Management and classification of the fracture of lateral process of talus:An overview and literature update

Fracture of the lateral process of the talus(FLPT)is uncommon in clinical practice and can be easily missed or misdiagnosed.In recent years,as researchers from all over the world have further deepened their research on FLPT,there has been a breakthrough in the classification,and the methods and principles of clinical management have changed accordingly;however,there is still no standardized guideline for the diagnosis and management of FLPT,and there have been few relevant literature review articles related to this kind of fracture in the past at least 5 years.In this article,we review the clinical classification,classification-based therapeutic recommendations,and prognosis of FLPT,with the aim of providing a reference for the clinical diagnosis and management of this infrequent fracture.

Discovery of rhyolitic tuffaceous slate in the southwestern margin of Yangtze Craton:Zircon U-Pb ages(2491 Ma)and tectonic-thermal events

The Mesoproterozoic Dongchuan Group that is widely exposed in Yimen area,central Yunnan Province is a series of sedimentary sort of low-grade metamorphic rocks interbedded with volcanic rocks,which are closely related to the early tectonic evolution of the Earth.However,its formation era,sedimentary filling sequence,and geotectonic characteristics have always been in dispute.In this study,several rhyolitic tuffaceous slate interlayers with a centimeter-level thickness were found in the previously determined Heishan Formation of the Dongchuan Group located to the western part of Yimen-Luoci fault zone.This paper focuses on the study of the rhyolitic tuffaceous slate in Qifulangqing Village,Tongchang Township,Yimen County.LA-ICP-MS zircon dating was conducted,achieving the crystallization age of magma of 2491±15 Ma and the metamorphic ages of about 2.3 Ga,2.0 Ga,and 1.8 Ga for the first time.Meanwhile,according to in-situ Hf isotope analysis,the zirconεHf(t)values were determined to range from−3.0 to 7.6,with an average of 2.7.Furthermore,the first-stage Hf model age(TDM1)was determined to be 2513−2916 Ma,indicating that the provenance of the rhyolitic tuffaceous slate is the depleted mantle or juvenile crust between the Middle Mesoarchean and the Late Neoarchean.Therefore,it is believed that the strata of the slate were deposited in the Late Neoarchean,instead of the Mesoproterozoic as determined by previous researchers.Accordingly,it is not appropriate to group the strata into the Mesoproterozoic Dongchuan Group.Instead,they should be classified as the Maolu Formation of the Neoarchean Puduhe Group given the lithologic association and regional information.Furthermore,the magma ages of 2491±15 Ma are highly consistent with the eras of the large-scale Late Neoarchean orogenic magmatic activities on the northern margin of the Yangtze Craton,and thus reflect the orogenic process consisting of subduction and collision from Late Neoarchean to Early Paleoproterozoic.The magmatic activities during this period were possibly caused by the convergence of the supercontinent Kenorland.Meanwhile,the metamorphic ages of 2.3 Ga,2.0 Ga,and 1.8 Ga are highly consistent with three metamorphic ages of 2.36 Ga,1.95 Ga,and 1.85 Ga of the northern margin of the Yangtze Craton,indicating that the strata experienced Paleoproterozoic tectonic-thermal events.The study area is located on the eastern margin of Qinghai-Tibet Plateau,and thus was possibly re-transformed by magmatism subjected to the subduction of the Meso-Tethys Ocean during the Early Cretaceous.The discoveries made in this study will provide strong petrological and chronological evidence for analyzing the early crustal evolution of the Yangtze block.

Comparison of Efficacy between 3D Navigation-Assisted Percutaneous Iliosacral Screw and Minimally Invasive Reconstruction Plate in Treating Sacroiliac Complex Injury

The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.

Macrophage migration inhibitory factor may contribute to hypertrophy of lumbar ligamentum flavum in type 2 diabetes mellitus

To the Editor:Lumbar spinal canal stenosis(LSCS)is a common disease among older individuals.Hypertrophic lumbar ligamentum flavum(LLF)plays a vital role in the pathogenesis of LSCS.The physiological LLF is a kind of dense connective tissue with thickness of 2 to 4mm,which is mainly composed of fibroblasts and extracellular matrix(ECM).ECM contains elastic,collagen fibers and ground substances.The distribution characteristics of fibers show that a large number of elastic fibers are mixed with a small amount of the collagen fibers;mainly type I and type III collagen fibers.These fibers are arranged tightly and regularly along the direction of column’s axis.The LLF is located in the dorsal part of the dura mater of the spinal canal,and it attaches to the upper border and lower parts of anterior surfaces of the laminas.The hypotrophy of LLF is the consequence of several factors such as aging,inflammatory process,stress loading and genetic predisposition.