Objective To investigate the effects of tibiofibula crossing healing on ankle joint movement. Methods A retrospective study was done for seven patients who experienced tibiofibula crossing healing for an average of 30 months (10 to 54 months) from September 1999 to November 2003. There were four left sides and three right sides. Two patients received plate fixation for their open tibiofibula fractures, while the other five intramedullary nailing for their closed fractures. The plantar flexion and dorsiflexion of the ankle were measured at the follow-ups. Results According to the Kofoed' s evaluation system for the ankle joint, six were assessed as excellent and one as good in this series. Tibiofibula crossing healing had an average influence of 6.3 degrees on the dorsiflexion of ankle, but little influence on the normal gait. Five patients reported different extents of discomfortableness at the ankle. Conclusion Tibiofibula crossing healing has a significant influence on ankle cataplasia.

A medical robot that is used for closed reduction and the internal fixation of intramedullary locking nailing in treatment of tibial fracture is designed.The system is primarily composed of stereotaxic frame and computer system.Using C-shaped arm-taken X-ray images containing various marked points and keyhole-two-end-center of intramedullary nail,the system calculates the actual position of keyhole in the coordinate system of stereotaxic frame according to space mapping relation and locates the pilot hole on the reference coordinate according to computation.Electric-traction system can realize the precise reduction and remote control operation by network transmission of operation data.In the closed reduction and the internal fixation of intramedullary nail for treatment of tibial fracture in 17 patients,robot reducing fracture and computer-assisted localization of distal keyhole were used.Remote control operation was applied in 4 of them.All operations were performed according to the preset procedure and planning of robot and navigation system.All distal lock nails were successfully implanted at one time.Results demonstrated that both medical robot and computer-assisted localization and navigation system can satisfy fracture reduction and distal Iock nail implantation in the closed reduction and the internal fixation of intramedullary nail for treatment of tibial fracture and shorten intraoperative fluoroscopy time;in addition,remote control operation is reliable and easily mastered due to its simple systemic structure.

Medulla oblongata is precise in structure and the blood supply is complicated. After its infarction, it is easy to be misdiagnosed or missed because of its various clinical manifestations and lack of specificity. This article reviews the pathogenesis, clinical manifestations, and prognosis of medullary infarction in different sites.

Cerebral small vessel disease is a group of heterogeneous diseases with stroke and cognitive impairment as the main clinical features.It can be divided into sporadic type and hereditary type.Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL) belongs to hereditary cerebral small vessel disease.It has been reported in China,Japan,Spain,Greece,and other countries.The diagnosis mainly depends on characteristic clinical symptoms,imaging features,and genetic testing.CARASIL manifests as diffuse white matter abnormal signal and subcortical multiple infarcts on MRI,and it caused by HTRA1 gene mutation.