Background: Open pure tibiotalar dislocations with an associated superficial fibular nerve injury are rarely reported. Case presentation: The authors report a case of open tibiotalar dislocation without any associated...Background: Open pure tibiotalar dislocations with an associated superficial fibular nerve injury are rarely reported. Case presentation: The authors report a case of open tibiotalar dislocation without any associated fracture and an associated injury of superficial fibular nerve after a motorcycle accident. A debridement plus an open reduction and casting were performed sixteen hours after the trauma. After twenty-six months, the outcome was good without any infection and a sensitivity recovery of the foot. Conclusion: A delayed management of an open tibiotalar dislocation with an associated superficial fibular nerve injury led to a good mid-term outcome.展开更多
Accurate knowledge of the kinematics of the in vivo Ankle Joint Complex(AJC)is critical for understanding the biomechanical function of the foot and assessing postoperative rehabilitation of ankle disorders,as well as...Accurate knowledge of the kinematics of the in vivo Ankle Joint Complex(AJC)is critical for understanding the biomechanical function of the foot and assessing postoperative rehabilitation of ankle disorders,as well as an essential guide to the design of ankle–foot assistant devices.However,detailed analysis of the continuous 3D motion of the tibiotalar and subtalar joints during normal walking throughout the stance phase is still considered to be lacking.In this study,dynamic radiographs of the hindfoot were acquired from eight subjects during normal walking.Natural motions with six Degrees of Freedom(DOF)and the coupled patterns of the two joints were analyzed.It was found that the movements of the two joints were mostly in opposite directions(including rotation and translation),mainly in the early and late stages.There were significant differences in the Range of Motion(ROM)in Dorsiflexion/Plantarflexion(D/P),Inversion/Eversion(In/Ev),and Anterior–Posterior(AP)and Medial–Lateral(ML)translation of the tibiotalar and subtalar joints(p<0.05).Plantarflexion of the tibiotalar joint was coupled with eversion and posterior translation of the subtalar joint during the impact phase(R^(2)=0.87 and 0.86,respectively),and plantarflexion of the tibiotalar joint was coupled with inversion and anterior translation of the subtalar joint during the push-off phase(R^(2)=0.93 and 0.75,respectively).This coordinated coupled motion of the two joints may be a manifestation of the AJC to move flexibly while bearing weight and still have stability.展开更多
目的分析术前胫距关节间隙对保踝治疗术后预期结局的影响。方法选取2012年3月至2018年4月于杭州市富阳中医骨伤医院行踝关节保留手术的患者258例,按照术前胫距关节间隙不同分为<2mm组与≥2mm组,运用倾向性评分匹配法对两组患者进行配...目的分析术前胫距关节间隙对保踝治疗术后预期结局的影响。方法选取2012年3月至2018年4月于杭州市富阳中医骨伤医院行踝关节保留手术的患者258例,按照术前胫距关节间隙不同分为<2mm组与≥2mm组,运用倾向性评分匹配法对两组患者进行配对,比较匹配后两组患者术后末次随访时的预期结局。结果经倾向性评分匹配后,术前胫距关节间隙<2mm组与≥2mm组各纳入患者50例,两组患者的一般资料比较差异均无统计学意义(P>0.05),倾向性评分分布相似,匹配效果较好。术后末次随访时,≥2mm组患者距骨倾斜角及距骨前移距离均明显小于<2mm组,美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分、足踝能力评估量表(foot and ankle ability measure,FAAM)日常活动及运动评分均明显高于<2mm组(P<0.05);术前胫距关节间隙与距骨倾斜角和距骨前移距离呈负相关(r=–0.358、–0.320,P<0.05),与AOFAS踝-后足评分、FAAM日常活动及运动评分均呈正相关(r=0.404、0.385、0.340,P<0.05)。结论术前胫距关节间隙<2mm的患者行保踝治疗术后预期结局比≥2mm者差,可为术前临床决策提供参考。展开更多
文摘Background: Open pure tibiotalar dislocations with an associated superficial fibular nerve injury are rarely reported. Case presentation: The authors report a case of open tibiotalar dislocation without any associated fracture and an associated injury of superficial fibular nerve after a motorcycle accident. A debridement plus an open reduction and casting were performed sixteen hours after the trauma. After twenty-six months, the outcome was good without any infection and a sensitivity recovery of the foot. Conclusion: A delayed management of an open tibiotalar dislocation with an associated superficial fibular nerve injury led to a good mid-term outcome.
基金supported by the National Natural Science Foundation of China(52175270,91848204)the Project of Scientific and Technological Development Plan of Jilin Province(20220508130RC).
文摘Accurate knowledge of the kinematics of the in vivo Ankle Joint Complex(AJC)is critical for understanding the biomechanical function of the foot and assessing postoperative rehabilitation of ankle disorders,as well as an essential guide to the design of ankle–foot assistant devices.However,detailed analysis of the continuous 3D motion of the tibiotalar and subtalar joints during normal walking throughout the stance phase is still considered to be lacking.In this study,dynamic radiographs of the hindfoot were acquired from eight subjects during normal walking.Natural motions with six Degrees of Freedom(DOF)and the coupled patterns of the two joints were analyzed.It was found that the movements of the two joints were mostly in opposite directions(including rotation and translation),mainly in the early and late stages.There were significant differences in the Range of Motion(ROM)in Dorsiflexion/Plantarflexion(D/P),Inversion/Eversion(In/Ev),and Anterior–Posterior(AP)and Medial–Lateral(ML)translation of the tibiotalar and subtalar joints(p<0.05).Plantarflexion of the tibiotalar joint was coupled with eversion and posterior translation of the subtalar joint during the impact phase(R^(2)=0.87 and 0.86,respectively),and plantarflexion of the tibiotalar joint was coupled with inversion and anterior translation of the subtalar joint during the push-off phase(R^(2)=0.93 and 0.75,respectively).This coordinated coupled motion of the two joints may be a manifestation of the AJC to move flexibly while bearing weight and still have stability.
文摘目的分析术前胫距关节间隙对保踝治疗术后预期结局的影响。方法选取2012年3月至2018年4月于杭州市富阳中医骨伤医院行踝关节保留手术的患者258例,按照术前胫距关节间隙不同分为<2mm组与≥2mm组,运用倾向性评分匹配法对两组患者进行配对,比较匹配后两组患者术后末次随访时的预期结局。结果经倾向性评分匹配后,术前胫距关节间隙<2mm组与≥2mm组各纳入患者50例,两组患者的一般资料比较差异均无统计学意义(P>0.05),倾向性评分分布相似,匹配效果较好。术后末次随访时,≥2mm组患者距骨倾斜角及距骨前移距离均明显小于<2mm组,美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分、足踝能力评估量表(foot and ankle ability measure,FAAM)日常活动及运动评分均明显高于<2mm组(P<0.05);术前胫距关节间隙与距骨倾斜角和距骨前移距离呈负相关(r=–0.358、–0.320,P<0.05),与AOFAS踝-后足评分、FAAM日常活动及运动评分均呈正相关(r=0.404、0.385、0.340,P<0.05)。结论术前胫距关节间隙<2mm的患者行保踝治疗术后预期结局比≥2mm者差,可为术前临床决策提供参考。
