The curative effect of small-incision open distal subpectoral vs. arthroscopic proximal biceps tenodesis for lesions in the long head of the biceps tendon (LHBT) combined with rotator cuff repairs (RCR) has remained controversial. The aim of the present study was to compare the two surgical methods. A total of 71 patients who received surgical treatment for LHBT lesions accompanied by RC tears were analyzed. Following arthroscopic RCR and tendectomy of the affected LHBT, 35 patients underwent small-incision open distal subpectoral tenodesis through a small incision (the subpectoral group), while the remaining 36 patients received arthroscopic proximal tenodesis (the arthroscopic group). The surgery time and intra-operative blood loss were compared between the two groups. In addition, the clinical outcomes were evaluated using scoring systems for the functional assessment of the shoulder joint. The subpectoral group had a shorter surgery time and less intra-operative blood loss than the arthroscopic group (P<0.05). The functional scores of the two groups significantly improved as time passed (P<0.05). The subpectoral group was significantly superior to the arthroscopic group with regard to the American Shoulder and Elbow Surgeons score at 2 weeks post-operatively and visual analog scale score at 2 weeks and 3 months post-operatively (P<0.05). Small-incision open distal subpectoral and arthroscopic proximal tenodesis were demonstrated to effectively improve the function of the shoulder joint and relieve pain caused by LHBT lesions accompanied by RCR. However, small-incision open distal subpectoral tenodesis had the additional advantage of shorter surgery time, less intra-operative bleeding and encouraging early results compared to arthroscopic proximal tenodesis. The study was registered as a clinical trial in the Chinese Trial Registry (no. ChiCTR1800015643).

Introduction. The acromion is a small section of the scapula which extends anteriorly from the spine of the scapula and the acromial angle (AA) is a prominent bony point at the junction of the lateral border of the acromion and the spine of the shoulder blade. As is well known, the morphology of the acromion and the acromial angle are important as their anatomical variation may contribute to shoulder pathologies. However, few people have studied the morphology and the association between the acromion and the acromial angle. The study explores the acromion and the acromial angle in the anatomical morphology and the association, providing an anatomical basis for clinical diagnosis and treatment. Material and Methods. A total of 292 dry, intact scapulae (152 right, 140 left) were used in the study. Three types of the acromion were already measured, type I(flat shape), type II (curved shape), and type III (hooked shape), respectively. Three types of the acromial angles were also measured in this study, C shape, L shape, and Double Angle shape. Results. The research result shows that C shape and L shape were the most common, while Double Angle shape was the least common. C shape was often related to type I (flat shape) and L shape was often related to type II (curved shape). Conclusions. The presented data provides precise and well-sorted information about the acromion and the acromial angle variation in Chinese population, contributing to diagnosis and treating in shoulder pathology.

Background Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity. Methods We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane’s angle and Bohler’s angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot. Results We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type I and Type IV are significantly severer than Type II (P < 0.05). Type II (7.65 ± 1.38 cm2) was significantly smaller than Type I (8.40 ± 1.79 cm2) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm2) was smaller than Type I (8.40 ± 1.79 cm2), II (7.65 ± 1.38 cm2) and IV (7.81 ± 1.74 cm2) (P < 0.05). Type II (28.81 ± 7.44∘) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler’s angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane’s angle (P < 0.05). Conclusions After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity. Level of evidence Level III, retrospective comparative study.

BackgroundWith the complexity of calcaneal fracture (CF) increasing, its treatment has changed to include inserting the screw used to secure the facies articular posterior into the sustentaculum tail (ST). Some research progress has been made in this area, but there has been little in-depth research on the anatomical morphology of the sustentaculum tail, which is necessary for clinical surgery, and more information about Chinese anatomic characteristics and improved surgical techniques for CF are needed.Material/MethodsThis anatomical study, based on a three-dimensional (3D) computed tomographic (CT) reconstruction technique, included 287 dry calcaneus, consisting of 144 left and 143 right calcaneus. The images were reconstructed in 3D after CT scanning. Seven subjects were enrolled (L and R): (1) The vertical distance from inside the sustentaculum tail (IST) to inside the facies articularis talaris posterior; (2) The vertical distance from IST to the outside facies articularis talaris posterior; (3) The thickness of sulcus calcaneal nadir; (4) The distance from IST to processus medislis tuberis calcaneus; (5) The distance from IST to calcaneal posterosuperior tuber; (6) The angle of the prolate axial intersection between ST and calcaneus on the normal superior as ∠α; and (7) The angle of the prolate axial intersection between ST and calcaneus on the normal posterior as ∠β. All measurement results were analyzed by SPSS 22.0.ResultsBased on morphological classification, the average length of AB, AC, AE, and AF on left ST were 16.956±1.391 mm, 37.803±2.525 mm, 43.244±3.617 mm, and 51.113±4.455 mm, respectively. Among the others, ∠β was 81.227±6.317 mm on the left and 74.581±9.008 mm on the right (P<0.05).ConclusionsThese results suggest better ways to treat the special characteristics and to reduce the risk of CF surgery.

Background This retrospective study from a single center aimed to compare the safety and clinical outcomes of arthroscopic surgery vs open surgical repair of the anterior talofibular ligament (ATFL). Material/Methods We randomly divided 80 patients with ATFL injury divided into 2 groups: an open surgery group and an arthroscopic group. The operation time, intraoperative bleeding volume, and the postoperative recovery time of all patients were analyzed. The anterior displacement and talus tilt angle, the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS), the Jersey Shore Science Fair (JSSF) ankle-hindfoot scale score, and the Karlsson Ankle Functional Score (KAFS) were compared at 6 months, 1 year, and 2 years after surgery. We collected data on the incidence of postoperative complications during follow-up. All significant results were supported with a P value. Results The operation time, intraoperative bleeding volume, and postoperative recovery time in the arthroscopic group were better than in the open group ( P <0.05). The AOFAS, JSSF, and KAFS in the arthroscopic group were better than in the open group at 6 months after the operation ( P <0.05). The AOFAS, JSSF, and KAFS scale scores were not significantly different between the 2 groups at 1 year and 2 years after the operation ( P <0.05). Conclusions The findings from this retrospective study showed that the use of arthroscopic surgical repair of the ATFL is a safe minimally invasive technique with reduced blood loss and surgical duration and good clinical outcomes.