BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a nee...BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a need for culturally and linguistically adapted instruments.The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire(AAOS-FAOQ)is a widely used tool but has not been adapted for Arabic-speaking patients.AIM To translate,cross-culturally adapt,and validate the AAOS-FAOQ for Arabicspeaking patients with traumatic foot and ankle injuries.METHODS The cross-cultural adaptation followed established guidelines,involving forward and backward translations,expert review,and pre-testing.The final Arabic version was administered alongside the Arabic Short-Form 36(SF-36)to 100 patients for validity testing.Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours.Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales,while Cronbach's alpha and intraclass correlation coefficients(ICC)determined internal consistency and reliability.RESULTS Out of 100 patients,92 completed the first set of questionnaires.The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales,particularly in physical function and bodily pain(r>0.6).Test-retest reliability was robust,with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale,respectively.Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.CONCLUSION The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries.This adaptation will enhance the inclusion of this population in orthopedic clinical studies,improving the generalizability of research findings and patient care.展开更多
Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-t...Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-term,secondary effects.Studies have shown that the most common of these include a range of disabilities,pain,and dramatic decline in mental health and quality of life.Improving living conditions and providing rehabilitation services to veterans has always been a main priority of authorities.The goal of this study was to explain the methods and materials with which these priorities were explored.展开更多
Football is the most popular sport worldwide and is associated with a high injury rate, most of which are the result of trauma from player contact. Ankle injuries are among the most commonly diagnosed injuries in the ...Football is the most popular sport worldwide and is associated with a high injury rate, most of which are the result of trauma from player contact. Ankle injuries are among the most commonly diagnosed injuries in the game. The result is reduced physical activity and endurance levels, lost game time, and considerable medical cost. Sports medicine professionals must employ the correct diagnostic tools and effective treatments and rehabilitation protocols to minimize the impact of these injuries on the player. This review examines the diagnosis, treatment, and postoperative rehabilitation for common football injuries of the ankle based on the clinical evidence provided in the current literature.展开更多
Background:To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players.Methods:Searches were performed in MEDLINE/PubMed,Web of Science,Cochrane Libra...Background:To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players.Methods:Searches were performed in MEDLINE/PubMed,Web of Science,Cochrane Library,and SPORTDiscus databases.Studies were considered if they reported injury incidence rate in male and female youth(≤19 years old)football players.Two reviewers(FJRP and ALV)extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement and the Newcastle Ottawa Scale.The Grading of Recommendations Assessment,Development,and Evaluation approach determined the quality of evidence.Studies were combined using a Poisson random effects regression model.Results:Forty-three studies were included.The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females.Match injury incidence(14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females)was significantly higher than training injury incidence(2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females).The lower extremity had the highest incidence rate in both sexes.The most common type of injury was muscle/tendon for males and joint/ligament for females.Minimal injuries were the most common in both sexes.The incidence rate of injuries increased with advances in chronological age in males.Elite male players presented higher match injury incidence than sub-elite players.In females,there was a paucity of data for comparison across age groups and levels of play.Conclusion:The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.展开更多
It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of ou...It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.展开更多
