Objective To study the operative procedure and the effectiveness of arthroscopic therapy for ankle joint impingement syndrome after operation of ankle joint fracture dislocation. Methods Between March 2008 and April 2010, 38 patients with ankle joint impingement syndrome after operation of ankle joint fracture dislocation were treated. Among them, therewere 28 males and 10 females with an average age of 28 years (range, 18 to 42 years). The time from internal fixation to admission was 12-16 months (mean, 13.8 months). There were pressing pain in anterolateral and anterior ankle. The dorsal extension ranged from — 20 to — 5° (mean, —10.6°), and the palmar flexion was 30-40° (mean, 35.5°). The total score was 48.32 ± 9.24 and the pain score was 7.26 ± 1.22 before operation according to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system. The X-ray films showed osteophyte formation in anterior tibia and talus; MRI showed cartilage injury in 22 cases. Arthroscopic intervention included removing osteophytes, debriding fabric scars and synovial membrane tissues, and removing osteochondral fragments. Arthroscopic microfracture technique was used in 22 patients with cartilage injury. Results All incisions healed primarily. Thirty-eight cases were followed up 10-26 months (mean, 16 months). At last follow-up, 26 patients had normal range of motion (ROM); the dorsal extension was 15-25° (mean, 19.6°) and the palmar flexion was 35-45° (mean, 40.7°). Eight patients had mild l imited ROM; the dorsal extension was 5-15° (mean, 7.2°) and the palmar flexion was 35-45° (mean, 39.5°). Four patients had mild l imited ROM and pain in posterior portion of the ankle after a long walking (3-4 hours); the dorsal extension was 0-5° (mean, 2.6°) and the palmar flexion was 35-40° (mean, 37.5°). The total score was 89.45 ± 9.55 and the pain score was 1.42 ± 1.26 after operation according to AOFAS ankle and hindfoot score system, showing significant differences when compared with preoperative ones (t=21.962, P=0.000; t=16.762, P=0.000). Conclusion Arthroscopic treatment of ankle joint impingement syndrome after operation of ankle joint fracture dislocation is an effective, simple, and safe method.
Objective To study effects of enteral immunonutrition and econutrition on intestinal mucosa barrier function in wounded rats. Methods Forty Wistar rats were randomly divided into four groups, with ten rats in each group 〔ie.control group, enteral nutrition (EN) group, enteral immunonutrition (EIN) group and enteral econutrition (EEN) group〕. After gastrostomy, rats in each group were treated with the isocaloric and isonitrogenous nutritional formulas for 7 days, respectively. The morphology of ileum membrane was studied, and the quantities of IgA+, CD3+, CD4+ and CD8+ cells (each HP) of ileum membrane were determined. Results The villus height, crypt depth, mucosal thickness (except EN group) and villus surface area of ileum were increased in EN, EIN and EEN group compared with control group (P＜0.05), but there was no significant difference among the former three groups (Pgt;0.05). The numbers of IgA+, CD3+, CD4+ and CD8+ cells were increased in EN, EIN and EEN group compared with control group (P＜0.05), and those numbers in EN group were lower than those in EIN and EEN group (P＜0.05). Conclusion EIN and EEN may improve intestine mechanical barrier function and promote restoration of small intestine mucous membrane barrier function in rats. EIN and EEN also improve intestine immune barrier function and strengthen its immune function.