Effect of chronic ankle instability on lower extremity kinematics,dynamic postural stability,and muscle activity during unilateral jump-landing tasks: A systematic review and meta-analysis

ObjectiveTo determine if individuals with chronic ankle instability (CAI) demonstrate altered landing kinematics, muscle activity, and impaired dynamic postural stability during a unilateral jump-landing task.Methods21 studies were included from PubMed, MEDLINE, Embase and CINAHL searched on September 26, 2021. Mean differences in joint angles and muscle activity between CAI and controls were analysed as continuous variables and pooled using a random-effects model to obtain standardised mean differences and 95% confidence intervals. Dynamic postural stability measured using time to stabilisation (TTS) was assessed qualitatively.ResultsWe found greater plantarflexion (pooled SMD = 0.33, 95%CI [0.02,0.65]), reduced knee flexion (pooled SMD = −0.67, 95%CI [−0.97, −0.37]), and reduced hip flexion (pooled SMD = −0.52, 95%CI [−0.96, −0.07]) in CAI after landing. Regarding muscle activity, we observed reduced peroneus longus muscle activation (pooled SMD = −0.77, 95% CI [−1.17, −0.36]) in CAI prior to landing.ConclusionOur study provides preliminary evidence of altered landing kinematics in the sagittal plane and reduced peroneus muscle activity in CAI during a dynamic jump-landing task. These results may have clinical implications in the development of more effective and targeted rehabilitation programmes for patients with CAI.     

用颈长肌重建预防颈前路植骨块滑脱的临床应用

目的:探讨颈长肌重建对颈椎前路手术并发症的预防作用。方法:将颈椎病确诊病例分为实验组126例和对照组128例。对照组病例采用颈椎前路减压、植骨和/或钢板内固定术。实验组病例在完成上述手术之后,利用两种方法使颈长肌瓣重建植骨块或钢板表面。两组病例术后均获得随访,并将两组术后疗效及手术并发症的随访结果进行统计学分析。结果:两组术后随访0.5~6年,平均3.5年。根据Odom评分标准,对两组术后临床疗效进行评价,经统计学分析,P>0.05,说明两组术后疗效无明显差异。而对两组病例术后并发症的统计学分析,P<0.05,两组有统计学意义,表明颈长肌重建可以减少术后并发症的发生。结论:颈长肌重建是预防颈椎前路手术并发症的一种有效方法。     

腓骨长肌转位修复陈旧性跟腱断裂

陈旧性跟腱断裂手术修复较困难，术后效果与新鲜断裂相比较差，且重建的跟腱由于瘢痕增生而粗大，踝关节活动受限。作者于2000年8月-2003年11月利用腓骨长肌转位重建跟腱术19例，取得满意效果。     

《解剖学报》投稿须知的补充

《解剖学报》投稿须知的补充８．废弃体积克分子浓度“Ｍ”。换算：１Ｍ＝１ｍｏｌ／Ｌｍ＝１ｋｍｏｌ／ｍ３废弃当量浓度“Ｎ”。换算：１Ｎ＝（１ｍｏｌ／Ｌ）÷离子价数９．暂时可与ＳＩ（国际单位制）并用的非法定计量单位如埃（Ａ）和居（里）（Ｃｉ）请换算成；１Ａ...     

Effect of diffusion distance on measurement of rat skeletal muscle glucose transport in vitro

The relationships between muscle size, diffusion distance, and glucose uptake were studied using the Type II b epitrochlearis (13 ± 1 mg intact), Type I soleus (25± 1 mg), and mixed Type II a/II b extensor digitorum longus (25 ± 1 mg) from 60–70 g rats. Using intact muscles, the relative rates of 3-O-methyl-glucose uptake in response to 2 mUml^-1 insulin were soleus = epitrochlearis > extensor digitorum longus, a finding inconsistent with the fibre-type compositions and the relative GLUT-4 protein levels (soleus > extensor digitorum longus > epitrochlearis). To test whether these results were influenced by substrate diffusion limitations in the tubular muscles, soleus and extensor digitorum longus were split longitudinally from tendon to tendon into strips of comparable size (13 ± 1 mg) to the epitrochlearis. Insulin-stimulated rates of 3-O-methyl-glucose uptake were significantly enhanced in the split soleus (+120%) and split extensor digitorum longus (+200%), but not in the epitrochlearis, with the relative rates being soleus > extensor digitorum longus > epitrochlearis. Diffusion distances of the split soleus and extensor digitorum longus, as reflected by [¹⁴C]mannitol space equilibration time, were markedly enhanced (by at least 50%) relative to the intact muscles, and were comparable to that of the epitrochlearis. These results indicate that when muscles of different size and/or shape are used for in vitro measurement of glucose transport, the muscle preparations used must have similar diffusion distances for physiologically meaningful comparisons to be made.     

