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Background Due to the lack of further studies on the influence of age factors on plantar fasciitis, this study evaluates the characteristic observation points of magnetic resonance imaging in various age cohorts of patients with plantar fasciitis to help diagnosis. Methods A retrospective analysis of 160 cases of plantar fasciitis patients and normal subjects (who have the disease unrelated to plantar fasciitis) who have undergone an MRI examination in our institution. The two groups were separately divided into young adult subjects (36 to 44 years old), middle age adult subjects (45 to 59 years old), and older adult subjects (60 to 79 years old). Data was gathered regarding plantar fascia thickness, the coronal length of the plantar fascia at the calcaneal origin, the signal intensity of plantar fascia and surrounding structures, and the presence or absence of plantar calcaneal spurs, all of which were assessed objectively by the investigators. Results There were statistical differences in the thickness of plantar fascia between two groups of three age cohorts (Older adult patients: 0.59 ± 0.09 cm; Middle age adult patients: 0.49 ± 0.09 cm; Young adult patients: 0.47 ± 0.05 cm) (all p < 0.001). In addition, there were also statistical differences in the high signal intensity changes of the plantar fascia and surrounding soft tissues between two groups of three age cohorts (all p < 0.001). In older adult plantar fasciitis patients, with regard to plantar calcaneal spur discovery, there was a statistical difference between the two groups (Chi-square = 12.799. df = 1. p < 0.001). Conclusion In plantar fasciitis cases where a diagnosis is difficult, abnormalities in the soft tissue surrounding the plantar fascia in patients of low age are noteworthy. In older adult patients, the discovery of plantar calcaneal spurs with abnormal thickening of plantar fascia deserves attention, and abnormal MRI findings are more manifest. But the final diagnosis should be based on the medical history. Level of Evidence Level 3.

Background: Percutaneous and Arthroscopically Assisted Osteosynthesis (PAAO) has been reported as beneficial for calcaneal fractures because of its visibility and minimal invasiveness. But reduction effect of it is not satisfactory, for some severe displaced intra-articular fractures (DIACFs). As calcaneal fractures are frequently related to displacement of calcaneal talar facets (CTF), the purpose of this study was to explore whether the effect of PAAO is different, for calcaneus with different CTF after fractures. This can offer direction and help for clinical practice.Methods: A total of 117 patients (129 fractures) treated with PAAO were included and classified by their CTF in this study. Radiological parameters, including Bohler angle and height of calcaneus, and patient-reported outcomes, including the American Orthopedic Foot and Ankle Society (AOFAS) scores and Visual Analog Scale (VAS) were collected before surgery. The same results after surgery were analyzed and compared between different types.Results: Based on the CTF, calcaneal fractures were divided into five types ( 45 Type I, 31 Type II, 23 Type III, 18 Type IV, and 12 Type V). As for Bohler angle, Type III was smaller than Type I, II, IV and V (all P < 0.05), and Type V was larger than Type I, II, III and IV (all P < 0.05) at three time points of postoperative follow-up. The height of calcaneus of Type III was lower than that of Type I, II, IV and V (all P < 0.05), and Type V was higher than Type I, II, III and IV (all P < 0.05). There was no significant difference in AOFAS scores of five types (all P > 0.05). VAS scores were comparable between Type III (3.1) and Type I (2.2) and V (1.8)(all P < 0.05).Conclusions: The treatment effect of PAAO on DIACFs varied from different types of CTF. Therefor, PAAO can be given priority when it comes to Type V of CTF, but careful consideration should be given to whether to choose this method for Type III.

BackgroundPrevious studies have studied more factors on the ankle stability of the posterior ankle fracture, which is related to a stereostructure of the fracture fragment. Previous studies have shown that the ankle stability may be affected by the sagittal surface of the fracture block, with less research in this field. The aim of this study was to explore the influence of the sagittal angle(SA) on ankle joint stability by scanning and reconstructing three types of posterior malleolus fractures(PMFs) with different sagittal angle (SA).MethodsThe CT data of 87 patients with PMFs were collected retrospectively and reconstructed. PMFs were divided into three types: posterolateral-oblique type (type I), medial-extension type (type II) and small-shell type (type III).The collected sagittal angle data were statistically analyzed with the posterior fragment area, fragment area ratio (FAR), fragment transverse diameter ratio (FWR), fragment length ratio (FLR), fragment height (FH), and contact area (CA).Results(1)SA was positively correlated with posterior fragment area(r = 0.804,P < 0.01),with regression equation s = 0.085*SA + 0.34;(2)SA was positively correlated with FAR(r = 0.392,P < 0.01),with regression equation FAR = 0.004*SA + 0.092;(3)SA was positively correlated with FWR(r = 0.261,P < 0.05), with regression equation FWR = 0.03*SA + 0.4624;(4)SA was positively correlated with FLR(r = 0.481,P < 0.01), with regression equation FLR = 0.05*SA + 0.209;(5) SA was positively correlated with CA (r = 0.474, P < 0.01),with regression equation CA = 7.942*SA + 160.866;(6)SA was positively correlated with FH(r = 0.474,P < 0.01), with regression equation FH = 0.046*SA + 1.406.ConclusionThe sagittal angle was positively correlated with posterolateral-oblique type (type I) of Posterior malleolus fractures, and SA could be considered to reflect the ankle joint stability of PMFs.Level of evidence: Level III, retrospective comparative study.