Charcot foot is a rare disease in clinic, its pathogenesis includes neurotrauma theory, neurovascular theory, comprehensive theory, and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease, the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. It is not difficult to make a diagnosis based on characteristic findings of CT and MRI and clinical manifestations such as swelling, pain and skin temperature rising of foot and ankle. Charcot foot has multiple classification methods including anatomy, imaging and clinical classification. Improved Eichenholtz staging classification is most commonly used currently which could make a more comprehensive assessment of disease and guide treatment better. According to the stage of disease, treatment could be carried out including non-weight bearing and brace protection, drugs therapy and surgical treatment, etc. Early diagnosis, brace protection, could protect joint and delaying progression of deformity. There is no clear long-term and generally accepted conclusion about the efficacy of drug therapy. For advanced patients, surgical treatment must be actively performed to preserve a stable and functional ankle joint and reduce amputation rate.
Amputation ; Ankle Joint ; Arthropathy, Neurogenic ; Diabetic Foot ; Humans ; Radiography

BACKGROUND: We assessed the frequency and types of ankle fractures that frequently occur during parachute landings of special operation unit personnel and analyzed the causes. METHODS: Fifty-six members of the special force brigade of the military who had sustained ankle fractures during parachute landings between January 2005 and April 2010 were retrospectively analyzed. The injury sites and fracture sites were identified and the fracture types were categorized by the Lauge-Hansen and Weber classifications. Follow-up surveys were performed with respect to the American Orthopedic Foot and Ankle Society ankle-hindfoot score, patient satisfaction, and return to preinjury activity. RESULTS: The patients were all males with a mean age of 23.6 years. There were 28 right and 28 left ankle fractures. Twenty-two patients had simple fractures and 34 patients had comminuted fractures. The average number of injury and fractures sites per person was 2.07 (116 injuries including a syndesmosis injury and a deltoid injury) and 1.75 (98 fracture sites), respectively. Twenty-three cases (41.07%) were accompanied by posterior malleolar fractures. Fifty-five patients underwent surgery; of these, 30 had plate internal fixations. Weber type A, B, and C fractures were found in 4, 38, and 14 cases, respectively. Based on the Lauge-Hansen classification, supination-external rotation injuries were found in 20 cases, supination-adduction injuries in 22 cases, pronation-external rotation injuries in 11 cases, tibiofibular fractures in 2 cases, and simple medial malleolar fractures in 2 cases. The mean follow-up period was 23.8 months, and the average follow-up American Orthopedic Foot and Ankle Society ankle-hindfoot score was 85.42. Forty-five patients (80.36%) reported excellent or good satisfaction with the outcome. CONCLUSIONS: Posterior malleolar fractures occurred in 41.07% of ankle fractures sustained in parachute landings. Because most of the ankle fractures in parachute injuries were compound fractures, most cases had to undergo surgical repairs.
Adult ; Ankle Fractures/classification/etiology/radiography/*surgery ; Ankle Injuries/etiology/radiography/*therapy ; Ankle Joint/radiography/*surgery ; Aviation ; Bone Plates ; Fracture Fixation, Internal ; Fractures, Comminuted/etiology/radiography/surgery ; Fractures, Open/etiology/radiography/surgery ; Humans ; Male ; Military Personnel ; Retrospective Studies ; Young Adult

Adolescent ; Adult ; Ankle Injuries ; Ankle Joint ; diagnostic imaging ; Female ; Humans ; Ligaments, Articular ; diagnostic imaging ; injuries ; Male ; Middle Aged ; Radiography ; Rupture

Bleeding into joint space is critical to develop hemophilic arthropathy. To reduce the frequency of bleeding in the ankle joint of children with hemophilic arthropathy, low dose external beam irradiation was performed for 37 patients. Among them, 35 patients followed-up for longer than 1 yr (median 87 months) were enrolled for analysis. The average number of bleedings per month was 3.6 during one year prior to radiation therapy. After radiation therapy, it was decreased to 2.1 during the first year, after then it was maintained in the range of 1.0 to 1.5 until the tenth year. The bleeding frequency was reduced to 42% at the first year and it was maintained in the range of 58% to 73% from the second to the tenth year. Especially the patients who had 3 or more bleedings per month, and who had MRI score more than 3 showed significant decreases. During the follow-up period, growth disturbances and secondary malignancies were not found. External beam radiotherapy can be considered for the hemophilic patients with surgical or isotope therapies are not amenable.
Adolescent ; *Ankle Joint/radiography ; Child ; Child, Preschool ; Hemarthrosis/etiology/*radiotherapy ; Hemophilia A/*complications ; Humans ; Male ; Prognosis

