OBJECTIVETo conduct the anatomical study about the posterior coaxial portals via posterior tibial tendon (PTT) sheath for ankle arthroscopy.

METHODSCoaxial portals were established in 20 ankles by K-wires which were left in place for distance measurement between them and the posterior nerves, tendons and vessels. Ankle arthroscopy was performed in 5 fresh ankles using 2.7 mm 300 arthroscopy with the same portals as mentioned above. The maximum visible scope were recorded and the distance between the arthroscopy and the posterior nerves, tendons and vessels was also measured.

RESULTSThe medial portal was located 5 - 12 mm (average, 8 mm) above the tip of medial malleolus, and the lateral portal was located 8 - 24 mm (average, 15 mm) above the tip of lateral malleolus. The coaxial portals, which traversed the PTT sheath and passed posterior to the fibular, not only separated the arthroscopy and instrument from the posterior nerves, tendons and vessels by posterior capsule but also enlarged their distance. The medial and lateral malleolus articular gap, the posterior capsule could be viewed by these portals with as much as 1/2 - 2/3 posterior articular surface of talus. Not only the tibiotalar articular gap but also the dynamic movement between the mortise and the talus were clearly observed. Arthroscopic operation could be performed by instrument through the posterolateral portal.

CONCLUSIONSThe posterior coaxial portals via PTT sheath for ankle arthroscopy have such advantages as easy maneuverability, superior safety, clear vision and larger operation field under arthroscopy.

Ankle Joint ; anatomy & histology ; surgery ; Arthroscopy ; methods ; Humans

OBJECTIVETo investigate the clinical effects of surgical vs manual reduction of ankle fractures.

METHODSFrom March 2006 to April 2010,301 patients with ankle fractures were analyzed retrospectively, of whom 134 patients were treated by manual reduction and plaster fixation, and the other 167 patients underwent surgical treatment. In manual reduction group, there were 86 males and 48 females with a mean age of (38.2 +/- 15.7) years, involving Weber-Denis A in 55 cases,Weber-Denis B in 60 cases, and Weber-Denis C in 19 cases. In surgical reduction group, there were 115 males and 52 females with a mean age of (39.6 +/- 11.9) years, involving Weber-Denis A in 59 cases, Weber-Denis B in 52 cases and Weber-Denis C in 56 cases. The score of the ankle's symptoms and function was calculated according to Mazur,and the difference was analyzed by Chi-squire test.

RESULTSOf the 114 patients with Weber-Denis A, 55 patients were in manual reduction group, with excellent, good, acceptable and poor results in 18, 20, 11 and 6 patients respectively vs 26, 25, 6 and 2 in surgical reduction group of 59 patients. In patients with Weber-Denis B, there were 60 patients in manual reduction group, with excellent, good, acceptable and poor results in 20 , 26, 8 and 6 patients vs 25, 21, 5, and 1 in surgical reduction group of 52 patients. There was no significant difference in clinical effects between the two group of Weber-Denis A and B. The remaining 75 patients belonged to Weber-Denis C, of whom 19 patients were in manual reduction group,with excellent, good, acceptable and poor results in 2, 3, 7 and 7 patients vs 21, 18, 11 and 6 in surgical reduction group of 56 patients. There was no significant difference in clinical effects between the two groups of Weber-Denis C (P=0.007).

CONCLUSIONThe clinical effect of surgical reduction group was obviously better than that of manual reduction group for Weber-Denis C, and therefore surgical intervention is recommended for this type of fracture.

Adult ; Ankle Injuries ; therapy ; Ankle Joint ; anatomy & histology ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged

OBJECTIVETo compare the image quality of isotropic 3-dimensional fast spin echo (3D-FSE), 3D fast field echo (3D-FFE), and 2D fast spin echo (2D-FSE) sequences in magnetic resonance imaging (MRI) of the anatomical structure of the ankle joint.

METHODSThe ankle joints of 10 healthy volunteers were examined with isotropic 3D-FSE, 3D-FFE and 2D-FSE sequences using a 1.5T MR scanner and 3D reconstruction. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the tissues were measured. Two radiologists evaluated the image quality of the 3 sequences using a 5-point Likert scale in a double-blinded manner.

RESULTSThe 3D-FSE sequences resulted in the highest SNRs for all the tissues and the highest CNRs for differentiation between cartilage and marrow, between muscle and tendon, and between tendon and fluid. In the estimation of image quality for cartilages, 3D-FFE had the highest score followed by 3D-FSE, and the latter had the highest score among the 3 sequences in displaying the tendon.

CONCLUSION3D-FSE sequence has a high performance in displaying the anatomical structures of complex joints especially for cartilage, ligament, and tendon tissues.

Ankle Joint ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging

OBJECTIVETo study therapeutic effects of lateral ankle ligaments reconstruction for the treatment of chronic lateral instability of the ankle joint.

METHODSFrom July 2005 to January 2008, among 13 patients with chronic lateral instability of the ankle joint, 10 patients were male and 3 patients were female, ranging in age from 24 to 45 years,with an average of 33 years. Anterior talo-fibular ligament (ATFL) and calcanea-fibular ligament (CFL) were anatomy reconstructed with a split peroneus brevis tendon graft for all patients. The ankle scoring system was used to evaluate ankle joint function before and after operation, which including stability, pain, locomotor activity and X-ray films.