Background:Veterans with purely physical disorders,such as ankle-foot neuromusculoskeletal disorders,are often neglected in psychological assessments because mental health evaluations are usually focused on those with...Background:Veterans with purely physical disorders,such as ankle-foot neuromusculoskeletal disorders,are often neglected in psychological assessments because mental health evaluations are usually focused on those with a psychological disturbance or with a high percentage of injury.The purpose of this study was to evaluate the psychological condition of veterans with ankle-foot neuromusculoskeletal disorders.Methods:A cross-sectional study was performed between 2014 and 2016 on veterans with war-related ankle-foot injuries living in two provinces of Iran.An information form for demographic data and injury-related factors was used.Additionally,the previously validated Persian version of the Symptom Checklist-90-Revision(SCL-90-R)questionnaire was used for data collection.Results:The respondents were 215 male veterans with a mean age of 51.7±7.5 years.The most common mental health problems were observed for the somatization(24.7%),obsessions-compulsions(14.4%),and anxiety(12.6%).Based on the Global Severity Index(GSI),48.6%of individuals had a possible psychiatric/psychological illness.According to the multivariate regression analysis,GSI scores were significantly higher among veterans who were older than 27 years at the time of injury(P=0.005),had an associated injury(P=0.002),and had a history of hospitalization within the past 12 months for reasons other than their injury(P=0.035).Conclusion:Approximately half of the combat veterans with ankle-foot neuromusculoskeletal disorders likely had psychological problems.The evaluation of the patterns and predicting factors of psychological conditions may inform strategic planning efforts and decision-making,which,in turn,may provide a better quality of life for veterans.Further studies that utilize longitudinal designs are needed to evaluate and compare the psychological status of different groups of veterans and other groups in the general population.展开更多
Background:Football is the most practised sport in the world and is associated with the risk of injuries in the players.Some studies have been published that identify injury prevention programs,but there is no review ...Background:Football is the most practised sport in the world and is associated with the risk of injuries in the players.Some studies have been published that identify injury prevention programs,but there is no review of the full body of evidence on injury prevention programs for use by football coaches.The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers,identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.Methods:PubMed and EMBASE databases were used to identify relevant published articles using the following keywords:"soccer"AND"injury"AND"prevention".Results:A total of 2512 studies were identified initially,but only 11 studies met the inclusion criteria,and their outcomes are presented.Results revealed that injury prevention programs in football have focused on strength training,proprioceptive training,multicomponent programs(balance,core stability,and functional strength and mobility),and warm-up programs.Conclusion:Based on results from the studies analyzed,football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions,and by adding strength,balance,and mobility training to the training sessions.展开更多
Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited ...Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited understanding of how prescribed exercises affect muscle activation and force output.This study examined muscle activation and torque production about the metatarsophalangeal joints of intrinsic and extrinsic foot muscles during common foot strengthening exercises.The secondary aim was to determine whether the addition of a postural change(leaning forward)or addition of mass can further increase muscle activation and torque.Methods Fifteen healthy participants(9 males,6 females;age=36.5±8.0 years,mean±SD)participated.Muscle activation was measured using fine-wire electromyography(EMG)electrodes for 2 intrinsic and 2 extrinsic muscles,and surface EMG electrodes for 4 superficial muscles.Metatarsophalangeal joint torque was measured using a custom toe dynamometer.Participants attended one 90-min session and performed 16 exercises.Five included the addition of leaning forward and 3 the addition of mass(20%of participant’s mass)to compare their effects on muscle activity and torque.Results Muscle activation and metatarsophalangeal joint torque varied considerably across exercises.Both the addition of leaning forward and the addition of mass increased muscle activation and metatarsophalangeal joint torque,with the addition of leaning forward producing a 35%median increase in torque about the metatarsophalangeal joints.Conclusion Many common exercises,despite high muscle activation,produce relatively low metatarsophalangeal joint torque,raising questions about their clinical value.Adding a forward lean significantly increases toe flexor muscle activity and torque,reaching levels greater than added mass and comparable to walking.展开更多
Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-...Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-inflammatory,and immunomodulatory activities.However,its active constituents and mechanisms of action against diabetic foot remain to be elucidated.Methods:In this study,the chemical constituents of Sanhuang Oil were identified using UPLC-QE-Orbitrap-MS.Subsequently,the mechanism by which Sanhuang Oil promotes diabetic foot ulcer healing was predicted by integrating network pharmacology and molecular docking.Additionally,diabetic mouse model was established in ICR mice using a combination of a high-fat diet(HFD)and streptozotocin(STZ)chemical induction.A full-thickness skin defect was created on the dorsum of the mice.Wound healing and the healing rate were observed following Sanhuang Oil intervention.The mechanism underlying Sanhuang Oil’s promotion of diabetic ulcer healing was further investigated using transcriptomics and histopathological