OBJECTIVE: To evaluate the prevalence of deltoid ligament and distal tibiofibular syndesmosis injury on 3T magnetic resonance imaging (MRI) in patients with chronic lateral ankle instability (CLAI). MATERIALS AND METHODS: Fifty patients (mean age, 35 years) who had undergone preoperative 3T MRI and surgical treatment for CLAI were enrolled. The prevalence of deltoid ligament and syndesmosis injury were assessed. The complexity of lateral collateral ligament complex (LCLC) injury was correlated with prevalence of deltoid or syndesmosis injuries. The diagnostic accuracy of ankle ligament imaging at 3T MRI was analyzed using arthroscopy as a reference standard. RESULTS: On MRI, deltoid ligament injury was identified in 18 (36%) patients as follows: superficial ligament alone, 9 (50%); deep ligament alone 2 (11%); and both ligaments 7 (39%). Syndesmosis abnormality was found in 21 (42%) patients as follows: anterior inferior tibiofibular ligament (AITFL) alone, 19 (90%); and AITFL and interosseous ligament, 2 (10%). There was no correlation between LCLC injury complexity and the prevalence of an accompanying deltoid or syndesmosis injury on both MRI and arthroscopic findings. MRI sensitivity and specificity for detection of deltoid ligament injury were 84% and 93.5%, and those for detection of syndesmosis injury were 91% and 100%, respectively. CONCLUSION: Deltoid ligament or syndesmosis injuries were common in patients undergoing surgery for CLAI, regardless of the LCLC injury complexity. 3T MRI is helpful for the detection of all types of ankle ligament injury. Therefore, careful interpretation of pre-operative MRI is essential.
Adolescent ; Adult ; Ankle Injuries/pathology/*radiography ; Ankle Joint/*radiography ; Arthroscopy ; Chronic Disease ; Female ; Humans ; Joint Instability/pathology/radiography/*surgery ; Ligaments, Articular/pathology/radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult

BACKGROUND: Ankle arthrodesis and replacement are two common surgical treatment options for end-stage ankle osteoarthritis. However, the relative value of these alternative procedures is not well defined. This study compared the clinical and radiographic outcomes as well as the early perioperative complications of the two procedures. METHODS: Between January 2, 1998 and May 31, 2002, 138 patients were treated with ankle fusion or replacements. Seventy one patients had isolated posttraumatic or primary ankle arthritis. However, patients with inflammatory arthritis, neuropathic arthritis, concomitant hind foot fusion, revision procedures and two component system ankle replacement were excluded. Among them, one group of 42 patients had a total ankle replacement (TAR), whereas the other group of 29 patients underwent ankle fusion. A complete follow-up could be performed on 89% (37/42) and 73% (23/29) of the TAR and ankle fusion group, respectively. The mean follow-up period was 4.2 years (range, 2.2 to 5.9 years). RESULTS: The outcomes of both groups were compared using a student's t-test. Only the short form heath survery mental component summary score and Ankle Osteoarthritis Scale pain scale showed significantly better outcomes in the TAR group (p < 0.05). In the radiographic evaluation, there was no significant difference in preoperative and postoperative osteoarthritis between the TAR and fusion groups. CONCLUSIONS: The clinical results of TAR are similar to those of fusion at an average follow-up of 4 years. However, the arthroplasty group showed better pain relief and more postoperative complications that required surgery.
Aged ; Ankle Joint/radiography/*surgery ; *Arthrodesis ; *Arthroplasty, Replacement, Ankle ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis/radiography/*surgery ; Pain Measurement ; Postoperative Complications ; Treatment Outcome

OBJECTIVETo measure the stability of Evans procedure and Chrisman-Snook technique in the treatment of II degree lateral collateral ligament of ankle joint, and provide basis for treatment and prognosis.

METHODSFrom July 2008 to June 2009,18 frozen corpes were collected, including 10 males and 8 females, with an average age of fresh 39.3 +/- 11.2 years. The frozen corpes were randomly divided into three group, including normal controls(group A), Evans procedure (group B) and Chrisman-Snook technique ( group C), 6 specimens in each group. Anterior talofibular ligament and calcaneofibular ligament were cut off to cause II degree lateral collateral ligament in group B and C. Evans procedure or Chrisman-Snook technique were applied to restore lateral collateral ligament, and measure biomechnics. The displacement of tibiotalar joint and subtalar joint were observed.

RESULTS(1) The lateral stress results of tibiotalar joint showed the displacement by Evans procedure (group B) was greater than other groups (P < 0.0001). There were no significant differences between group A and C (P > 0.05). (2) The lateral stress results of subtalar joint showed the displacement by Evans procedure (group B) was greater than other groups (P< 0.0001). There were no significant differences between group A and C (P > 0.05).

CONCLUSIONAnkle instability is caused by ankle joint lateral collateral ligament injury. Chrisman-Snook technique is better than Evans procedure in stability on the early stage of ankle joint restoration, and conform to principle of biomechanics.