RESULTSAll the patients were followed up ranged from 6 to 32 months, averaged 16.4 months. The postoperative scores of the ankles increased in respect to stability, pain and locomotor activity. The total average score increased from preoperative (43.54+/-7.04) to postoperative (73.38+/-4.17). There was significant difference between preoperative scores and postoperative scores (P<0.01). All the patients were satisfied with the results.

CONCLUSIONAnatomy reconstruct of the ATFL and CFL with a split peroneus brevis tendon graft (Sammarco method) is a practical method for lateral ankle instability and promise good results especially for patients complained of instability.

Adult ; Ankle Joint ; anatomy & histology ; pathology ; surgery ; Female ; Humans ; Joint Instability ; pathology ; surgery ; Lateral Ligament, Ankle ; anatomy & histology ; pathology ; surgery ; Male ; Middle Aged ; Models, Biological ; Reconstructive Surgical Procedures ; methods ; Young Adult

DLUT4060 piezoelectric multi-component force platforms and DVM8820 three-dimensional infrared image capture system were used to test the sit-to-walk (STW) movements of 11 healthy elderly (72. 6 +/- 12. 2 years old) and 11 healthy young (19. 7 +/-1. 3 years old) individuals. Firstly, we studied the effects of seat-heights on the ground reaction forces, the velocity of the center of mass, and action time duration. Then we discussed the movement strategies and falling risks of the persons in the two age groups respectively. Finally, we decided the best seat height for the two age groups. It was found that the best seat heights for both the two age groups were 100% popliteal height. This height may make the subject get the greatest biomechanical advantages and the lowest falling risks. The popliteal height must be concerned when designing and fixing up the public activity area facilities and daily life of the elderly. To some extent, it can reduce the falling risk of the elderly.
Accidental Falls ; prevention & control ; Aged ; Aged, 80 and over ; Ankle Joint ; physiology ; Buttocks ; physiology ; Hip Joint ; physiology ; Humans ; Interior Design and Furnishings ; Knee Joint ; physiology ; Leg ; anatomy & histology ; physiology ; Male ; Middle Aged ; Movement ; physiology ; Posture ; Weight-Bearing ; physiology ; Young Adult

OBJECTIVE: To compare the image quality of volume isotropic turbo spin echo acquisition (VISTA) imaging method with that of the three-dimensional (3D) isotropic fast field echo (FFE) imaging method applied for ankle joint imaging. MATERIALS AND METHODS: MR imaging of the ankles of 10 healthy volunteers was performed with VISTA and 3D FFE sequences by using a 3.0 T machine. Two radiologists retrospectively assessed the tissue contrast between fluid and cartilage (F-C), and fluid and the Achilles tendon (F-T) with use of a 4-point scale. For a quantitative analysis, signal-to-noise ratio (SNR) was obtained by imaging phantom, and the contrast ratios (CRs) were calculated between F-T and F-C. Statistical analyses for differences in grades of tissue contrast and CRs were performed. RESULTS: VISTA had significantly superior grades in tissue contrast of F-T (p = 0.001). Results of 3D FFE had superior grades in tissue contrast of F-C, but these result were not statistically significant (p = 0.157). VISTA had significantly superior CRs in F-T (p = 0.002), and 3D FFE had superior CRs in F-C (p = 0.003). The SNR of VISTA was higher than that of 3D FFE (49.24 vs. 15.94). CONCLUSION: VISTA demonstrates superior tissue contrast between fluid and the Achiles tendon in terms of quantitative and qualitative analysis, while 3D FFE shows superior tissue contrast between fluid and cartilage in terms of quantitative analysis.
Achilles Tendon/*anatomy & histology ; Adult ; Ankle Joint/*anatomy & histology ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Magnetic Resonance Imaging/*methods ; Male ; Phantoms, Imaging ; Retrospective Studies ; Statistics, Nonparametric

PURPOSE: Despite technical simplicity and the low cost of brachial-ankle pulse wave velocity (BA-PWV), its use has been hampered by a lack of data supporting its usefulness and reliability. The aim of this study was to evaluate the usefulness of BA-PWV to measure aortic stiffness in comparison to using cardiovascular magnetic resonance (CMR). MATERIALS AND METHODS: A total of 124 participants without cardiovascular risk factors volunteered for this study. BA-PWV was measured using a vascular testing device. On the same day, using CMR, cross-sectional areas for distensibility and average blood flow were measured at four aortic levels: the ascending, upper thoracic descending, lower thoracic descending, and abdominal aorta. RESULTS: Compared to PWV measured by CMR, BA-PWV values were significantly higher and the differences therein were similar in all age groups (all p<0.001). There was a significant correlation between BA-PWV and PWV by CMR (r=0.697, p<0.001). Both BA-PWV and PWV by CMR were significantly and positively associated with age (r=0.652 and 0.724, p<0.001). The reciprocal of aortic distensibility also demonstrated a statistically significant positive correlation with BA-PWV (r=0.583 to 0.673, all p<0.001). CONCLUSION: BA-PWV was well correlated with central aortic PWV and distensibility, as measured by CMR, regardless of age and sex.
Adult ; Ankle Brachial Index/*methods ; Ankle Joint ; Aorta/anatomy & histology/*physiology ; *Blood Flow Velocity ; Cardiovascular Diseases ; Female ; Heart/physiopathology ; Humans ; *Magnetic Resonance Imaging, Cine ; Male ; Pulse Wave Analysis/*methods ; Regional Blood Flow ; Reproducibility of Results ; Risk Factors ; *Vascular Stiffness