examination(H&E staining).Results:A total of 97 active ingredients were identified from Sanhuang Oil.Network pharmacology analysis predicted 543 common targets,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis identified 203 relevant pathways.Molecular docking further confirmed high binding affinity(binding energy≤−5.0 kcal/mol)between specific active components in Sanhuang Oil(e.g.,coptisine,phellodendrine,baicalein)and key targets associated with diabetic foot ulcers(e.g.,EGFR,AKT1,STAT3).In vivo experimental results demonstrated that the wound healing rate was significantly higher in Sanhuang Oil-treated groups compared to the model group(P<0.001).HE staining revealed that the high-dose Sanhuang Oil group exhibited more pronounced epithelial tissue coverage over the wound,reduced inflammatory cell infiltration,and increased collagen deposition and fibroblast proliferation.transcriptomic analysis identified Pdk4,Ttn,Csrp3,Actn2,Myoz2,Tnnc2,Myod1,Myog,Myot,and Myf6 as key regulatory proteins involved in promoting wound healing.Conclusion:Sanhuang Oil promotes wound healing in diabetic ulcer mice,potentially by mitigating inflammation and regulating key targets such as Pdk4 to enhance fibroblast function.These findings provide novel insights into the multi-target,multi-pathway mechanism of Sanhuang Oil for treating diabetic foot ulcers.展开更多
Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall ...Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.展开更多
Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between J...Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.展开更多
[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rot...[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rotator cuff injuries managed conservatively.[Methods]Eighty patients diagnosed with rotator cuff injury were selected and randomly assigned to either the control group or the experimental group,each comprising 40 individuals.The control group received conventional rehabilitation treatment,whereas the experimental group underwent phased rehabilitation training in addition to the conventional treatment for 6 weeks.Assessments were conducted prior to treatment,6 weeks following treatment,and 8 weeks after the completion of treatment(follow-up period).The visual analogue scale(VAS)was employed to evaluate pain intensity,the Constant-Murley score was utilized to assess shoulder joint function,and the shoulder joint range of motion was measured.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups across all measured indicators(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups exhibited significant reductions in VAS scores compared to baseline measurements,alongside improvements in Constant-Murley scores and shoulder joint range of motion(P<0.05).Furthermore,the magnitude of improvement in the experimental group was significantly greater than that in the control group(P<0.05).[Conclusions]Phased rehabilitation training can enhance shoulder joint function and alleviate pain in patients with rotator cuff injuries beyond the effects of conventional rehabilitation treatment,demonstrating notable clinical application value.展开更多
The regenerative capacities of organs in adult mammals vary significantly.Unlike the liver,which possesses remarkable regenerative potential,the repair of cardiac injuries has long posed a critical medical challenge.R...The regenerative capacities of organs in adult mammals vary significantly.Unlike the liver,which possesses remarkable regenerative potential,the repair of cardiac injuries has long posed a critical medical challenge.Recent studies have highlighted the pivotal role of the immune microenvironment in repairing damage in these tissues,but the key cell types and their mechanisms of action remain incompletely understood.In this study,we established a model of concurrent physical trauma to the hearts and livers of adult mice,revealing that these two injured tissues drive distinct immune microenvironments.The liver primarily accumulates lymphocytes,whereas the heart recruits macrophages and neutrophils.Notably,CD160^(+)CD8^(+)intraepithelial lymphocytes in the liver were found to suppress fibrosis postliver injury and mitigate cardiac fibrosis when delivered via hydrogel patches.Conversely,in response to heart trauma,recruited inflammatory macrophages not only express proinflammatory cytokines but also coexpress CCRL2.While CCRL2 did not directly alter the intensity of the inflammatory response,it facilitated fibroblast proliferation and migration through its interaction with Na^(+)/K^(+)-ATPase on fibroblasts.These findings elucidated the contrasting immune microenvironments between the heart and liver following injury and provided novel insights and strategies for diagnosing and treating cardiac diseases.展开更多
