip of the acromion and extended 1.4mm inferiorly below the inferior surface of the acromion. 5. The long (34.8mm) diameter, and superior (15.0mm), middle (19.5mm), and inferior (25.6mm) short diameters of the glenoid cavity were measured. The long and both superior and inferior short diameters were significantly longer in the males.

THE COMPARATIVE STUDY ON THE DISTAL ARTICULATION OF HUMERUS AMONG Macaca mulatta, M. thibetana and M.assamensis / 解剖学报

M. mulatta, M. thibetana and M. assamensis have a part of sympatry in distribution areas and closed relationships in phylogeny, but there also exist certain differences among them in the morphology and function of skeleton. In recent years, on their locomotion and adaptive behaviors, the different viewpoints were suggested by many authors. The comparison of distal articular surface of humerus in these species were carried out in this paper. The major results based on 24 humerus including 48 sides are as follows:1. The results of the discriminant analysis suggest that the features and structures of humeral distal articulation of M. thibetana is similar to that of M. assamensis than that of M. mulatta.2. The relative width of articulation (AFT), olecranon fossa (OFW) and internal epicondyle (MEW), and the relative length of trochlea (THL) play more important rule to distinguish the three species of macaques. The. first discriminate function is: F1=13.64MEW-15.57ATF+23.500FW+14.09THL-9.63.3. The characters on distal articulation of humerus of the three species of monkeys differ evidently from the apes.4. The results of principal component analysis show that the locomotion of M. mulatta is similar to Presbytes obscurus, Hylobates and M. nemestrina, and it seems that they are more adaptive to arboreal movement than that in M. thibetana and M. assamensis based on the osteological features and functional morphology of the distal articular surface of humerus.

DETERMINATION OF THE SACROILIAC ARTICU-LAR SURFACE WITH SPECIAL REFERENCE TO THE STRESS LOADING / 解剖学报

The diameters and projection area of the articular surfaces, contributed to the formation of the sacroiliac joint, were determined on 50 sets of pelvic bones with image analysing apparatus.By drawing a line connecting the most anterior point of the prominence to the deepest point of the posterior incisure, the articular surface may be divided into a superior and an inferior portions. The inferior portion was larger than the superior portion. Each portion of the articular surface on the ilium is slightly larger than that on the sacrum.In order to explore the relationship between the form of the articular surface and its function in transmitting the gravity of the human body, the stress of the neighbouring area near the anterior margin of the articular surface was determined. Moreover, the bony architecture on the cross section passing through the articular surface was observed. It suggests that the strain in the neighbouring area was in linear equation with the gravity loaded on the spinal column. The strongest stress was determined at the anterior margin of the anterior prominence and the thickness of the cortex lying on the relevant bones appears most obvious at the same sites. These results further improve that the bony architecture was consistent with the strain in bearing the body weight. Besides, the form of the articular surface was also adapted to its function.