Classification of peroneal muscle trochlear and its correlation with calcaneus / 解剖学报

Objective To measure and classify the trochlear size of fibular muscle, and to analyze its correlation with calcaneus. Methods In 824 calcaneal specimens, the length, width and height of the peroneal muscle trochlear were measured and classified according to the four types of flat, convex, concave and tunnel. Results The prevalence of the peroneal tubercle was 62. 5%. The average length, width, and height of the tubercle were ( 11.5±3.32) (2.56-23.14) mm, (6.27±2.20) (1.34-14.99)mm, and (2.69±1.30) (0.41-8.18)mm respectively. The four types of peroneal tubercle were classified as flat in 191 (37.09%), prominent in 189 (36.7%), concave in 131 (25.44%), and tunnel in 4 (0.77%). Conclusion This data may help understand pathology of peroneus tendon and its relationship with peroneal tubercle, and it may help make standard to define the abnormal peroneal tubercle.

Anatomical basis in the treatment of sinus tarsi syndrome by local steroid injection / 解剖学报

Objective To provide anatomical basis for the treatment of sinus tarsi syndrome by developing the anatomical structure of sinus tarsi. Methods Thirty formalin fixed lower limb specimens were dissected. The anatomic structures of the sinus tarsi, neurovascular tissue, ligament and adipose tissue were observed and measured. Morphologies of the sinus tarsi and canal of tarsus in intact dry calcaneus and talus of 136 Chinese adult specimens were investigated and measured. Results The artery of the sinus tarsi and its periphery issued from the dorsalis pedis artery, anterior medial malleolar artery, perforating peroneal artery and lateral tarsal artery. The laterosuperior point of cuboidal articular surface of calcaneus was the obvious osseous marks of the lateral surface of sinus tarsi. The length canal of tarsus, sinus tarsi and the calcaneal sulcus were (14. 85 ±2. 08) ( 8. 33-22. 00) mm, (26.38±3.05) ( 16. 54-35. 79) mm and (41. 25 ± 3. 52) (31. 06-53. 92) mm respectively. There was a angle between two axes of calcaneus and tarsal canal, which was (49. 37± 4.76) (39. 18~56.37)°. Conclusion During the treatment of sinus tarsi syndrome by the local steroid injection, the laterosuperior point of cuboidal articular surface of calcaneus should be palpated firstly, which is the point of inserting the needle. Then, the injection needle is towards posteromedial at 49°, and advance 2.5 mm to touch the sinus tarsi.

Anatomy of the safe zone of sustentaculum tali screw fixation / 解剖学报

Objective To explore the safe zone of sustentaculum tali screw fixation in treatment of calcaneal fracture. Methods Morphologies of sustentaculum tali in intact dry calcaneus of 589 Chinese adult were investigated and classified. The clinically significant data were observed and measured in sustentaculum tali and calcaneus. Results Type B calcaneus (77. 92%) was defined as the most common type, and type A calcaneus (21. 73%) was the second most common type. There were two osseous marks in the medial surface of sustentaculum tali: the posterior tip of middle articular surface for talus and the front end of medial margin of groove for flexor hallucis longus. In the medial of sustentaculum tali, the each side length of quadrilateral was (8. 07±1. 33)(3. 88-12. 31)mm, (10. 27±1. 57)(5. 62-15. 91) mm, (14. 99± 2. 33) (5. 86-21. 87) mm and (15. 43±2. 16) (9. 82-22. 70) mm, respectively. The length of the its diagonal line was (15. 83±2. 94) (3. 83-26. 59) mm. The length of middle articular surface for talus was (18. 97±2. 85)mm (9. 90-25. 41). Conclusion The quadrilateral in the medial surface of sustentaculum tali is the safe zone for sustentaculum tali screw fixation in treatment of calcaneal fracture.

Pathological changes of the skeletal muscle after loca loosening therapies / 中国组织工程研究

BACKGROUND: Local soft tissue lysis has been widely used in clinical rehabilitation treatment of chronic soft tissue injuries, and has achieved certain clinical outcomes. However, it is an invasive treatment, and there is little information about the pathological changes and prognosis of the local tissues post-treatment. OBJECTIVE: To observe the repair process and pathologic changes of the muscles after local soft tissue lysis with several needles. METHOD:Songjin-needle,Yinzhi-needle,Changyuan-needle,Xiaozhen-needle,Ren-needle and Pi-needle were inserted into the belly of rat gastrocnemius gastrocnemius with a depth of 0.5-1.0 cm, twice or thrice. Then the rats were killed at 3, 7, 14, 21 and 30 days after acupuncture. The corresponding parts of tissues were removed and fixed with paraformaldehyde, and stained with hematoxylin and eosin and immunohistochemistry to observe the histomorphological features and pathological changes under light microscope. The CellSens-Entry 1.15 software was used for image acquisition, and the number of fibroblast cells and microvessel density were calculated. The integral absorbance values of collagen type Ⅰ were calculated by Image Pro plus 6 software. RESULTS AND CONCLUSION: On day 3 after intervention, muscle fiber dissolution, necrosis and inflammatory cell infiltration were visible. On day 7, there was a reduction in inflammatory cells, fibroblast activation and proliferation, and granulation tissue hyperplasia. On day 14, there was local accumulation of collagen with substantial granulation tissues. On day 21, collagen fibers decreased and granulation tissues organized. On day 30, there was local scar formation. Immunohistochemical staining results showed that there was collagen type Ⅰ in the surgical area after intervention. The microvessel density, fibroblast count and integral absorbance value increased firstly and then decreased, which showed significant differences among groups (P < 0.01). These findings imply that the new types of needles for local soft tissue lysis do certain damage to the gastrocnemius muscle, and the inflammatory changes of the local tissue and granulation tissue organized will result in local scar formation after loosening therapies.