Diabetic foot attack(DFA)is the most severe presentation of diabetic foot disease,with the patient commonly displaying severe sepsis,which can be limb or life threatening.DFA can be classified into two main categories...Diabetic foot attack(DFA)is the most severe presentation of diabetic foot disease,with the patient commonly displaying severe sepsis,which can be limb or life threatening.DFA can be classified into two main categories:Typical and atypical.A typical DFA is secondary to a severe infection in the foot,often initiated by minor breaches in skin integrity that allow pathogens to enter and proliferate.This form often progresses rapidly due to the underlying diabetic pathophysiology of neuropathy,microvascular disease,and hyperglycemia,which facilitate infection spread and tissue necrosis.This form of DFA can present as one of a number of severe infective pathologies including pyomyositis,necrotizing fasciitis,and myonecrosis,all of which can lead to systemic sepsis and multiorgan failure.An atypical DFA,however,is not primarily infection-driven.It can occur secondary to either ischemia or Charcot arthropathy.Management of the typical DFA involves prompt diagnosis,aggressive infection control,and a multidisciplinary approach.Treatment can be guided by the current International Working Group on the Diabetic Foot/Infectious Diseases Society of America guidelines on diabetic foot infections,and the combined British Orthopaedic Foot and Ankle Society-Vascular Society guidelines.This article highlights the importance of early recognition,comprehensive management strategies,and the need for further research to establish standardized protocols and improve clinical outcomes for patients with DFA.展开更多
The prosthesis is an artificial device that can replace an organ of a human body member to restore a compromised function. It is necessary following the removal of a human organ, which can occur as a result of an illn...The prosthesis is an artificial device that can replace an organ of a human body member to restore a compromised function. It is necessary following the removal of a human organ, which can occur as a result of an illness, trauma or congenital malformation. The trans-tibia prosthesis, in particular, allows the amputee patient to recover the impaired function and regain autonomy, while facilitating their daily social integration. The trans-tibia prosthesis consists of a socket, a sleeve, connecting elements and a prosthetic foot. Each of these components plays a very important role. Among these components, the prosthetic foot usually called “SACH foot” is very often replaced due to cracking and therefore has a fairly short lifespan. At the Center for Equipment and Rehabilitation of Kabalaye (CERK), the SACH foot made using polyurethane and wood is imported and is given to patients with reduced mobility. The aim of this article is twofold, on the one hand, to make a social and pathological study of trans-tibia amputees in relation to the use of the SACH foot prosthesis, on the other hand, to compare this foot with a new prosthetic foot proposed and which is manufactured using extruded polystyrene. The result of prosthetic tests carried out on twenty-four amputees showed that the foot manufactured using extruded polystyrene is better in terms of resistance, bulk and adaptability to active amputees.展开更多
Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young pa...Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young patients with post-traumatic HFOA.Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement.Recently,orthobiologic treatments have gained interest for their potential regenerative effects.This review aims to summarize the current evidence on intra-articular injections for HFOA,highlighting the potential benefits,perspectives,and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma,bone marrow aspirate concentrate,and adipose-derived stem cells.展开更多
BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM ...BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.展开更多
Background:This prospective study explored the effects of endurance running(ER) in minimal versus standard running shoes on the foot’s superficial layer intrinsic muscles and the function of the longitudinal arch.Our...Background:This prospective study explored the effects of endurance running(ER) in minimal versus standard running shoes on the foot’s superficial layer intrinsic muscles and the function of the longitudinal arch.Our hypothesis was that running in minimal shoes would cause hypertrophy in these muscles and lead to higher,stronger,stiffer arches.Methods:The hypothesis was tested using a sample of 33 healthy runners randomized into two groups,a control group shod in traditional running footwear and an experimental group shod in minimal support footwear,whose feet were scanned in an MRI before and after a 12-week training regime.Running kinematics as well as arch stiffness and height were also assessed before and after the treatment period.Results:Analysis of anatomical cross-sectional areas and muscle volumes indicate that the flexor digitomm brevis muscle became larger in both groups by 11%and 21%,respectively,but only the minimally shod runners had significant areal and volumetric increases of the abductor digiti minimi of 18%and 22%,respectively,and significantly increased longitudinal arch stiffness(60%).Conclusion:These results suggest that endurance running in minimal support footwear with 4 mm offset or less makes greater use of the springlike function of the longitudinal arch,thus leading to greater demands on the intrinsic muscles that support the arch,thereby strengthening the foot.