Adult ; Ankle Joint ; Biomechanical Phenomena ; Female ; Humans ; Lateral Ligament, Ankle ; diagnostic imaging ; injuries ; surgery ; Male ; Mechanical Phenomena ; Prognosis ; Radiography ; Reconstructive Surgical Procedures ; methods

OBJECTIVE: The gout characterized by hyperuricemia is a disorder of purine metabolism and clinical manifestations were seen such as arthritis and tophi in the subcutaneous fitssues. But clinical symptoms were not correlated with the serum level of uric acid. So we analysis of clinical orthopaeclic manifestations and associated factors in gout. METHODS: We have reviewed the medical records, radiography and clinical results of forty six patients admitted at out department between july 1981 and July 1990. RESULTS AND SUMMARY: 1) OF the forty-six patient, 44 cases(95.6%)were male and two female. The age at initial attack was 47.7 year-old in average, from 13 to 66 year-old. 2) Hyperuricemia was associated with obesity in 17 cases(40%), and hyper-tension in 16 cases(35%). 3) The level of uric acid in serum was 9.7mg/% in average on admission and 5.9mg/% on discharge after treated with allopurinol about 2 weeks. 4) The first metatarsophalangeal joint was involved in 28 cases(60.9%) and the ankle joint in 12 cases. Topbus was observed in 14 cases(30.4%) and they were surgically treated in 10 cases.
Aged ; Allopurinol ; Ankle Joint ; Arthritis ; Arthritis, Gouty* ; Female ; Gout ; Humans ; Hyperuricemia ; Male ; Medical Records ; Metabolism ; Metatarsophalangeal Joint ; Obesity ; Radiography ; Uric Acid

Degenerative joint disease is a non-inflammatory disorder of movable joints characterized by deterioration and abrasion of articular cartilage, and also by formation of new bone at the joint surfaces. It is by far the most common form of arthritis in persons over the age of fifty, but manifestation of this disease do not appear as a rule until the fourth or fifth decade. Despite the frequent occurrence of osteoarthrosis in the adult population, many parameters of its pathogenesis have not yet been established. It is generally accepted that many types of injury, and prolonged strenous sporting activity are capable of producing the initial cartilage lesion that leads to the development of degenerative joint disease. But little information is available on its frequency in young athletes. The present study was designed to obtain more precise information about the effect of prolonged strenuous athletic activities on the development of osteoarthrosis in young women athletes. After a detailed clinical examination of the joints of 50 Korean young women volley ball players between 19 and 24 years of age, routine roentgenography was taken of hips, knees, ankles, shoulders, elbows, wrists and hands. The following results were obtained: 1. 23(46%) of 50 young women volley ball players had radiological evidence of osteoarthrosis in one or other of the joint X-rays, but there was no instance of apparent narrowing of the joint space. Nine(18%) of 50 young players had osteoarthrosis in more than 2 joints. Among 50 young volley ball players, 19(38%) athletes had symptomatic osteoarthrosis. 2. The knee joints were most commonly affected(34%). Less frequent sites were ankles(16%), elbow(8%), shoulders(8%) and hips(2%). But there was no involvement of the distal interphalangeal joints of the hand which are most frequently affected in the elderly. 3. 8(16%) of 50 athletes were found to have osteoarthrosis at the site of an injury. The knee joints showed this association most frequently. 4. It was found that body weight and occupation did not affect the incidence of the osteoarthrosis significantly.
Adult ; Aged ; Ankle ; Arthritis ; Athletes ; Body Weight ; Cartilage ; Cartilage, Articular ; Elbow ; Female ; Hand ; Hip ; Humans ; Incidence ; Joint Diseases ; Joints ; Knee ; Knee Joint ; Occupations ; Osteoarthritis ; Radiography ; Shoulder ; Sports ; Wrist

OBJECTIVETo explore operative method in the treatment of syndesmosis injury of ankle fractures.

METHODSTwenty-four patients with ankle fractures and syndesmosis diastasis were treated with shape memory fracture staples, including 10 males and 14 females ranging in age from 19 to 71 years, with an average of 43 years. All patients were diagnosised with history, body examination and image data and were operated according to classification of Lauge-Hansen.

RESULTSAll patients were followed up from 6 to 28 months with an average of 16 months, and all fractures healed, with a mean time 9.2 (8 to 14) weeks. Only one case had radiological and clinical manifestations of traumatic arthritis, but no breakage of shape memory fracture staple in all cases. Sixteen patients got excellent results, good in 5, fair in 2, poor in 1.

CONCLUSIONShape memory staple fixation for the treatment of syndesmosis diastasis in ankle fractures not only can perseve the physical motion of ankles, but also be remove earlier before weight bearing.

Adult ; Aged ; Ankle Fractures ; Ankle Injuries ; complications ; diagnostic imaging ; surgery ; Ankle Joint ; diagnostic imaging ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult