BACKGROUND:Calcaneus is a kind of irregular bone, with complicated three-dimensional structure. Calcaneus is often measured with X-ray plain film, while spiral CT three-dimensional imaging is a potent technology for anatomic measurement and has good application prospect. However, little is known about it. OBJECTIVE:To measure calcaneal anatomic data in Chinese peoples with spiral CT three-dimensional reconstruction and to explore its clinical significance.
METHODS:Calcaneal spiral CT three-dimensional reconstruction in 100 Chinese adults (including 50 males and 50 females) were performed. The length, width, height of calcaneus, and Bohler’s and Gissane’s angles were measured after reconstruction, and compared with the data of westerners.
RESULTS AND CONCLUSION:The mean length, width and height of the Chinese calcaneus were respectively (74.60±5.06) mm, (29.71±2.93) mm and (45.23±4.46) mm in male group, and (71.48±5.36) mm, (26.65±3.01) mm and (42.23±4.49) mm in female group. There were no significant differences between male group and female group in al the above parameters (P>0.05). There was no significant difference in the Gissane’s angle between the two groups (123.3±8.5° versus 122.7±8.9°;P>0.05). The Bohler’s angle in male group (35.98±4.34)° was significantly lower than that in female group (38.81±4.43)° (P<0.05). The length, width and height of Chinese calcaneus were significantly lower than those of westerners (P<0.05). The Bohler’s angle and Gissane’s angle in Chinese adults showed no statistical significance compared with the westerners (P>0.05). Experimental findings indicate that, the length, width and height of Chinese calcaneus in female were lower than that in male, but Bohler’s angle is significantly higher than that in male, there was no significant difference in Gissane’s angle between males and females. Compared with the data of westerners, the length, width and height of Chinese adult calcaneus are significantly decreased, and no difference is found in Bohler’s angle and Gissane’s angle.

BACKGROUND:Crowe type-IV developmental dysplasia of the hip presented complete dislocation of the femoral head, significantly shortening lower limb, serious adverse development of upper segment of acetabulum and femur, and even deformity. At present, there are no reports concerning its therapeutic strategy.
OBJECTIVE:To explore the therapeutic strategy of adult bilateral Crowe type-IV developmental dysplasia of the hip.
METHODA total of 12 cases of adult bilateral Crowe type-IV developmental dysplasia of the hip, who were treated in the Department of Orthopedics, The First People’s Hospital of Changzhou from January 2000 to January 2013, were col ected. There were 5 males and 7 females, at the age of 19-47 years old, averagely 33.5 years old. After two or three weeks of skeletal traction, they received bilateral total hip arthroplasty. Hip rotation center was reconstituted at the level of the“true”acetabulum. The subtrochanteric osteotomy was performed for patients with reduction difficulty. For patients with femoral neck anteversion>40°, subtrochanteric rotary osteotomy was performed.
RESULTS AND CONCLUSION:Disappearance of hip pain, satisfied move function and normal gait were gained after operation. Lower limbs recovered to be isometric. The average leg lengthening was 3.1 cm (range, 2.5 to 4.8 cm). One patient affected sciatic nerve irritation. The average fol owed-up time was 3.5 years. No fracture, dislocation or loosening of the prosthesis appeared. The post-operative Harris Hip Score averaged 86.3. By reconstruction of the hip rotation center in the“true”acetabular level, correction of femoral neck anteversion, reconstruction of function of the abduction muscle and proper selection of prosthesis, total hip arthroplasty for adult bilateral Crowe type-IV developmental dysplasia of the hip could obtain good curative effects.

Objective: To build an automatic bone age assessment system based on China 05 Bone Age Standard and the latest deep learning technology, and preliminary clinical verification was carried out. Methods: The left-hand radiographs of 5 000 children with suspected metabolic disorders were acquired from Wuxi Children′s Hospital. Among these cases, 2 351 patients were randomly chosen as training set, and 101 patients were randomly used as validation set. Four professional pediatric radiologists annotated the development stage according to the China 05 RUS-CHN standard with double-blind method. The mean value of the bone age assessed by experts was the reference standard which was used to train and validate the deep learning mothods based artificial intelligence (AI) model. Accuracy, mean absolute error (MAE), root mean squared error (RMSE) and time efficiency of bone age assessment were compared by using Chi-square test and t test and F test between resident doctors and AI model in the validation set. Results: The MAE and RMSE was (0.37±0.35) years and 0.50 years between AI model and reference standard, respeactively. When the error range was within ±1.0, ±0.7 and ±0.5 years, the accuracy of model on the validation set was 94.1% (95/101), 89.1% (90/101), 74.3% (75/101) respectively. The accuracy between two resident doctors and AI prediction wasn′t statistical significant (P>0.05). Conclusion The AI model of bone age assessment based on deep learning is feasible and has the characteristics of high accuracy and efficiency.