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)affect approximately 18.6 million people worldwide every year.Patients with DFU often present with symptoms such as lower limb infections,ulcers,and deep tissue damage.Platelet-ric...BACKGROUND Diabetic foot ulcers(DFUs)affect approximately 18.6 million people worldwide every year.Patients with DFU often present with symptoms such as lower limb infections,ulcers,and deep tissue damage.Platelet-rich plasma(PRP)is a concentrated platelet product that can trigger the release of growth factors and cytokines,which stimulate tissue healing and regeneration and thus alleviates DFU.At present,no comprehensive study has been conducted to verify the effect of PRP in both in vitro and clinical settings for treating DFUs.AIM To perform the in vitro and clinical evaluation of PRP combined with endovascular angioplasty in treating diabetic foot.METHODS This study focused on both in vitro and clinical settings.In the in vitro study,human umbilical vein endothelial cells(HUVECs),human dermal fibroblasts(HSFs),and human immortalized keratinocytes(HaCaTs)were treated with PRP.Experiments involving proliferation,migration,tubule formation,and angiogenesis signaling pathways were conducted.In this clinical study,patients who visited the Affiliated Panyu Central Hospital of Guangzhou Medical University from 2020 to 2024 and met enrollment criteria were randomly assigned to 2 groups using prospective block randomization.In the control group,the DFU was treated with endovascular angioplasty and wound debridement.In the PRP+endovascular angioplasty group,PRP was evenly used on the surface of superficial ulcers,followed by endovascular angioplasty to treat vascular occlusion.The key outcomes were measured,including the Rutherford scale,Wagner scale,foot skin temperature,and ulcer repair area before and after treatment.RESULTS In the in vitro study,6%PRP could promote the proliferation and migration of HUVECs,HSFs,and HaCaTs in a high-glucose environment.Additionally,it promoted tubule formation in HUVECs by activating signaling proteins such as Ak strain transforming and extracellular regulated protein kinases 1/2.In the clinical study,a total of 208 patients participated.After 12 months of treatment,the ulcer repair area(14.95±0.16 cm^(2))and ulcer healing rate were improved in the PRP+endovascular angioplasty group than in the control group(P<0.05).CONCLUSION The combination of 6%activated PRP and endovascular angioplasty may improve the microcirculation and tissue repair in DFUs.This study offers a novel treatment option for patients with diabetic foot.展开更多
文摘BACKGROUND Arabic-speaking patients are underrepresented in orthopedic clinical studies,particularly in foot and ankle trauma research.The lack of validated Arabic language tools hinders their inclusion,creating a need for culturally and linguistically adapted instruments.The American Academy of Orthopedic Surgeons Foot and Ankle Outcomes Questionnaire(AAOS-FAOQ)is a widely used tool but has not been adapted for Arabic-speaking patients.AIM To translate,cross-culturally adapt,and validate the AAOS-FAOQ for Arabicspeaking patients with traumatic foot and ankle injuries.METHODS The cross-cultural adaptation followed established guidelines,involving forward and backward translations,expert review,and pre-testing.The final Arabic version was administered alongside the Arabic Short-Form 36(SF-36)to 100 patients for validity testing.Reliability was assessed through test-retest methods with 20 patients completing the questionnaire twice within 48 hours.Pearson correlation coefficients measured convergent and divergent validity with SF-36 subscales,while Cronbach's alpha and intraclass correlation coefficients(ICC)determined internal consistency and reliability.RESULTS Out of 100 patients,92 completed the first set of questionnaires.The Arabic AAOS-FAOQ showed strong correlations with the SF-36 subscales,particularly in physical function and bodily pain(r>0.6).Test-retest reliability was robust,with ICCs of 0.69 and 0.66 for the Global Foot and Ankle Scale and Shoe Comfort Scale,respectively.Cronbach's alpha for internal consistency ranged from 0.7 to 0.9.CONCLUSION The Arabic version of the AAOS-FAOQ demonstrated validity and reliability for use in Arabic-speaking patients with traumatic foot and ankle injuries.This adaptation will enhance the inclusion of this population in orthopedic clinical studies,improving the generalizability of research findings and patient care.
基金financially supported by Janbazan Medical and Engineering Research Center
文摘Despite the passage of time,a large number of veterans are still affected by injuries acquired during Iran-Iraq war.In addition to their primary injuries,the majority of veterans also experience difficulty with long-term,secondary effects.Studies have shown that the most common of these include a range of disabilities,pain,and dramatic decline in mental health and quality of life.Improving living conditions and providing rehabilitation services to veterans has always been a main priority of authorities.The goal of this study was to explain the methods and materials with which these priorities were explored.
文摘Football is the most popular sport worldwide and is associated with a high injury rate, most of which are the result of trauma from player contact. Ankle injuries are among the most commonly diagnosed injuries in the game. The result is reduced physical activity and endurance levels, lost game time, and considerable medical cost. Sports medicine professionals must employ the correct diagnostic tools and effective treatments and rehabilitation protocols to minimize the impact of these injuries on the player. This review examines the diagnosis, treatment, and postoperative rehabilitation for common football injuries of the ankle based on the clinical evidence provided in the current literature.
