Vera Pamidronate on Cardiac Norepinephrine Release in Rats and Its Significance, Relation to Catecholamines in Myocardial Ischemia. Circulation. 1990.82 (Suppl1): 11l3 II22. (Received EJ period: 2005 - 06 - 25) Combined with inferior tibiofibular syndesmosis separation fracture and dislocation of ankle joint in diagnosis and treatment of Abstract Objective To investigate the peak of the Han Jinrong open reduction and internal fixation for the treatment of combined with inferior tibiofibular joint fracture dislocation of the ankle efficacy methods 21 patients with tibial syndesmosis separation fracture and dislocation of ankle joint, with open reduction and plate screw internal fixation were analyzed retrospectively. In all cases, according to the type of fracture of medial malleolus fracture of posterior malleolus, merge, selection of cancellous bone screws, fibular fracture with plate fixation, abruption of lower tibiofibular ligament with cortical bone screw fixation results in the group of 21 were followed up, fracture healing time of J0 ~ 20 Monday efficacy evaluation according to the modified Baird and Jackson main objective and X-ray evaluation, 21 cases of 1l patients rated as excellent, 7 patients rated as good. 3 cases as may be, the excellent and good rate was 85.7%, wound healing, no incision infection, broken nails and other complications conclusion open reduction and internal fixation combined with inferior tibiofibular syndesmosis separation effect is satisfied fracture and dislocation of ankle joint key words ankle fracture; tibiofibular joint; separation; internal fixation of ankle joint fracture dislocation combined with inferior tibiofibular syndesmosis separation, not only closed to repair, if success is difficult to maintain, so much that operation treatment. Our hospital from 1998 to 2004 July were treated by lO fracture and dislocation of ankle joint in 7O patients, which combined with inferior tibiofibular syndesmosis separation 2L patients treated by operation, satisfactory result, report as follows now. Materials and methods 1 general information: the group of 2l patients, 13 were male, 8 female, age L6 ~ 60 years old on average 34.5 years of age. Cause of injury: traffic injury lO cases, fall injury in 3 cases, female 2 cases with, fall sprains 6 example, are unilateral limb injury. The complicated with spinal fracture in 2 cases, 2 cases of head injury, pelvic fractures of 1 cases, 1 cases of closed abdominal injury. Open injury in 4 cases of L7 patients, closed injury. According to AO - Weder - Danis classified type: 7 cases of type B, type C L4 cases. The X-ray showed that: the ankle mortise widened, and the medial malleolus talus gap increases markedly or abruption of lower tibiofibular ligament significantly. The injury to the hospital asked 2H 7d, the mean 15h. The 2 treatments: continuous epidural anaesthesia, using lateral incision, such as with a medial malleolus fracture is taken inside and outside dual incision were exposed inside and outside ankle fracture, lateral incision outside ankle tip below LCM to about L2 - 15cm around a longitudinal incision exposure fibular fracture end affixed to the lateral malleolus fibula, and anterior to the medial dissection revealed the ankle mortise upper tibia under section 2L cases were anterior lateral, inferior tibiofibular joint anterior ligament rupture. After the merger of ankle fracture of ankle and repair after exposure, with 1 - 2 cancellous screws internal fixation, with all export expose lateral malleolus and brown bone distal segments, with half element shape plate fixation of fibular fractures. Reconstruction of lower tibiofibular joint author unit: 463500 County of Henan province people after bonding, ankle horizontal clearance is 2 ~ 3cm after fibular lateral, in parallel to the tibial articular surface and tilted forward 25 . ~ 3O .Direction through two layers of the cortex to the tibia fibula fixation of 1 3.5ram diameter cortical bone screws, screw tip attention does not pass through the tibial contralateral cortex. Combined fracture of the medial malleolus, to the medial malleolus medial do a curved incision, fracture anatomic reduction with 1 ~ 2 cancellous screws. Suture of each layer of tissue. In 3 patients after treatment: after conventional plaster fixation of ankle in 0 .Bit, early toe and ankle activities, based on X-ray films shown in fracture healing decided to remove gypsum, partial weight-bearing and full weight-bearing time. After 8 ~ J0 week ankle load before operation for fixation of the inferior tibiofibular joint screw. Results in the group of 2l patients were followed up for 3 years, l, an average of 1.5 years. Fracture healing time for the l0 - 20 weeks. Efficacy was assessed according to the modified Baird and Jackson main objective and X-ray evaluation ... .2L patients in Il patients rated as excellent, 7 cases as good, 3 cases as may be, the excellent and good rate was 85. 7%, wound healing, no incision infection, broken nails and other complications. Discussion of the ankle is a flexor of the joints, abercrombie fitch nederland, and other large joints, involved in the human motor function and weight, it requires both stability and load, and achieve the convenience and flexibility of the foot movement. In the foot dorsiflexion and plantar flexion of all activities within the scope of the ankle mortise, talus and all of the articular surface in close contact, when the fibular fracture combined with inferior tibiofibular syndesmosis separation, talar shift instability, the ankle mortise broadening, mortise anatomy destruction, ankle joint surface stress again distribution, will...