BACKGROUND:The ankle fusion is an important treating means of end-stage ankle joint disease. Internal fixation of implant has become the preferred way of fixation, but fixation of different implants has different effects. OBJECTIVE:To explore the value of different internal fixation methods in ankle fusion. METHODS:A retrospective analysis was performed in 64 cases of ankle fusion from September 2012 to March 2015. They were divided into the observation group (32 cases) and control group (32 cases) according to the way of internal fixation of implant. The observation group underwent headless compression screw fixation. The control group underwent interlocking compression plate fixation. Length of incision, operation time, postoperative drainage volume, postoperative complications, healing time of bone and functional recovery of ankle-hindfoot were observed and compared between the two groups. RESULTS AND CONCLUSION:(1) There was no statistical significance in operation time and healing time of bone between the two groups (P>0.05). (2) Length of incision and postoperative drainage volume were significantly greater in the control group than in the observation group. The incidence of postoperative complications was significantly higher in the control group than in the observation group (P<0.05). (3) No significant differences in preoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot score were found between the two groups (P>0.05), but the score was significantly higher in the observation group than in the control group in final fol ow-up (P<0.05). (4) These findings suggest that compared with the interlocking compression plate, headless compression screw treatment for ankle fusion can obtain better effect, smal trauma, less postoperative complications, fixed firmly, more in line with the physiological and biomechanical requirements.

Objective To discuss the morphological features and diagnosis of congenial double orifice mitral valve (DOMV) deformity by echocardiography.Methods Twenty consecutive patients were examined.The changes of the morphology and flow dynamics of DOMV were studied,and other congenital cardiac abnormalities were also observed.These results were compared with those of surgery.Results Thirteen cases of adult patients were all with significant hemodynamic abnormalities,and underwent mitral replacement.One case of school child with muscular ventricular septal defect underwent mitral replacement because of obvious hemodynamic changes.Six cases were under 2 years old,2 cases with complete endocardial cushion defect accompanied with pulmonary hypertension,1 case with partial endocardial cushion defect accompanied with coarctation of the aorta underwent corrective operation.No significant hemodynamic abnormalities in 2 cases,1 case was associated with coarctation of the aorta and patent ductus arteriosus,the other patient with membranous ventricular septal defect.Severe stenosis in 1 case with papillary muscle dysplasia,because there was no suitable operation and take conservative therapy.Seventeen cases were confirmed by the results of open-heart surgery.Conclusions Echocardiography can provide an accurate method to diagnose DOMV and evaluate the hemodynamic changes.

Objective To investigate the value of intra-cavitary contrast enhanced ultrasound(CEUS)in the location of drainage tubes which were unclear in conventional ultrasonography. Methods The locations of 32 drainage tubes in 26 patients were unclear in conventional ultrasonography. The diluted ultrasound contrast agent (SonoVue) was injected through the tubes. CEUS was used to evaluate the visualizations of the inner tubular portions and the distal ends. Whether the drainage tubes were in situ or not was also judged. The time-consumption of detection was counted. Results The percentages of the visualization of inner tubular portions and the distal ends in conventional ultrasonography were 52.25%(18/32) and 0,respectively. However,the percentages of visualization in CEUS were 100% and 93.75%(30/32), respectively. The difference were significant when compared conventional ultrasonography with CEUS ( P＜0.001 ). CEUS detected that three drainage tubes weren't in situ. And the median of timeconsumption of CEUS was just 4. 5 seconds (range: 1-77 seconds). Conclusions Intra-cavitary CEUS is a sensitive and high efficient technique in the visualization of drainage tube which may complement the insufficiency of conventional ultrasonography. It could be used as the first choice in the location of drainage tube.

Objective To analyze the imaging features and to enhance the understanding of pancreatic and renal involvement in yon Hippel-Lindau disease (VHLD). Methods CT and MRI appearances and clinical data of six patients with pancreatic and renal involvement in VHLD were studied retrospectively.Six patients underwent CT scanning, and two of them also had MRI.Results Pancreatic cysts found in all six patients varied from several small cysts to cystic replacement of the entire gland.Calcifications were detected in four patients. Multiple bilateral renal lesions were detected in six patients.The renal lesions were classified as cystic, cystic with solid components and solid.Multiple combined renal lesions were found in five patients, and multiple simple cysts in one patient.Unilateral nephrectomy was performed in two patients, and the renal masses were diagnosed as clear cell carcinoma by pathology.Bile carcinoid was found in one patient, and retroperitoneal metastasis in another.Conclusion Multiple pancreatic cysts and/or multiple and bilateral combined renal lesions are highly suggestive of VHLD.