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Orthop Surg ; 9(1): 49-53, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28276651


OBJECTIVE: To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture. METHODS: Thirty-three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (TAS), the tibiotalar tilt angle (TTA), the malleolar angle (MA), and the tibial lateral surface angle (TLS) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system. The Wilcoxon matched-pairs test was used to analyze the difference between the preoperative and the postoperative data. RESULTS: The mean follow-up was 36 months (range, 20-60 months). The mean age at the time of realignment surgery was 37.1 years (range, 18-62 years). Compared with preoperation, the TAS at the last follow-up showed a significant increase (88.50° ± 4.47° vs. 90.80° ± 3.49°, P = 0.0035); similar results were observed in TTA (1.62° ± 1.66° vs. 0.83° ± 0.90°, P < 0.01) and MA (82.30° ± 8.03° vs. 78.70° ± 4.76°, P = 0.005). At the last follow-up, the mean AOFAS score was significantly increased compared with the score at preoperation (44.5 ± 13.7 vs. 78.0 ± 8.9, P < 0.01). Significant differences in VAS scores were found at the last follow-up (6.76 ± 1.03 vs. 2.03 ± 1.21, P < 0.01). There was no significant difference in the Takakura grade between the preoperation and the last follow-up. One patient had increased talar tilt postsurgery; the postoperative talar tilt angle of this patient was 20°. One patient had progressive ankle osteoarthritis, and was treated by ankle joint distraction. CONCLUSIONS: Realignment surgery for a malunited ankle fracture can reduce pain, improve function, and delay ankle arthrodesis or total ankle replacement. Postoperative large talar tilt and advanced stages of ankle arthritis are the risk factors for the surgery.

Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Fraturas Mal-Unidas/cirurgia , Adolescente , Adulto , Fraturas do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/diagnóstico por imagem , Feminino , Seguimentos , Fraturas Mal-Unidas/diagnóstico por imagem , Humanos , Deformidades Articulares Adquiridas/diagnóstico por imagem , Deformidades Articulares Adquiridas/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia/métodos , Radiografia , Adulto Jovem
J Org Chem ; 77(7): 3589-94, 2012 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-22375896


The diastereoselectively switchable enantioselective Mannich reaction of isatin imines with hydroxyacetone is reported. The chiral primary amino acid catalyzed this Mannich reaction to afford both anti- and syn-Mannich adducts in high yields, good diastereoselectivities, and enantioselectivities. The reason for the solvent control of the diastereoselectivity phenomenon was investigated.

Acetona/análogos & derivados , Iminas/química , Indóis/síntese química , Isatina/química , Solventes/química , Acetona/química , Catálise , Indóis/química , Estrutura Molecular , Oxindois , Estereoisomerismo