基金supported by the Program of Human Resources Formation for Science and Technology(20326/FPI/2017)from the Seneca Foundation-Agency for Science and Technology in the Region of Murcia(Spain)supported by a Ramón y Cajal postdoctoral fellowship given by the Spanish Ministry of Science and Innovation(RYC2019-028383-I)+2 种基金funded by the Spanish Ministry of Science and Innovation(DEP2017-88775-P)the State Research Agency(AEI)the European Regional Development Fund(ERDF).
文摘Background:To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players.Methods:Searches were performed in MEDLINE/PubMed,Web of Science,Cochrane Library,and SPORTDiscus databases.Studies were considered if they reported injury incidence rate in male and female youth(≤19 years old)football players.Two reviewers(FJRP and ALV)extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement and the Newcastle Ottawa Scale.The Grading of Recommendations Assessment,Development,and Evaluation approach determined the quality of evidence.Studies were combined using a Poisson random effects regression model.Results:Forty-three studies were included.The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females.Match injury incidence(14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females)was significantly higher than training injury incidence(2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females).The lower extremity had the highest incidence rate in both sexes.The most common type of injury was muscle/tendon for males and joint/ligament for females.Minimal injuries were the most common in both sexes.The incidence rate of injuries increased with advances in chronological age in males.Elite male players presented higher match injury incidence than sub-elite players.In females,there was a paucity of data for comparison across age groups and levels of play.Conclusion:The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.
文摘It is believed that human ancestors evolved the ability to run bipedally approximately 2 million years ago. This form of locomotion may have been important to our survival and likely has influenced the evolution of our body form. As our bodies have adapted to run, it seems unusual that up to 79% of modern day runners are injured annually. The etiology of these injuries is clearly multifactorial. However, 1 aspect of running that has significantly changed over the past 50 years is the footwear we use. Modern running shoes have become increasingly cushioned and supportive, and have changed the way we run. In particular, they have altered our footstrike pattern from a predominantly forefoot strike(FFS) landing to a predominantly rearfoot strike(RFS) landing. This change alters the way in which the body is loaded and may be contributing to the high rate of injuries runners experience while engaged in an activity for which they were adapted. In this paper, we will examine the benefits of barefoot running(typically an FFS pattern),and compare the lower extremity mechanics between FFS and RFS. The implications of these mechanical differences, in terms of injury, will be discussed. We will then provide evidence to support our contention that FFS provides an optimal mechanical environment for specific foot and ankle structures, such as the heel pad, the plantar fascia, and the Achilles tendon. The importance of footwear will then be addressed, highlighting its interaction with strike pattern on mechanics. This analysis will underscore why footwear matters when assessing mechanics. Finally, proper preparation and safe transition to an FFS pattern in minimal shoes will be emphasized. Through the discussion of the current literature, we will develop a justification for returning to running in the way for which we were adapted to reduce running-related injuries.
基金financially supported by Janbazan Medical and Engineering Research Center.
文摘Background:Veterans with purely physical disorders,such as ankle-foot neuromusculoskeletal disorders,are often neglected in psychological assessments because mental health evaluations are usually focused on those with a psychological disturbance or with a high percentage of injury.The purpose of this study was to evaluate the psychological condition of veterans with ankle-foot neuromusculoskeletal disorders.Methods:A cross-sectional study was performed between 2014 and 2016 on veterans with war-related ankle-foot injuries living in two provinces of Iran.An information form for demographic data and injury-related factors was used.Additionally,the previously validated Persian version of the Symptom Checklist-90-Revision(SCL-90-R)questionnaire was used for data collection.Results:The respondents were 215 male veterans with a mean age of 51.7±7.5 years.The most common mental health problems were observed for the somatization(24.7%),obsessions-compulsions(14.4%),and anxiety(12.6%).Based on the Global Severity Index(GSI),48.6%of individuals had a possible psychiatric/psychological illness.According to the multivariate regression analysis,GSI scores were significantly higher among veterans who were older than 27 years at the time of injury(P=0.005),had an associated injury(P=0.002),and had a history of hospitalization within the past 12 months for reasons other than their injury(P=0.035).Conclusion:Approximately half of the combat veterans with ankle-foot neuromusculoskeletal disorders likely had psychological problems.The evaluation of the patterns and predicting factors of psychological conditions may inform strategic planning efforts and decision-making,which,in turn,may provide a better quality of life for veterans.Further studies that utilize longitudinal designs are needed to evaluate and compare the psychological status of different groups of veterans and other groups in the general population.
