Background: Open reduction and internal fixation of intra - articular calcaneal fractures is technically difficult. Anatomical reduction is needed in order to obtain good Subtalar motion and satisfactory clinical outcome. Reliable and accurate open reduction technique is needed for good results. We would like to report on a modification of open reduction technique for such a fracture.Methods: A cross - sectional study on 6 male and 1 female patients, with mean age of 39±7.72 with intra - aritcular calcaneal fracture was performed from 2001 to 2002. The cases had articular surfacer with Bohler angles of zero degree or less. The Sander’s classification of CT images included 4 cases into type IV and 3 into type III fracture types. Open reduction using the modified technique was performed through a lateral approach. The cases were evaluated by AOFAS functional scoring system with a mean follow - up of 3 years (18-60) months.Results: All the cases were satisfied to full pre - fracture jobs and activities. The AOFAS score was 82 (good) in type IV and 89 (excellent) for type III Sander’s fractures.Conclusions: Accurate open reduction of complex intra - articular calcaneal fracture with the modified reduction technique gives good functional results.

Background: Talus has unique anatomical, biomechanical and vascular-supply features. Talar neck fracture is not common, but when it happens, would be associated with high complication rate, resulting in significant disability. We would like report our experience with a small group of such fractures.Methods: 11 cases of talar neck fractures who had referred to our center in 3 years period (2002-4) were retrospectively studied. The mean age was 23 years old. There were 9 types II and 2 types III (Hawkins classification). All the cases had undergone open reduction and inertial fixation. The result of treatment was evaluated with a mean follow-up of 17 months.Results: All fractures healed. Varus malunion was observed in two cases, one of whom required repeat surgery, and one with superficial infection. Avascular necrosis of the talar body was seen after the 2 type III and 3 of type II cases. Degenerative arthritis of Subtalar joint was evident in 8, and ankle arthritis in 5 patients. Conclusions: Talar neck fractures are associated with high complication rates. Post traumatic arthritis and stiffness are more common, especially in those who develop avascular necrosis. Prompt accurate reduction, rigid fixation and early motion can reduce the complications to some extent.

Balance plays a key role in daily and sports activities. The aim of this study was to investigate the effect of fatigue induced by exhaustive exercises on dynamic balance and balance recovery time in active men with genu varum and normal knee. 40 active healthy male students including 20 subjects with genu varum deformity and 20 normal subjects participated in this semi-experimental study. Genu varum deformity was assessed with a caliper and a goniometer. Strand test was used to create fatigue. SPSS software and statistical tests of analysis of combined variance within- between groups, t test and paired t test were used to analyze data. The results of the mean dynamic balance index by paired t test showed that this index increased significantly in the posttest and pretest comparison in both groups (P=0.00). However, independent t test showed that the mean of these changes was not significantly different between the groups (P=0.56). The dynamic balance index in both groups was fully recovered 10 minutes after fatigue. Medial displacement of the gravity line could increase the lateral posture sways in subjects with genu varum and since this deformity causes internal rotation of the leg and pronation of the Subtalar joint in weight- bearing condition, leg structure changes can change leg function to control balance.

Objectives: Flexible Flat Foot (FFF), a common foot deformity decreasing medial longitudinal arch height is often comorbid with Subtalar joint pronation causing physical activity difficulties in this population. Among the orthotic insoles prescribed for improving foot function, foot orthoses with medial heel skive technique have a limited research background. The present study aimed to investigate the effects of the custom-mold insole with medial heel skive technique on physical function in FFF. Methods: Eighteen adults with FFF from the University of Social Welfare and Rehabilitation Sciences students and staff participated in this study. Custom-Mold insole with medial heel skive was fabricated for all research participants. Physical function in the activities of daily living and sports was assessed by the Foot and Ankle Ability Measure (FAAM), Activities of Daily Living (ADL) subscale (ADL-FAAM), and SPORT-FAAM questionnaires at the beginning of the study and 6 weeks after. Paired Samples t-test and nonparametric tests were used to compare the collected results. Results: After 6 weeks of using the insole with medial heel skive technique, scores in both ADL and SPORTS activities were significantly improved. Discussion: Foot function improvement was not found in all of the studies assessing foot function in flat feet after using different orthotic insoles, by different questionnaires or other systems. In this study, foot and ankle function was significantly improved per FAAM questionnairewhich had highly limited use in orthotic interventions in flat feet population-using medial heel skive technique; however, further studies are required to accentuate medial heel skive technique effect on flat feet function by comparing this technique with other positive cast modifications to control the flat foot. According to the present study results, custom-mold insole with medial heel skive may improve physical function in FFF and can be prescribed in this group.