高弓足畸形矫正

对不同类型的高弓足及跖筋膜挛缩所致的足弓变形患者,应经足舟骨下后3cm处向前足作“S”形切口;分离出跖筋膜,作“S”形切断延长术及跟舟韧带,跖长韧带部分切断术。如仍不能解除高弓时,可向深层作跖长韧带及肌肉移位术,但对青少年或成人发生骨     

高弓足的功能性矫正术

高弓足在足之畸形中是较难矫正之疾病。一般临床上所称之高弓足实际上不包括儿麻后遗症者，后者主要为跟腱力弱，跟骨下沉所致，多合并有足部其他肌力不足，故往往非单纯性高弓畸形，其治疗原则以调整肌力平衡，同时做两关节或三关节固定为主，高弓足（以下将指特发性高弓...     

便携式步态分析仪量化评价全膝关节置换病人的步态特征

[目的]利用便携式步态分析仪了解患者膝关节置换前后的步态参数变化及特点,指导全膝关节置换术(total knee arthroplasty,TKA)后的康复治疗,进而得出适用于临床的评价方式。[方法]通过便携式步态分析仪对行单侧TKA的患者进行术前及术后3个月的步态分析,评估术后步态参数改善程度。[结果]患者手术侧肢体摆动时间、步幅持续时间、摆腿强度、蹬地强度、跖屈强度、步速、步频、步长、步幅及行走中活动度在行TKA后3个月有明显改善。[结论]1全膝关节置换患者术后3个月疼痛明显减轻,膝关节活动度增加,功能得到良好改善;2对于术后康复锻炼,除常规增加膝关节活动锻炼外,还应加强股四头肌的锻炼,以增强术后膝关节稳定性,改善功能;3便携式步态分析仪(portable motion analyzer,PMA)可以客观地记录全膝关节置换患者术前及术后的步态参数,对评价手术效果及指导功能康复具有一定的参考价值。     

个体化治疗对高弓马蹄内翻足畸形的疗效分析

目的探讨个体化治疗对高弓马蹄内翻足畸形的临床疗效。方法笔者回顾性分析自2014-04—2016-02诊治的15例(24足)高弓马蹄内翻足畸形的临床资料,根据患者的发病原因和畸形的情况实施个体化治疗,行软组织手术(松解、转位和延长)、骨性手术(截骨和融合)或Ilizarov外固定架固定手术。手术前后采用美国矫形足踝协会(AOFAS)踝与后足评分系统评价足踝部功能,采用疼痛视觉模拟评分(VAS)评定疼痛改善情况,采用李克特量表评价患者主观满意度。结果全部患者均获随访6~20个月,平均13.8个月。所有患者术后切口均一期愈合,未出现切口感染。AOFAS评分术前(35.6±7.6)分,术后12个月(81.2±9.3)分,VAS评分术前(8.5±1.1)分,术后12个月(3.2±1.0)分,术后1年AOFAS评分和VAS评分较术前明显改善,差异均有统计学意义(t=14.700,P=0.010;t=-13.928,P=0.015)。末次随访疗效按AOFAS评分评定:优9例,良4例,可1例,差1例,优良率86.7%。末次随访患者主观满意度采用李克特量表评价:所有患者主观满意率86.7%。结论高弓马蹄内翻足畸形的种类多样,可合并多种足部畸形,治疗的难度较大,在临床上应根据个体的发病原因和畸形的情况有针对性选择软组织手术、骨性手术或者Ilizarov外固定架手术等联合的组合术式,实施个体化治疗,有助于矫正畸形,提高患者满意度,疗效确切。     

一次性手术治疗高弓足并足下垂畸形

本文报告了一种一次性手术疗法治疗高弓足并足下垂畸形６４例，７岁以下患儿１１人，经软组织松解术均得到矫正；７￣２０岁患者３８人，２５例经软组织松解得到矫正，１３例加用二关节融合术后得到矫正；２０岁以上患者１５人，８例行软组织松解加二关节融合术，７例在三关节融合及肌腱移位术后，畸形得到完全矫正，术后８月￣１年获随访６１人，疗效均满意。     

高弓足的跖骨截骨术

高弓足是前足马蹄的一种畸形类型,可与后足畸形同时存在,常伴有爪形趾畸形和跖痛,所谓特发性类型可能与进行性神经性腓骨肌萎缩有关。高弓足分为前高弓畸形(早期跗跖关节畸形)和后高弓畸形(继发于小腿三头肌瘫痪的跟骨畸形)也可为儿麻     

