[Deltoid ligament augmentation and repairing in ankle fracture associated with deltoid ligament injury and syndesmosis diastasis].

Objective: To evaluate the outcome of the deep component augmentation and superficial component repairing and syndesmosis screw fixation in treating ankle fracture associated with deltoid ligament injury and syndesmosis diastasis. Methods: From January 2014 to December 2017, 16 patients with ankle fracture combined with deltoid ligament injury and syndesmosis diastasis were treated with the deep component augmentation and superficial component repairing in Beijing Jishuitan Hospital.Of the patients, 13 were males and 3 were females, with an average age of (38±10) years (21-57 years). Nine cases were athletic injuries, 4 cases were daily-life injuries and 3 cases were traffic injuries.According to the Weber classification, 6 cases were type B, 10 cases were type C. According to the Lauge-Hansen classification, 6 cases were supination external rotation Ⅳ injury, 9 cases were pronation external rotation Ⅳ injury, 1 case was pronation abduction Ⅲ injury.The surgical treatment method was rigid fixation of the lateral malleolus and deep deltoid ligament augamentation instead of syndesmosis screw fixation.The effect of the surgical method was observed. Results: The average follow up was (24±12) months (6-40 months). The mean degree of dorsiflexion was 17.8°±6.8° (5°-30°), with 3.8°±6.0° (0°-15°) less than that in normal side, the mean degree of plantar flexion was 46.9°±7.9°, with 1.9°±3.9° (0°-10°) less than that in normal side.The mean Philips and Schwartz score was 96.8±5.1 (82-100), the American Orthopaedic Foot and Ankle Society (AOFAS) Score was 97.4±4.6 (84-100). Conclusion: In the treatment of ankle fracture associated with deltoid ligament injury and syndesmosis diastasis, the deep component augmentation and superficial component repairing and proper rehabilitation can benefit the functional recovery.

Relapses in leprosy patients treated with rifampicin plus dapsone after varying periods of dapsone monotherapy.

Leprosy patients treated formerly with dapsone monotherapy followed by combined therapy with rifampicin plus dapsone were surveyed for relapse and rifampicin resistance. The relapse rate was significantly low for the 482 multibacillary (MB) patients receiving > 12 months combined therapy compared with the 49 MB cases receiving < 12 months of combined therapy. The relapse rate was related to the duration of dapsone monotherapy prior to combined therapy. The difference in relapse rate in 247 paucibacillary (PB) patients following > 12 months combined therapy was also of significance, compared with the 66 PB cases who had received < 12 months combined therapy. Five strains of M. leprae isolated from relapsed patients were sensitive to rifampicin by mouse foot-pad test and all relapsed patients responded favourably to fixed duration MDT regimen for MB cases.

Long-term effect of leprosy control in two Prefectures of China, 1955-1993.

In Weifang Prefecture, Shandong Province, and Wenshan Prefecture, Yunnan Province of China, leprosy was highly prevalent in the 1950s. Due to differences in geographical conditions and socioeconomic development, the decline in leprosy prevalence between 1955 and 1993 was 99.5% (10.1 to 0.05/10,000) in Weifang and 93.9% (19.7 to 1.2/10,000) in Wenshan. The decrease in the detection rate was 99.9% (35.2 to 0.05/10,000) in Weifang and 91.7% (69.9 to 5.8/10,000) in Wenshan. The decrease was more apparent in these two prefectures since the implementation of multidrug therapy (MDT) in 1986. Findings such as specific detection rates by age, sex and type, as well as the multibacillary, child, and deformity rates of patients detected since 1980 were studied. Using the detection and prevalence rates between 1980 and 1993, the number of patients until the year 2000 is extrapolated for these two prefectures.

[Long-term effect of leprosy control in both highly endemic prefectures, Weifang of Shandong and Wenshan of Yunnan].

The long-term effect of leprosy control was studied in two prefectures of different geographical conditions and socio-economic status. During 1955-1985, the incidence rate in Weifang of Shandong decreased by 94.5% (9.1-0.5/10,000) and became evident after the introduction of MDT in 1986 (0.04/10,000, 1993). In Wenshan of Yunnan, however, it remained at about 20/10,000 before 1980. After the introduction of rifampin plus dapsone in 1979 and fixed duration MDT in 1986, it decreased by 94% (20-1.2/10,000), whereas the detection rate remained constant (+5/100,000). In comparison with the features of new patients detected since 1980, we noted a steady increase of MB rate and voluntary reporting, and a decrease of deformity rate, in the last 8 years in Weifang. It is estimated that by the year 2000 Weifang may have the detection rate of 0.001260/10 thousand and the incidence rate of 0/00757/10 thousand in contrast to the detection rate of 0.2980/10 thousand and the incidence rate of 0.316/10 thousand in Wenshan.