ABSTRACT
Objective To evaluate the clinical therapeutic effectiveness of Ilizarov technique for the treatment of congenital brachymetatarsia.Methods We retrospectively analyzed the 5 patients who had been treated in our department for congenital brachymetatarsia (12 metatarsal bones in 10 feet) from January 2008 to January 2011.All of them were female,aged from 22 to 26 years (mean,24.2 years).All cases were bilaterally involved.Three of them suffered from bilateral brachymetatarsia of the first metatarsal bone,one from bilateral brachymetatarsia of the fourth metatarsal bone,and the other one from bilateral brachymetatarsia of the first and fourth metatarsal bones.Bone transport was conducted with a monolateral mini-fixator in 3 patients and with a modified semi-ring Ilizarov fixator in the other 2.Dorsal incision was used for all osteotomy before the external fixator was mounted.Bone transport began 7 days after surgery at a rate of 0.3 mm/d and was completed in 3 times.Results The 5 patients were followed up from 12 to 48 months (mean,22.0 months).The metatarsal bones were lengthened by 13.5 mm(12 to 17 mm) on average.The functions of the toe and ankle joint were normal without skin necrosis,vascular or nerve injury,tylosis of the footplate,or walking pain.The lengthened segments were mineralized well,with an average lengthening index of 48 d/cm(45 to 53 d/cm) and average time of external fixation of 64.8 days.At the last follow-up,the average AOFAS score was 92.2 points (90 to 95 points).Conclusions Although the Ilizarov technique necessitates a patient's prolonged fixation with an external fixator in the treatment of congenital brachymetatarsia,it has advantages of simplicity,minimal invasion,and satisfactory correction of brachymetatarsia.Consequently it is a good treatment for this disease.
ABSTRACT
BACKGROUND: Routine magnetic resonance imaging(MRI)scans can comparatively show intra-articular soft tissue structures,but there are still some limitations in the diagnosis of intra-articular lesions and injury due to deficiency in contrast of imaging.Enhanced MRI scan has been applied to the liver,brain and other parts,which effectively improves the diagnostic accuracy,but there are few reports on the enhanced scans of knee.OBJECTIVE: To evaluate clinical application value of MRI enhancement pattern in diagnosis of knee injury.METHODS: Totally 21 patients with knee injury(22 knees)were routinely scanned by 0.5T Signa Contour MRI scanner(GE company,USA).Then enhancer was injected into knee joint by the same physician and MRI enhancement pattern was performed in these patients.Film-reading and comparison were completed by two associate chief physicians.RESULTS AND CONCLUSION: Different levels of joint structural damage,such as bone,meniscus,ligaments,and articular cartilage and so on,were found in all patients by routine MRI scan.The extent and scope of its damage had been more clearly displayed by enhanced MRI scan.Meanwhile,misdiagnosis of meniscal injury by routine MRI scan was confirmed by enhanced MRI scan in 2 patients.Some damaged parts that were not found by routine MRI scan were Confirmed by enhanced MRI scan.All these demonstrated that positive rate of knee injury in MRI enhancement pattern was higher than conventional MRI scan.There was significant difference in meniscus injury between two patterns(P = 0.035).MRI enhancement pattern in comparison with conventional MRI can further improve the diagnostic accuracy rate of knee injury.