Treatment outcomes of triplane and Tillaux fractures of the ankle in adolescence.

BACKGROUND: To identify the fracture configuration and treatment results for patients with triplane and Tillaux fractures in the ankle joint. METHODS: A retrospective study was performed on 14 patients with a more than one year follow-up. This study investigated the fracture configuration, concomitant fibula fracture, treatment methods and complications. The treatment outcomes were analyzed using modified Weber protocol. RESULTS: Among the 14 cases, 11 were triplane fractures and 3 were Tillaux fractures. Seven were two part triplane fractures, and 4 were three part triplane fractures. Eight were lateral triplane fractures, and 3 were medial triplane fractures. A fibula fracture was accompanied by 7. The fibular fracture comprised of oblique fractures in all cases. A closed and open reduction was performed in 6 and 8 cases, respectively. All but one showed excellent treatment outcomes at the final follow-up. Traumatic arthritis developed in 1 case. CONCLUSIONS: Precisely detecting the fracture configuration by computed tomography and understanding the injury mechanism have greatly improved the outcomes of triplane fractures and Tillaux fractures of the ankle in adolescent patients.

COMP-Angiopoietin-1 ameliorates surgery-induced ischemic necrosis of the femoral head in rats.

INTRODUCTION: Ischemic necrosis of the femoral head (INFH) can lead to loss of femoral head architecture and deformity. Moreover, the process of bone healing is intimately associated with angiogenesis. We considered that COMP-Ang1 (an angiogenic factor) might preserve femoral head structure and facilitate bone repair. METHODS: INFH was induced in the femoral head of rats by dissecting the cervical periosteum and placing a ligature tightly around the femoral neck. Two weeks later, COMP-Ang1 was injected directly into infarcted areas. Rats were divided into the following groups; 1) the sham-operated group (the sham group), 2) the bovine serum albumin-injected group (the BSA group), and 3) the COMP-Ang1-injected group (the COMP-Ang1 group) (n=20/group). At 8 weeks post-surgery animals were sacrificed and radiologic and histomorphometric assessments were performed. RESULTS: Radiographs obtained at 8 weeks post-surgery showed better preservation of femoral head architecture in the COMP-Ang1 group than in the BSA group. Histological findings and immunostainings of endothelial cells for factor VIII revealed that COMP-Ang1 group animals showed higher levels of vascularity in the secondary ossification center of infarcted femoral heads. CONCLUSIONS: When INFH was surgically induced in rats, an intraosseous injection of COMP-Ang1 preserved the trabecular framework of the osseous epiphysis and prevented femoral head deformities by promoting angiogenesis and bone remodeling.