正常足步态周期中动及足横弓形态的初步分析

目的：观察正常步态周期中跖骨头平面足横横弓的运动形态,并探讨跖骨头平面足横弓在行走过程中的重要意义。方法：以C臂机观察模拟正常步态周期中跖骨头平面足横弓冠状面的变化形态并以录相机记录,通过视频转换为电脑工作站可以分析的MPGE格式文件,在电脑工作站与C＋ ＋Builder下精确的计时器链接,分析足横弓的变化,结果：得到足横弓塌陷时间与足横弓指数Q：I－II跖间角;I－IV跖间角,个体体重等的关系曲线,结论：跖骨头平面存在由5个跖骨头构成的足横弓,以1,5跖骨头为底,2,3跖骨头为顶,步态周期中,由站立相到推离相时,2,3跖骨头渐渐塌陷,负重份额渐增加,足横弓指数Q与足横弓塌陷时间密切相关,Q值增大,则2,3跖骨头塌陷的时间缩短,第2,3跖骨头就越早负重,在整个步态周期中的负重时间延长,导致过度负重,2,3跖骨头下疼痛性胼胝体形成。     

应用三维步态分析技术评价儿童特发性足内偏的步态参数特征

目的 通过对比健康对照组与足内偏组儿童的三维步态数据特征,总结足内偏儿童的步态特征及足内偏的影响因素,为足内偏儿童的早期评估及干预提供科学依据。方法 选择2019年1月至2021年9月上海中医药大学附属岳阳中西医结合医院步态与运动分析中心门诊的48例足内偏儿童,其中男23例,女25例;年龄5～10岁,平均(7.75±1.55)岁。同时于正常儿童数据库中收集48例健康步态儿童的三维步态数据资料,其中男29例,女19例;年龄范围5～10岁,平均(7.81±2.13)岁。分析并总结足内偏儿童的步态参数特征及影响因素。结果 (1)足内偏组儿童的时空参数表现为步宽增加(P<0.01);(2)足内偏组儿童的运动学参数表现为髋关节最大内旋角度增加(P<0.05),髋关节最大屈曲角度、膝关节最大内旋角度及踝关节最大内旋角度明显增加(P<0.01),踝关节最大背屈角度减少(P<0.05);(3)足内偏组儿童的动力学参数表现为髋关节最大屈曲力矩增加(P<0.05)、最大外展力矩及最大功率减少(P<0.05),膝关节支撑相初期内收力矩峰值及最大功率明显增加(P<0....     

高弓马蹄内翻足术后复发与跟骨截骨

目的 探讨高弓内翻足手术治疗后的内翻复发,跟骨截骨外移的矫正度与内翻复发的关系.方法 23例(31足)成人高弓内翻足患者,年龄13～59岁,平均36岁.以术前Coleman试验可否矫正、经内侧软组织和(或)肌腱松解后后足内翻被动矫正情况以及是否行跟骨截骨,将患足分为4组.并以被动可矫正至中立位和外翻5°以上为两个界限.进行统计.跟骨截骨可以为跟骨轴位水平方向上的截骨外移,截骨外移后的欠状面上的上移,以及跟骨的楔形闭合截骨.结果 内翻复发9足,5°以下5足,5°以上4足,平均4.23°±2.15°.末行跟骨截骨12足中,术前Coleman试验可矫正至中立位3足均复发,术前Coleman试验可矫正至外翻5°以上的4足均未复发.术前Coleman试验不町矫正,术中经软组织松解后可矫正至中立位的2足,术后均复发;术前Coleman试验不可矫正,术中可矫正至外翻5°以上的3足,内翻复发1足.行跟骨外移截骨19足中,术前Coleman试验可矫正至中立位9足,1足内翻复发;术前Coleman试验不可矫正,术中可矫正至中立位的7足,术后2足复发;术前Coleman试验不可矫正,术中可矫正至外翻5°以上者3足,无内翻复发.结论 Coleman试验能否矫正后足的内翻,并非是否行跟骨外移截骨术的依据;而被动手法矫正是判断是否行跟骨截骨的关键,外翻5°是一个重要的指标.     

