Objective:To compare our self-designed elastic syndesmosis hook plate (ESHP) and suture-button technique in treatment of injury to the distal tibiofibular syndesmosis.Methods:A retrospective study was conducted of the 53 patients who had been treated at Military Orthopaedic Center, 909 Hospital of Joint Service Support Force of PLA for ankle fractures complicated with syndesmosis injury by ESHP or suture-button technique from March 2013 to March 2017. Of them, 28 were treated by ESHP (ESHP group: 15 males and 13 females aged from 26 to 60 years) and 25 by suture-button technique (suture-button group: 14 males and 11 females aged from 24 to 59 years). The 2 groups were compared in terms of syndesmosis fixation time, postoperative incision bleeding, hospital stay, and ankle dorsiflexion and plantarflexion and ankle function by Baird-Jackson scoring at 3, 6, 12 months after surgery. Postoperative complications were observed.Results:The 2 groups were comparable because there was no statistically significant deference in general data between the 2 groups ( P>0.05). Surgery went on uneventfully in all the patients. The syndesmosis fixation time [(9.7±2.2) min] and postoperative incision bleeding [(49.3±10.4) mL] in the ESHP group were significantly less than in the suture-button group [(16.2±1.4) min and (62.4±6.3) mL] ( P<0.05); the maximum plantar flexion (29.9°±1.3°) and Baird-Jackson scores (87.2±2.9) at 3 months after surgery in the ESHP group were significantly greater than in the suture-button group (22.8°±1.3° and 78.7±4.1) ( P<0.05). There were no significant differences between the 2 groups in hospital stay, maximum plantar flexion at postoperative 6 or 12 months, maximum dorsiflexion at postoperative 3, 6 or 12 months, or Baird-Jackson scores at postoperative 6 or 12 months (all P>0.05). This cohort was followed up for 12 to 14 months (average, 12.5 months). All fractures united during follow-up and all the implants were removed around postoperative 12 months. Follow-up within 12 months observed internal fixation failure caused by metal fatigue in one case in the ESHP group, and internal fixation irritation in one case, internal fixation failure in 2 cases and internal fixation sinking and osteolysis in one case in the suture-button group. Conclusion:Compared with the suture-button technique, treatment of injury to the distal tibiofibular syndesmosis with ESHP may lead to shorter fixation time, less postoperative bleeding and complications, and faster functional recovery of the ankle.

Objective To investigate the value of MSCTA in diagnosing the origin of abdominal ectopic ovarian tumor. Methods Twenty-eight patients with 30 ectopic ovarian tumors that mainly manifested as abdominal lumps were evaluated with MSCTA retrospectively. Vascular three-dimensional reconstruction by VR based on add vessel (AV) and MIP was performed for all these patients after MSCT scanning.The origin of these tumors was judged by the feeding artery and ovarian vascular pedicle (OVP) sign.The result was compared with surgical findings.Results The maximum diameter of the 30 ectopic ovarian tumors ranged from 5.2 to 19.5 cm with an average of 9.3 cm.Of the 30 ectopic ovarian tumors, the ramus ovaricus arteriae uterinae (ROAU) and ovarian artery (OA) were demonstrated in 96.7% (29/30) and 56.7% (17/30) respectively.The feeding artery of the tumor was ROAU (29 cases) or OA (1 case), and OA participated in feeding the tumor in 16 cases.The accuracy rate of diagnosis of ectopic ovarian tumors according to the feeding artery was 100% (30/30).According to OVP the accuracy rate was 85.2% (23/27) with an incidence of 76.7% (23/30).Conclusion By showing ROAU and OA as the feeding artery and ovarian vein (OV) as the draining vein, MSCTA can accurately diagnose ectopic ovary tumors in the abdomen.