OBJECTIVE: To investigate the characteristics of forensic clinical identification on common peroneal nerve injury in traffic accident. METHODS: Eight cases of common peroneal nerve injury in traffic accidents were analyzed, including general condition of the wounded, the way of injury, the imaging results, the EMG results, and the degree of injury, etc. RESULTS: In 8 cases, 2 cases of complete common peroneal nerve injury were determined to grade 9 (disability degree) and 6 cases of partial common peroneal nerve injury were determined to grade 10 (disability degree). CONCLUSION By comparison, the disability degree of complete common peroneal nerve injury is higher than that of partial common peroneal nerve injury. The forensic clinical identification of common peroneal nerve should be made with synthetical consideration of medical history, symptoms, and auxiliary examinations.
Accidents, Traffic ; Adult ; Age Distribution ; Disability Evaluation ; Expert Testimony ; Female ; Fibula/injuries* ; Fractures, Bone/physiopathology* ; Humans ; Leg Injuries/physiopathology* ; Male ; Middle Aged ; Peroneal Nerve/physiopathology* ; Peroneal Neuropathies/physiopathology* ; Radiography ; Trauma Severity Indices

BACKGROUND: We wanted to report on stress fracture of the proximal fibula and to suggest the pathomechanism of this fracture. METHODS: Between April 2004 through April 2005, the military recruits who complained of leg pain during the 6 weeks basic training in the Republic of Korea Marine Corps education and training group were evaluated according to their clinical manifestations and plain radiographs. RESULTS: Twelve recruits of 635 recruits who complained leg pain were diagnosed as having fibular stress fracture. Eleven cases (10 recruits) appeared at the junction of the proximal and middle 1/3 of the fibula and 2 cases (2 recruits) were in the middle 1/3 of the fibula, as assessed radiologically. Tenderness was the most reliable clinical manifestation. All the fractures occurred after repetitive walking or jumping in a squatting position. Conservative treatments that included bed rest, immobilization and non-steroidal anti-inflammatory drugs administration according to the symptom severity were satisfactory. CONCLUSIONS: Proximal fibular stress fracture is not rare in military recruits. The shearing force on the proximal fibula and the repetitive stress by walking or jumping in a squatting position contribute to the stress fracture of the proximal fibula.
Fibula/*injuries/radiography ; Fractures, Stress/*etiology/radiography ; Humans ; Male ; *Military Personnel ; Physical Exertion ; Republic of Korea ; Resistance Training/adverse effects ; Young Adult

OBJECTIVETo explore a new method for the treatment of ankle joint fractures, and to evaluate its therapeutic effects.

METHODSAmong 42 patients with ankle joint fractures, 34 patients had complete data for analysis, 19 patients were male and 15 patients were female, ranging in age from 21 to 61 years, with an average of 37 years. According to Weber-AO classification, there are 28 patients of B-type and 6 patients of C-type. The Baird and Jackson Rating System was used to evaluate therapeutic effects, and the relationship between the final function and fracture type, fracture fixation and, the time of functional training after operation were analyzed. Thirty-four patients with ankle joint fractures of B and C type were treated with internal fixation of posterior fibula plate to avoid injury of articular facet by the nails. The patients combined with the fractures of posterior malleolus were treated with fixation of both fibula and posterior malleolus through the same incision.

RESULTSAll the patients were followed up ranging from 1.2 to 3.2 years, with an average of 1.8 years. According to evaluation criterion, 24 patients got an excellent result, 6 good and 4 fair, the excellent and good rate was 88.2%.

CONCLUSIONThe internal fixation of posterior fibula plate, as a treatment for ankle joint fractures, successfully avoids the injury of articular facet by the nails. Not only does it enhance the pullout strength of the nails, but it is able to treat the fracture of lateral malleolus and posterior malleolus with a single incision. It has provided a new way for the treatment of ankle fractures.

Adult ; Ankle Injuries ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Bone Plates ; Female ; Fibula ; diagnostic imaging ; physiopathology ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Recovery of Function ; Treatment Outcome

OBJECTIVETo study the influence of separation of distal tibiofibular syndesmosis on ankle joint and to compare various operative methods so as to find suitable stabilization for separated distal tibiofibular syndesmosis.

METHODSFrom July 1997 to July 2002, we treated 87 patients (64 males and 23 females, aged 18-54 years) with separation of distal tibiofibular syndesmosis, among whom, 79 were combined with fracture of malleolus. Manipulative reduction, internal fixation with cancellous screws and external fixation with plaster support were performed on 37 patients, fixation with plate and screws for fibular fracture and fixation with cancellous screws for distal tibiofibular syndesmosis on 34 patients, and repair of the distal tibiofibular ligaments with tendon of peroneus longus, reduction of the separated distal tibiofibular syndesmosis, and fixation with cancellous screws on 16 patients. The ankle joint had been dorsiflexed for 30 degrees when the distal tibiofibular syndesmosis was fixed with cancellous screws. And the cancellous screws were taken out at 8-10 weeks after operation.

RESULTSThese patients were followed up for at least two years. The curative effects were assessed according to the complaints of the patients and the contour, function and radiogram of the ankle joint: excellent in 55 patients (63%), good in 18 patients (21%), and fair in 14 patients (16%). Separation of distal tibiofibular syndesmosis recurred in 2 patients, who underwent a reoperation for repairing the distal tibiofibular ligaments with tendon of peroneus longus and recovered. One cancellous screw was broken off. No necrosis developed in the anterior skin of the ankle mortise.

CONCLUSIONSSeparation of distal tibiofibular syndesmosis can be treated with various reasonable operations. Repair with tendon of the peroneus longus can get excellent outcomes for complete separation of the distal tibiofibular syndesmosis.

Adolescent ; Adult ; Ankle Injuries ; diagnostic imaging ; physiopathology ; surgery ; Bone Screws ; Casts, Surgical ; Female ; Fibula ; injuries ; physiopathology ; Follow-Up Studies ; Humans ; Ligaments, Articular ; injuries ; physiopathology ; Male ; Middle Aged ; Radiography ; Tibia ; injuries ; physiopathology ; Treatment Outcome