Supraspinatus tendon injury is a common clinical shoulder joint disease and is one of the most common causes of shoulder pain and dysfunction. Supraspinatus tendon injury will lead to articular cartilage injury and degeneration, then cause joint disease, seriously affect the quality of life of patients, and bring a huge burden to the family and society. This paper mainly studies and evaluates the application value of special signs of shoulder joint and indirect MR imaging in the diagnosis of supraspinatus tendon injury. Through a series of special examinations for the diagnosis of supraspinatus tendon injury in 90 patients, including zero degree abduction resistance test, arm drop test, Jobe test, Neer sign, and Hawkins sign, all patients in the study underwent indirect magnetic resonance imaging of the shoulder joint. Finally, arthroscopic examination results were used as the “gold standard” to evaluate and analyze the diagnosis. The results showed that among the special signs, the specificity of the falling-arm test was the highest (72.2%) in the diagnosis of full-thickness supraspinatus tendon injury. Hawkins sign had the highest sensitivity (84.0%). In the diagnosis of partial supraspinatus tendon injury, the specificity of the Jobe test was the highest, which was 66.6%. The Neer sign had the highest sensitivity of 50.0%. In the diagnosis of full-thickness supraspinatus tendon injury, there was no significant difference in sensitivity between indirect MRI and Hawkins sign, but the diagnostic specificity of indirect MRI was higher than that of special sign examination. In the diagnosis of partial supraspinatus tendon injury, the sensitivity and specificity of indirect MR imaging are higher than those of special sign examination.

Rationale: Coracoid processes (CPs) fracture with acromioclavicular (AC) joint dislocation are extremely rare. This combined injury has brought many challenges to surgeons, and the mechanism underlying the injury is still not fully understood. There is no clear consensus on its treatment. Patient concerns: Here, we describe a CP fracture with AC joint dislocation in a middle-aged manual worker. Diagnosis: Radiographs showed a fracture of the base of the CP and a third-degree AC joint separation. Interventions: The patient was treated surgically with open reduction and internal fixation of the AC joint by LCP clavicle hook plate, and the CP was fixed with a 3.5 mm diameter cannulated screw. Outcomes: Three months after the operation, shoulder function was completely restored, and the affected shoulder had full mobility with no tenderness. Plain film radiography showed anatomical indications of the healing of these combined injuries. Lessons: Although AC joint dislocation with CP fractures is extremely rare in adults, it is important to remind and remember that this possibility exists. In unclear cases, special radiographic films and CT are necessary. Surgical treatment of AC joint dislocation with CP fractures can provide solid stability and restore normal shoulder function with an excellent prognosis.

Rationale: Widely applied in the treatment of severe ankle arthritis (AA), ankle distraction arthroplasty (ADA) can avoid not only the ankle range of motion loss but also ankle fusion. However, the clinical outcomes of ADA for severe AA are poorly understood. This study aims to present our clinical outcomes of severe AA treated by ADA. Patient concerns: A 53-year-old man suffered right ankle sprain 10 years ago, endured right ankle pain and limited movement for 6 years. Diagnosis: The patient was diagnosed as severe AA. Interventions: He received ankle distraction arthroplasty. No adjuvant procedures were performed. The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the short-form (SF)-36 physical component summary (PCS) score and ankle activity score (AAS) were recorded to access the clinical outcomes pre- and postoperatively. Moreover, ankle joint space distance was evaluated on weight-bearing radiographs. Outcomes: The patient derived effective pain relief and restored a satisfactory range of movement. There was a 13-month follow-up period after frame removal. The AOFAS score improved from 56 preoperatively to 71 postoperatively. The VAS score decreased from 6 prior to surgery to 1 after surgery. The SF-36 PCS was 47.2 and 71.8 pre- and postoperative, respectively. The AAS scores were improved from 3.4 preoperatively to 7.3 postoperatively. Lessons: ADA is reliable to achieve pain relief, functional recovery, and serve AA resolution. Besides, it is an alternative to ankle arthrodesis or total ankle arthroplasty in selected patients with severe AA.

The purpose of this study is to evaluate the gait characteristics of bilateral limbs after unilateral total knee arthroplasty (TKA) using three-dimensional (3D) dynamic capture technology. Forty-two patients who underwent TKA were selected from the Orthopedic Medical Center of The Second Hospital of Jilin University from November 2018 to May 2019. We used a 3D dynamic capture system to measure the gait characteristics of patients at 3 months after TKA. The data, including relative position and direction of different body parts, the force between feet and ground, spatial and temporal relationship of the lower limb muscles, were measured. Besides, the surface electromyogram signal and the force plate analog signal were also collected. The walking ability, knee 3D kinematic, and kinetic characteristics were analyzed by the Cortex software. Spatial and temporal parameters, including stride frequency, double support phase, single support phase, step length, step time, step width, stride length, gait cycle, velocity, were no significant difference in bilateral lower extremities ( P > .05). The reaction force of hip, knee, and ankle joint in the operation side were less than that of the healthy side, but the difference was not statistically significant ( P > .05). However, when compared with the healthy side, the hip joint in operation side had a larger maximum extension angle ( P < .001), the knee joint in operation side had a larger maximum valgus angle and valgus activity ( P < .05), and had a smaller tibial maximum internal rotation angle ( P < .05). Besides, the surface electromyogram signals of tibialis anterior muscles were reduced ( P < .05). 3D gait analysis, as an objective and quantitative evaluation method, is a safe, effective, and reliable method for evaluating postoperative knee function. The data of gait analysis prove that TKA is a vital treatment to improve the function of patients with knee arthritis. Besides, gait analysis also showed that there were various kinematic and biomechanical abnormalities in the knee after TKA, which may be the reason why the surgical knee could not immediately return to normal level.

Aim. To study the application value of ankle fracture classification and diagnosis. In this paper, the clinical data of 100 cases of ankle fracture patients admitted from May 2020 to May 2021 were analyzed by CT 3D reconstruction. All patients received surgical treatment and underwent spiral CT 3D reconstruction and X-ray examination before surgery. The results showed that 20 cases (20.00%) of the 100 cases were PER, 24 cases (24%) of the 100 cases were PAB, 31 cases (31%) of the 100 cases were SER, and 25 cases (25%) of the 100 cases were SAB, respectively. Conclusion. The diagnostic accuracy of CT 3D reconstruction for different types of ankle fracture is higher than that of X-ray, and the differences are statistically significant ( P < 0.05 ). CT 3D reconstruction is applied in the early diagnosis of ankle fracture, which can accurately detect the classification of patients. It has important clinical application value and can be used as the first choice for the early classification diagnosis of ankle fracture.