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METHODSSeventeen patients with posterior Pilon fracture were treated through posterolateral approach from February 2010 to April 2013. Among them,including 11 males and 6 females aged from 29 to 59 with an average of 43.4 years old. All fractures were associated with more than 20% of articular surface of distal tibial. The causes of injury included falling down (11 cases), traffic accident (4 cases) and sports injury(6 cases). Fracture classification was based on posterior pilon fracture by YU Guang-rong, including type I (6 cases), type II (2 cases) and type III (6 cases). Fracture healing time, fracture reduction and postoperative complications were observed, AOFAS score were applied to evaluate clinical efficacy.

RESULTSAll patients were followed up from 13 to 24 months with an average of 20.5 months. All incisions were healed at stage I, and fractures obtained healing,the time of fracture healing ranged from 12 to 21 weeks with an average of 15.2 weeks. No incision infection, neurovascular injury, bone ununion and fracture deformity were found after operation. Postoperative AOFAS score was 92.0 ± 10.2, and 14 cases got excellent results, 2 good and 1 moderate.

CONCLUSIONPosterior pilon fracture through posterolateral approach could obtain effective reduction, stable fixation. It is a safe, simple and effective operation for treating posterior Pilon fracture, and it is worth popularizing.

Adult ; Ankle Fractures ; surgery ; Ankle Joint ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

9.Expression and implications of human interleukin-32 in acute exacerbation with chronic obstructive pulmonary disease

Xingqi DENG ; Jinyan SHAO ; Wei GU ; Mei LIU ; Deshah CHENG ; Aiyong YU

Chinese Journal of General Practitioners 2012;11(3):195-198

Objective To measure the levels of human interleukin (IL)-32 in the serum and induced sputum of patients with chronic obstructive pulmonary disease (COPD) and investigate the possible roles of IL-32 in COPD.Methods Sixty patients with acute exacerbation of COPD ( AECOPD),60 patients with stable COPD,and 30 healthy subjects were recruited.The concentrations of IL-8,tumor necrosis factor alpha (TNF-α),and IL-32 in serum and induced sputum were measured by enzyme-linked immunosorbent assay (ELISA).The correlations among IL-32,IL-8,TNF-α,and lung functions were investigated. The data were analyzed using a statistical software package (SPSS 13.0).Variables were compared with one-way ANOVA,and correlations among variables were analyzed using Pearson's correlation coefficient or Spearman's correlation coefficient.Results The serum IL-32 level was significantly higher in AECOPD patients [(175 ± 88) ng/L] than in healthy subjects [ (59 ± 21 ) ng/L] and in stable COPD patients [ (89 ± 34) ng/L] (P ＜ 0.05) ; the serum IL-32 level was also significantly higher in stable COPD patients than in healthy subjects (P ＜ 0.05).The sputum IL-32 level was significantly higher in AECOPD patients [ ( 163 ± 117) ng/L] than in healthy subjects [ ( 75 ± 38 ) ng/L] and stable COPD patients [ ( 108 ± 63 )ng/L] (P ＜0.05); the sputum IL-32 level was also significantly higher in stable COPD patients than in healthy subjects ( P ＜ 0.05 ).The sputum IL-32 level in AECOPD patients was positively correlated with the sputum IL-8 and TNF-α levels (r =0.49 and 0.53,respectively) (P ＜0.01 ).The sputum IL-32 level in AECOPD patients was negatively correlated with FEV1 predicted values,FEV1/FVC,and PaO2 (r =-0.44to -0.33) (P ＜ 0.01 ).The serum IL-32 level in AECOPD patients was positively correlated with the serum IL-8 and TNF-o levels (r =0.45 and 0.61,respectively) (P ＜ 0.01 ).The serum IL-32 level in AECOPD patients was negatively correlated with FEV1 predicted values,FEV1/FVC,and PaO2 (r =-0.46to - 0.29) ( P ＜ 0.01 ).Conclusions IL-32 may be involved in the pathogenesis of airway inflammation in COPD.IL-32 may be a useful marker of acute exacerbation of COPD.