Objective To provide the anatomic basis of flap which was anatomized to the ankle by Anatomy study of vascular net around ankle joint.Methods 32 lower limbs were infiltrated into red emulsion;4 perfusions of lower limbs,artery;2 cases of radiography;1 lower limb was infiltrated into black ink.Application anatomy was observed the origin,track-way,branches and configuration in ankle and foot.Results The blood provision in ankle includes three parts;All the patients recovered well after treatment by careful flap-design.Conclusion The vascular net around anatomy of the ankle can provide help for the design,the choice and the operation of ankle's,tissue flap,and the function's,recovery after surgery.

Objective To investigate the accuracy of the positioning of the prosthesis of the femur and tibia by the individual navigation template assisted Oxford unicompartmental arthroplasty and to evaluate of the value of navigation template in unicompartmental arthroplasty.Methods Twenty cadaveric legs were randomly divided into two groups (n=10),group 1 for navigation template and 2 for conventional method.ACT scan was performed preoperatively on the lower limb for navigational group.Geomagic software was used to process the CT data.A navigational template was constructed as the inverse of the distal femur and proximal tibia surface with an osteotomy gap.Two drills were used to define the rotational alignment of the femur in the computer.The navigational templates were produced using a rapid prototyping (RP) technique to assist UKA.The traditional method group was guided by the tibial extramedullary localization and the femoral intramedullary localization for the osteotomy and prosthesis placement.Both groups were performed according to the same standard.The position of the single condyle was evaluated by the anteroposterior X-ray films of the knee joint.The vertical relationship between the osteotomy surface and its mechanical axis was evaluated by CT.The parallel relationship between the central placement of femoral prosthesis and the posterior femoral cortex was also evaluated.Results The navigation template was close to the femoral condyle and tibial plateau without obvious movement.The mean operative duration of the navigation template group were 50.75 ±2.3 min and the traditional method group were 58.57 ± 1.5 min (P＞0.05).The postoperative femoral prosthesis flip angles of the navigation template group and the traditional group were 2.5° ±-0.65° and-7.8°± 3.26° respectively (P＜0.05).The femoral prosthesis flexion angles were-2.9° ±4.18° and -6.5°±4.25° (P＜0.05),and the tibial prosthesis varus and valgns angles were-1.5°±0.50° and-5.8°±3.15° respectively (P＜0.05).The tibial implant posterior inclination angles were 4.50°±1.55°and 3.05°±3.63° respectively (P＜0.05).The average angles between navigational group distal femoral osteotomy surface and mechanical shaft were 89.5o±2.3° (range 87.5°-91.8°).The average angle between the proximal tibial resected surface and the mechanical axis was 90.3°±0.5° (range 89.4°-90.7°).There were 17 specimens of central column of femoral prosthesis parallel with the posterior femoral cortex.However,the angle of remaining 3 samples were less than 5°.In the traditional method group,the osteotomy surface and its mechanical axis were all angled.The deviation of distal femur distal surface in 7 specimens from the mechanical axis was larger than 10°,while that in 5 specimens was larger than 5°.Conclusion The navigation template can improve the accuracy of the femoral prosthesis localization,orientation and tibial prosthesis implants in the direction of valgus and valgus.However,there was no significant effect on the tibial prosthesis in the direction of posterior inclination.

Objective:To evaluate the efficacy and safety of periarticular cocktail injection analgesia after arthroscopic rotator cuff repair surgery.Methods:From June 2020 to May 2021, 120 patients with rotator cuff tears were treated at Shandong University Qilu Hospital (Qingdao) with arthroscopic rotator cuff repair surgery. The cohort included 45 males and 75 females, aged 61.35±5.75 years (range 57-67 years), with 58 cases involving the left shoulder joint and 62 cases involving the right shoulder joint. Patients were randomly divided into a cocktail group (receiving periarticular injections of ropivacaine, morphine, adrenaline, and compound betamethasone) and an analgesic pump group (using an analgesic pump). Standardized protocols were used for perioperative and postoperative analgesia. The visual analog scale (VAS) of pain and shoulder joint range of motion were recorded on the day of surgery, the first and second postoperative days, the day of discharge, and at follow-up at 2 and 6 weeks. The postoperative demand for temporary analgesics (celecoxib), as well as adverse reactions to cocktail injections and analgesic pump applications were also recorded.Results:There were no statistically significant differences in age, gender, surgical time, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, preoperative VAS score, surgical time, postoperative hospital stay, rotator cuff tear area, and intraoperative anchor number between the two groups of patients ( P>0.05). Patients who received periarticular cocktail injections performed better in terms of postoperative VAS scores and functional recovery. Compared with the analgesic pump group, the temporary use of analgesics in the cocktail group was significantly reduced at 6, 12, and 24 hours after surgery. After 12 hours of surgery, the cocktail group received 3(3, 4) points and the analgesic pump group received 5(5, 6) points, with statistically significant differences ( Z=143.004, P=0.003); 18 hours after surgery, the VAS score in the cocktail group showed a rebound, rising to 4(3, 4) points, but still lower than 5(4, 5) points in the analgesic pump group. There was no significant difference in VAS scores between the cocktail group and the analgesic pump group at 24-48 hours after surgery ( P>0.05). The use of cocktail injections was associated with lower VAS scores at 12 hours post-surgery ( OR=4.125; 95% CI: 2.672, 4.328; P=0.015). There is no correlation between age, BM, ASA, pre-operative VAS, surgical time, rotator cuff tear size, number of anchor bolts used, and postoperative VAS score at 12 hours. Multivariate regression analysis of postoperative 24-hour VAS scores showed that no factors were associated with postoperative 24-hour VAS scores. Conclusion:Periarticular cocktail injection can significantly reduce the need for postoperative pain relief and improve patient satisfaction, without posing significant risks after arthroscopic rotator cuff repair surgery.