Hyperuricemia as an independent risk factor for achilles tendon rupture in male: a case-control study.

OBJECTIVE: To study the correlation between achilles tendon rupture (ATR) and hyperuricemia, also verify the known risk factors for ATR. METHODS: A retrospective review of 488 subjects was performed (182 with Achilles tendon rupture, 306 controls with ankle sprains). Demographic variables and risk factors for rupture were tabulated and compared. The baseline data and related indicators were compared, and the risk factors of ATR were analyzed by constructing a binary logistic regression model. RESULTS: Univariate logistic analysis showed that BMI, smoking, and hyperuricemia were risk factors for the development of ATR (OR = 1.65, 95%CI 1.13-2.42, P = 0.01; OR = 1.47, 95%CI 1.00-2.24, P < 0.05; OR = 2.85, 95%CI 1.84-4.42, P < 0.01). Multifactorial analysis showed that BMI ≥ 25 kg/m2, smoking, and hyperuricemia were independent risk factors for the development of ATR (OR = 1.66, 95%CI 1.11-2.49, P = 0.01; OR = 2.15, 95%CI 1.28-3.60, P < 0.01; OR = 3.06, 95%CI 1.92-4.89, P < 0.01). Among the blood biochemical indicators, total cholesterol (TC) and uric acid (UA) were independent risk factors for the occurrence of ATR (OR = 1.54, 95% CI 1.12-2.12, P = 0.01; OR = 1.01, 95% CI 1.01-1.01, P < 0.01). CONCLUSION: Our study confirmed that, as in previous results, higher BMI, smoking, and total cholesterol are risk factors for ATR, Hyperuricemia may contribute to the development of ATR, and adjunctive tests for TC and UA in the blood biochemistry may be helpful in predicting the risk of ATR.

Fracture gap of the lateral malleolus via posterolateral approach: Improved visualization of the posterior malleolus fracture.

The treatment of posterior malleolar fractures is a popular issue. Anatomic reduction of posterior malleolar fractures is critical for re-establishing the stability of the ankle mortise and ligamentous union after trauma. Inappropriate treatment ultimately leads to poorer functional outcomes and lower quality of life. Open reduction and internal fixation through a posterolateral approach are preferred over indirect reduction and anterior-posterior screw fixation. Although the posterolateral approach, which is more common and direct, provides good exposure to the fracture site, it has some limitations. In this report, we describe the posterolateral approach through the lateral ankle fracture gap for the treatment of posterior ankle fractures. Moreover, we discuss the indications, benefits, and limitations of this approach.

Risk Factors for Dupuytren's Contracture: A Case-Control Study.

Objective: To study the risk factors of Dupuytren's contracture (DC) and to provide a reference for the clinical prevention and treatment of DC. Methods: The clinical data of 21 DC patients treated with surgery in Qilu Hospital of Shandong University (Qingdao) from March 2014 to January 2022 were collected. During the same period, 31 subjects who were admitted to the hospital for treatment of finger numbness, difficulty in movement, and other reasons were selected as the control group, and the clinical data of the control group were collected. A case-control study was used to analyze the risk factors for DC. The receiver operating curve (ROC) was used to analyze the efficacy of blood biochemical indexes and coagulation-related indexes in predicting the occurrence of DC. Results: Multivariate logistic regression analysis showed that male and diabetes were independent risk factors for the occurrence of DC (HR = 19.69, 95%CI: 3.12-124.19, P = 0.002; HR = 7.61, 95%CI: 1.25-46.47, P = 0.03). The results of the ROC analysis showed that the area under the curve (AUC) for the DC predicted by cystatin C was 0.7565 (95%CI: 0.6203-0.8928, P = 0.0018), and the AUC for the DC predicted by blood chloride level was 0.8121 (95%CI: 0.6880-0.9362, P = 0.0002), the AUC for the DC predicted by fibrinogen was 0.7796 (95%CI: 0.6439-0.9152, P = 0.0007), the AUC for the DC predicted by D-dimer level was 0.8740 (95%CI: 0.7812-0.9669, P < 0.0001), and the AUC for the DC predicted by thrombin time was 0.7803 (95%CI: 0.6411-0.9196, P = 0.0007). The AUC for the DC predicted by the combined detection of cystatin C, blood chloride, fibrinogen, D-dimer, and thrombin time was 0.9441 (95%CI: 0.8926-0.9957, P < 0.001). Conclusion: Male and diabetes are independent risk factors for the occurrence of DC. Combined detection of cystatin C, blood chloride, fibrinogen, D-dimer, and thrombin time has a certain value in predicting the occurrence of DC.