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METHODSFrom October 1988 to September 2005,34 patients with shearing-type or comminuted talar body fractures were followed up. There were 19 males and 15 females ranged from 13 to 55 years (averaged 28.8 years). The disease course ranged from 3 to 14 days (averaged 6.0 days). Ten patients with a displacement of no more than 3 mm were treated with plastic cast. Eighteen patients were treated with open reduction and internal fixation, 6 patients were treated with joint fusion. The assessment of clinical efforts depend on patients' ache, active range of the joint and limp.

RESULTSThe mean follow up was 5.04 years (ranged from 3 to 19 years). All the patients were healed. The clinical outcomes were evaluated according to Hawkins evaluation score in which ache, active range of the joint and limp was respectively acssessed. There were 6 patients reached an excellent result, 9 good, 11 fair and 8 poor. Fifteen patients had osteonecrosis, 18 patients had traumatic arthritis of ankle joint, and 14 patients had traumatic arthritis of subtalar joint.

CONCLUSIONPatients whose displacement of fracture is not more than 3 mm should be treated with plastic cast. Operation and internal fixation should be performed in patients whose displacement of fracture is more than 3 mm after close reduction. Joint fusion should be performed in patients whose talar body fracture is comminuted severely and the surface of joint can not be repaired. The patients of talar body scissored fracture or comminuted fracture has bad prognosis.

Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Closed ; surgery ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Talus ; injuries ; surgery ; Young Adult

8.Simultaneous repair of complete cleft lip and palatein infancy-preliminary observation (271 cases report).

Xihe DENG ; Ningxin CHENG ; Hongtao WANG ; Jiayu ZHAI ; Yingqiu CUI ; Hui DENG ; Xia PEI ; Jie JIANG ; Fan LI

Chinese Journal of Plastic Surgery 2002;18(4):211-213

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.