Objective To review the progress in the diagnosis and treatment of distal tibiofibular syndesmosisinjury. Methods Different kinds of documents were widely collected, current developments of the diagnosis and treatmentof distal tibiofibular syndesmosis injury were summarized. Results The disease history (damage mechanism), cl inicalexamination, and imaging examination (X-ray, CT scan, and MRI) can assist the diagnosis of distal tibiofibular syndesmosisinjury. Patients with unstable distal tibiofibular syndesmosis injury needs active surgery treatment, and the princi ple isanatomical reduction and fixation so as to avoid the instabil ity of the ankle joint, long-term chronic pain, and traumaticarthritis. Conclusion The diagnosis of distal tibiofibular syndesmosis injury is still lack of specific quantitative parameters, socl inical study for large sample is needed to explicit the effectiveness.
Objective To review the progress in the diagnosis and treatment of tarsal coal ition. Methods Recent l iterature concerning the diagnosis and treatment of tarsal coal ition was reviewed. Results Tarsal coal ition is a bridge between the tarsal bones of the foot. The most common types are talocalcaneal and calcaneonavicular coal itions. Calcaneonavicular coal itions can be diagnosed with an oblique radiograph of the hindfoot. Most talocalcaneal coal itions require computer tomography for diagnostic confirmation. Magnetic resonance imaging may be useful for diagnoses of cartilaginous andfibrous coal ition. Casting is the usual initial treatment for the symptomatic individual. For patients with treatment failure and no degenerative changes, resection of the coal ition can be performed with good results. Isolated subtalar fusion may be performed for patients with failure of talocalcaneal resections. For patients undergoing failure of subtalar fusions and calcaneonavicular resection, tri ple arthrodesis may be performed. During minimally invasive operation, operation indications should be strictly controlled. Conclusion The diagnosis method of tarsal coal ition is clear. The cl inical manifestation combined with imaging examination can improve the diagnosis rate. The surgical indication of tarsal coal ition remains controversial, the randomized prospective studies are still required.
Objective To review the progress in amputation technique of diabetic foot. Methods Recent l iterature concerning the amputation technique of diabetic foot was reviewed and analyzed. Results According to the different levels of the amputation, the diabetic foot’s amputation can be classified as major amputation and minor amputation, and differentkinds of methods can derive from these styles. Different factors should be considered when the style and method of amputation are chosen. Conclusion To the diabetic foot amputation, the general rule is to l imit the amputation level on the premise of the good cl inical effect. The health state, the region of the diabetic foot, the tissue perfusion, the susceptibil ity to infection in local tissue, and the abil ity of wound healing are important factors in selecting the styles and methods of diabetes-related amputations. Importance should be attached to the synthesis treatments of diabetes to prevent the higher level amputation.
Objective To review the progress in the diagnosis and treatment of chronic disorders of achilles tendon. Methods Recent l iterature concerning the diagnosis and treatment of chronic disorders of achilles tendon was revi ewed. Results Ultrasonography and MRI were commonly used for diagnoses, and MRI could provide extensive informationfor the choice of therapy protocol. Nonsurgical therapy was the mainstay of treatment for most patients with overuse syndromes, surgical techniques for patients due to no effect in the conservative treatment and with chronic rupture, the cl inical treatment project should be determined based on the cl inical evaluation. Conclusion The surgical indication of chronic disorders of achilles tendon remains controversial, the long-term results of each treatment method are unknown, the randomized prospective studies are still required.
Objective To introduce the basic research and cl inical appl ication of stem cells transplantation for treating diabetic foot. Methods The recent original articles about the stem cells transplantation for treating diabetic foot were extensively reviewed. Results Transplanted different stem cells in diabetic foot could enhanced ulceration heal ing in certain conditions, increase neovascularization and avoid amputation. Conclusion Stem cells transplantation for treating diabeticfoot may be a future approach．
Objective To review the application progress of minimally invasive technique in the treatment of calcaneus fractures and to analyze the advantages and disadvantages of each method as well as to predict the trend of development in the field. Methods Domestic and abroad literature concerning the minimally invasive technique applied in calcaneus fractures in recent years was reviewed extensively and analyzed thoroughly. Results There are both advantages and limitations of each minimally invasive technique including percutaneous reduction and fixation, limited incision, external fixator, arthroscopic assisted reduction, and balloon expansion reduction. But every technique is developing rapidly and becoming more and more effective. Conclusion A variety of minimally invasive technique can not only be used independently but also can be applied jointly to complement one another. It needs further study how to improve the effectiveness and expand the indications. And the theoretical basis of evidence-based medicine needs to be provided more.
Objective To review the appl ication progress of subtalar arthroereisis for the correction of pediatric flatfoot in children and to analyze the problems at present as well as to predict the trend of development in the field. Methods Domestic and abroad l iterature concerning the methods of subtalar arthroereisis applied in pediatric flatfoot in recent years was reviewed extensively and thoroughly analyzed. Results Subtalar arthroereisis has proved to yield good results for correction of the flatfoot in children. In addition to the advantages of subtalar arthroereisis for pediatric flatfoot treatment(simple procedure, mature technology, and less compl ications), it allows further surgery if needed. Conclusion Subtalararthroereisis is a simple and effective way to treat flatfoot in children, however, its biomechanics mechanism and managements to complication need to explore further.
Objective To explore the operative methods and effectiveness of open reduction and internal fixation for Bosworth fracture. Methods Between January 2005 and January 2012, 6 patients with Bosworth fractures caused by sprain were treated. There were 4 males and 2 females with an average age of 45.8 years (range, 24-73 years). The time from injury to operation was 1-5 days (mean, 1.8 days). They were all closed fractures. According to Lauge-Hansen classification, 6 cases were classified as supination-external rotation type. The surgical treatments included open reduction and internal fixation by plate and screws. Results Infection occurred in 1 case and was cured after dressing changing; primary healing of incision was obtained in the other 5 cases. Six patients were followed up 15 months on average (range, 12-24 months). The X-ray films showed fracture healing in all cases, with an average healing time of 9.5 weeks (range, 8-13 weeks). No loosening or breaking of internal fixator was observed during follow-up. The average full load-walking time was 12 weeks (range, 10-17 weeks). According to the ankle and hindfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS), the average score was 89.5 (range, 81-94). Conclusion For Bosworth fractures, good results can be achieved by early diagnosis, open reduction and internal fixation.