V—型截骨术治疗跗前型高弓足畸形

论述脊髓灰质炎后遗跗前型高弓足畸形的临床表现和影像学改变，介绍跗骨Ｖ形截骨术治疗的初步体会。作者认为，根据高弓足不同类型采用不同术式治疗有助于提高疗效。跗骨Ｖ形截骨术是矫正跗前型高弓足畸形的一种简单而有效的术式。     

Primary malignant triton tumor of the foot

. The malignant Triton tumor is a relatively rare, usually aggressive sarcoma comprised of both malignant schwannoma cells and malignant rhabdomyoblasts. Histopathologically the tumor is described as malignant with neurogenic and myogenic differentiation. A review of all reported cases of Triton tumors in the literature calls attention to their tendency to occur in neurofibromatosis. In this report we present a malignant Triton tumor of the foot not associated with von Recklinghausen's neurofibromatosis.     

Cavus foot surgery: a new approach by electrodynographic evaluation

The authors describe a calcaneal displacement rotational osteotomy for surgical correction of a cavus foot secondary to polio. The necessity of pre- and postoperative analysis of dynamic foot function with the use of the Electrodynogram is presented.     

Design and evaluation of a novel portable erythema-melanin-meter

BACKGROUND AND OBJECTIVES: Objective evaluation of the pigmentation index (PI) and the eythema index (EI) of human skin is a prerequisite for successful optimization of laser- and intense-pulsed-light (IPL)-based treatment modalities in dermatology. STUDY DESIGN/MATERIALS AND METHODS: We describe a three-wavelength technique for determining PI and EI as well as its particular implementation using LEDs operating at wavelengths of 560, 650, and 710 nm and a large-area photodiode. The instrument has been evaluated both in vitro and in vivo. RESULTS: In vitro, good correlation between the measured indices and results obtained with commercially available techniques has been observed. In addition, linearity of the PI with melanin concentration in the phantom medium up to 7 x 10(-3) nm(-1) (defined as a slope of the optical density spectrum) has been established. In vivo, feasibility of using the technique for predicting the minimal erythema dose (MED), minimal phototoxic dose (MPD), and the threshold of epidermal damage in a photothermal treatment has been demonstrated. CONCLUSIONS: The data suggest that the technique has a substantial potential as a method of pre-treatment diagnostics for photochemical and photothermal procedures.     

A portable blood analyzer that uses on-line data management to deliver higher-quality patient information

We constructed an on-line data management system and linked it to the communication protocol of a portable blood analyzer (i-STAT) in each operating room of our institution. We developed a new program that integrates circulatory dynamics data from a monitor with laboratory data from the i-STAT. Our new program permits the results to be viewed through an intranet using a novel prototype communication device for the i-STAT 300F. We verified that this system can improve the quality of patient care both bedside and in the monitoring room and compared the costs of blood testing using a conventional desktop blood-gas analyzer and using the i-STAT. We found that the novel integration of circulatory dynamics with laboratory data enhanced the quality of intraoperative patient monitoring and reduced the cost and work load of doctors working in the operating room.     

On-line data management system using a portable blood gas analyzer in the operating room

It is very important to establish a clinical testing system which is not only prompt, simple and accurate but also safe for the patients and medical staff in the operating room, emergency room and intensive care unit. In our institution an i-STAT portable blood gas analyser has been widely used for point of care testing in all the operating rooms. This clinical testing system has been upgraded by adding an i-STAT communication protocol to our online data management system. The analysed data transmitted by the i-STAT as an infrared signal is transformed to an electronic signal through the IR link and sent to the central data station (CDS) via RS232C. The data received by the CDS is then sent to the upper grade computer system where the data is recorded on the hard disk. One advantage of this system is that it is connected to the hospital computer system. Not only does this new system meet the need for accurate, safe, effective and economical laboratory testing, but also retrospective and multifactorial analysis of intraoperative events can be easily carried out. In the future this system can be applied to telemedicine through the Internet and contribute to the treatment of critically ill patients.     

An evaluation of three new blood-gas analyzer systems

Three new pH-blood-gas analyzer systems have been evaluated. These are the ABL-1, the Corning 165, the Il 513. Because of automation of analysis, accuracy, and speed of analysis, this generation of instruments represents great progress over the previous one. The ABL-1 is the most automated system: all analyses are computer controlled. The pH, P_{o 2} and P_{co 2} values are accurate. Calibration can not be adjusted.