Extensor hallucis longus distal tenotomy for spasticity in a patient with interphalangeal joint hyperextension after stroke

BackgroundThe extension deformity of the interphalangeal (IP) joint of the hallux is a rare focal clinical entity usually detected in patients with no underlying pathology. It may be due to extensor hallucis longus (EHL) overactivity, although it has not been previously reported in patients with neurological disorders. The lesion should be differentiated from the persistent hyperextension of the great toe at the metatarsophalangeal (MTP) joint. Although MTP hyperextension of the hallux due to hypertonia of the EHL is a typical sequel of stroke, it has also been detected in a wide variety of disorders.Materials and MethodsA patient with right hemiparesis following stroke, which had an almost complete functional recovery, is presented. She was disabled by focal spasticity of the EHL, leading to persistent hyperextension of the IP joint of the hallux. The deformity appeared on the long-term follow-up, on both sides within a 3-year period. It was treated with bilateral percutaneous distal EHL tenotomy. On the left side, a percutaneous dorsal IP joint capsulotomy was additionally performed.Results and ConclusionA complete reduction of the deformity was achieved on both sides with functional rehabilitation. It is assumed that EHL hyperactivity following stroke in our patient was complicated by IP instead of MTP extension deformity, due to the coexistent flexor hallucis longus weakness. Bilateral distal EHL tenotomy, associated with percutaneous dorsal IP joint capsulotomy on the left side, provided satisfactory long-term results.     

Reprint: Sehnentransfers in der Vorfußchirurgie

The aim of the current forefoot surgery is to retain function or to restore lost function. In contrast, in the past resection arthroplasty or amputation of the lesser toes were common. Included in the repertoire of every specialist are different operation techniques especially the tendon surgery, in addition to experience in indication and rehabilitation. It is important, that the focus during history taking, clinical examination and choice of treatment should not only be on the forefoot but also on the axis of the leg and the hindfoot position and function. As an example, the recruitment of the extensor digitorum longus – meaning the excessive support by the toe extension for forefoot extension – over time results in hammer toes. In some cases this excessive recruitment is the result of the rupture of the tibialis anterior tendon. Therefore, one should address the cause and repair the tibialis anterior tendon by suture and/or augmentation and not operate on the hammer toes in isolation.     

The role of post-operative radiographs in predicting risk of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures – A case control study

Background and aimVolar plating of distal radius fractures is one of the common procedures performed in trauma surgery. Flexor pollicis longus (FPL) rupture has been described as complication following volar plating of distal radius fractures.The aim of our study was to investigate the possible relation between parameters measured on post-operative radiographs and the occurrence of FPL ruptures.Materials and methodsThis was a case control study. The post-operative radiographs of 11 FPL rupture, and 22 non-FPL rupture patients were reviewed with respect to fracture reduction and plate position and the various parameters were calculated by five independent people.Logistic regression was used to examine the importance of the variables.ResultsWe identified two significant factors to predict FPL rupture after volar plating of distal radial fractures. These were radial tilt and plate distance from the joint line. The odds ratio of ruptures was 0.74 (95% CI 0.57–0.95) for every degree of radial tilt <25° and 0.50 (95% CI 0.28–0.88) for every millimetre that the distal end of the plate was away from the volar lip of the distal radius at the wrist joint.ConclusionPost-operative radiographs could help us predict FPL rupture after distal radius volar plating. The findings also highlight the need for good fracture reduction and thoughtful placement of the volar plate intraoperatively to minimise the risk of FPL tendon rupture.