Three-dimensional gait analysis of orthopaedic common foot and ankle joint diseases.

Walking is an indispensable mode of transportation for human survival. Gait is a characteristic of walking. In the clinic, patients with different diseases exhibit different gait characteristics. Gait analysis describes the specific situation of human gait abnormalities by observing and studying the kinematics and dynamics of limbs and joints during human walking and depicting the corresponding geometric curves and values. In foot and ankle diseases, gait analysis can evaluate the degree and nature of gait abnormalities in patients and provide an important basis for the diagnosis of patients' diseases, the correction of abnormal gait and related treatment methods. This article reviews the relevant literature, expounds on the clinical consensus on gait, and summarizes the gait characteristics of patients with common ankle and foot diseases. Starting from the gait characteristics of individuals with different diseases, we hope to provide support and reference for the diagnosis, treatment and rehabilitation of clinically related diseases.

[Effect of fascia iliaca compartment block on anterolateral small incision total hip arthroplasty].

OBJECTIVE: To compare the effects of simple intraspinal anesthesia and combined fascia iliaca compartment block(FICB) on total hip arthroplasty(THA) through anterior lateral small incision (orthop dische chirurgie München, OCM). METHODS: From January 2019 to October 2020, patients undergoing unilateral total hip arthroplasty were treated with intraspinal anesthesia combined with ultrasound-guided fascia iliaca compartment block(30 cases in group A) and simple intraspinal anesthesia(30 cases in group B). Two groups were treated with the same intravenous analgesia after operation. The operation time, the amount of bleeding, the peeling degree of middle gluteal muscle, the splitting of greater trochanter of femur, the visual analysis scale (VAS) of hip joint after operation, the abductor muscle strength of quadriceps femoris and hip joint before and 48 hours after operation, and the Harris score of hip joint function after operation were observed and compared between two groups. RESULTS: All patients were followed up for 48 to 62 weeks with an average of (54.2±4.0) weeks. The incision length, operation time and intraoperative bleeding in group A were significantly lower than those in group B (P<0.05). The level of hemoglobin 24 hours after operation in group A was significantly higher than that in group B (P<0.05). The abductor muscle strength of hip joint in group A was significantly higher than that in group B 48 hours after operation (P<0.05). The degree of middle gluteal muscle dissection in group A was significantly lower than that in group B (P<0.05). The VAS of group A at 8, 12 and 24 hours after operation was significantly lower than that of group B (P<0.05);The Harris score in group A was significantly higher than that in group B at 2 and 8 weeks after operation (P<0.05). CONCLUSION: The application of ultrasound-guided fascia iliaca compartment block in lateral position OCM approach THA can significantly shorten the operation time, reduce the amount of bleeding, reduce the perihip trauma such as the peeling of middle gluteal muscle during operation, and improve the early postoperative pain of patients, which is conducive to the clinical operation of OCM approach and the rapid postoperative recovery of patients.

[Radiological study on the cup abduction angle during total hip arthroplasty].

OBJECTIVE: To analyze the relationship among the parameters by measuring the relevant parameters of the anteroposterior X-ray of both hips in patients after total hip arthroplasty, to discuss the reliable anatomical markers and reference standards of acetabulum placement in total hip arthroplasty, and finally to accurately control the abduction angle of acetabulum. METHODS: From January 2016 to June 2017, 282 patients (235 hips) underwent total hip arthroplasty and 128 patients(157 hips) met the inclusion criteria. There were 91 males and 37 females, 82 cases of the left hip and 75 cases of the right hip; ranging in age from 22 to 78 years old, with a mean of 55.1 years old. The abduction angle(ß), ilium thickness (a), acetabular cup insertion depth (b), ischial thickness (c), acetabular cup insertion depth(d), acetabular abrasion and contusion depth(e) were measured on the postoperative AP X-ray of both hips, and the data were compared. RESULTS: There was a positive correlation between ß and b (r=0.424, P=0.000), a negative correlation between ß and d (r=-0.407, P=0.000), a positive correlation between ß and b/a (r=0.419, P=0.000), a negative correlation between ß and d/c (r=-0.472, P=0.000). There was a linear relationship between ß and b/a (t=5.753, P=0.000) and a linear relationship between ß and d/c (t=-6.671, P=0.000). CONCLUSIONS: The outreach angle is mainly controlled by the distance between the outer edge of the cup and the outer edge of the cup in the inferior portion(d) during the operation. The distance b from the outer edge of the cup can be used as a reference.

Glenoid morphology and the safe zone for protecting the suprascapular nerve during baseplate fixation in reverse shoulder arthroplasty.

PURPOSE: The purpose of this study was to investigate glenoid morphology and define the safe zone for protecting the suprascapular nerve baseplate screw during baseplate fixation in reverse shoulder arthroplasty (RSA) in a Chinese population. METHODS: Shoulder computed tomography (CT) scans from 56 subjects were retrospectively reviewed. Three-dimensional (3D) reconstruction was performed using Mimics software, and corresponding bony references were used to evaluate glenoid morphology. To standardize evaluation, the coronal scapular plane was defined. Safe fixation distances and screw placements were investigated by constructing a simulated cutting plane of the baseplate during RSA. RESULTS: Mean glenoid height was 35.83 ± 2.95 mm, and width was 27.32 ± 2.78 mm, with significant sexual dimorphism (p < 0.01). According to the cutting plane morphology, the average baseplate radius was 13.84 ± 1.34 mm. The distances from the suprascapular notch and from two bony reference points at the base of the scapular spine to the cutting plane were 30.27 ± 2.77 mm, 18.39 ± 1.67 mm and 16.52 ± 1.52 mm, respectively, with a gender-related difference. Based on the clock face indication system, the danger zone caused by the suprascapular nerve projection was oriented between the two o'clock and eight o'clock positions in reference to the right shoulder. CONCLUSIONS: Glenoid size and the safe zone for screw fixation during RSA were characterized in a Chinese population. Careful consideration of baseplate fixation and avoidance of suprascapular nerve injury are important for improved clinical outcome.