文摘Background:Football is the most practised sport in the world and is associated with the risk of injuries in the players.Some studies have been published that identify injury prevention programs,but there is no review of the full body of evidence on injury prevention programs for use by football coaches.The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers,identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.Methods:PubMed and EMBASE databases were used to identify relevant published articles using the following keywords:"soccer"AND"injury"AND"prevention".Results:A total of 2512 studies were identified initially,but only 11 studies met the inclusion criteria,and their outcomes are presented.Results revealed that injury prevention programs in football have focused on strength training,proprioceptive training,multicomponent programs(balance,core stability,and functional strength and mobility),and warm-up programs.Conclusion:Based on results from the studies analyzed,football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions,and by adding strength,balance,and mobility training to the training sessions.
文摘Background Intrinsic and extrinsic foot muscles contribute to foot and lower limb function.This knowledge provides opportunities to target these muscles in exercise and rehabilitation.However,a barrier is the limited understanding of how prescribed exercises affect muscle activation and force output.This study examined muscle activation and torque production about the metatarsophalangeal joints of intrinsic and extrinsic foot muscles during common foot strengthening exercises.The secondary aim was to determine whether the addition of a postural change(leaning forward)or addition of mass can further increase muscle activation and torque.Methods Fifteen healthy participants(9 males,6 females;age=36.5±8.0 years,mean±SD)participated.Muscle activation was measured using fine-wire electromyography(EMG)electrodes for 2 intrinsic and 2 extrinsic muscles,and surface EMG electrodes for 4 superficial muscles.Metatarsophalangeal joint torque was measured using a custom toe dynamometer.Participants attended one 90-min session and performed 16 exercises.Five included the addition of leaning forward and 3 the addition of mass(20%of participant’s mass)to compare their effects on muscle activity and torque.Results Muscle activation and metatarsophalangeal joint torque varied considerably across exercises.Both the addition of leaning forward and the addition of mass increased muscle activation and metatarsophalangeal joint torque,with the addition of leaning forward producing a 35%median increase in torque about the metatarsophalangeal joints.Conclusion Many common exercises,despite high muscle activation,produce relatively low metatarsophalangeal joint torque,raising questions about their clinical value.Adding a forward lean significantly increases toe flexor muscle activity and torque,reaching levels greater than added mass and comparable to walking.
基金supported by the Natural Science Foundation of Hubei Provincial Department of Education(D20232101)Shandong Second Medical University 2024 Affiliated Hospital(Teaching Hospital)Scientific Research Development Fund Project(2024FYQ026)+3 种基金the innovative Research Programme of Xiangyang No.1 People’s Hospital(XYY2023ZY01)Faculty Development Grants of Xiangyang No.1 People’s Hospital Affiliated to Hubei University of Medicine(XYY2023D05)Joint supported by Hubei Provincial Natural Science Foundation and Xiangyang of China(2025AFD091)Traditional Chinese Medicine Scientific Research Project of Hubei Provincial Administration of Traditional Chinese Medicine(ZY2025D019).
文摘Background:Diabetic foot,a severe complication of diabetes,is characterized by chronic refractory wounds.Sanhuang Oil,a topical herbal formula,demonstrates significant therapeutic effects including antibacterial,anti-inflammatory,and immunomodulatory activities.However,its active constituents and mechanisms of action against diabetic foot remain to be elucidated.Methods:In this study,the chemical constituents of Sanhuang Oil were identified using UPLC-QE-Orbitrap-MS.Subsequently,the mechanism by which Sanhuang Oil promotes diabetic foot ulcer healing was predicted by integrating network pharmacology and molecular docking.Additionally,diabetic mouse model was established in ICR mice using a combination of a high-fat diet(HFD)and streptozotocin(STZ)chemical induction.A full-thickness skin defect was created on the dorsum of the mice.Wound healing and the healing rate were observed following Sanhuang Oil intervention.The mechanism underlying Sanhuang Oil’s promotion of diabetic ulcer healing was further investigated using transcriptomics and histopathological examination(H&E staining).Results:A total of 97 active ingredients were identified from Sanhuang Oil.Network pharmacology analysis predicted 543 common targets,and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis identified 203 relevant pathways.Molecular docking further confirmed high binding affinity(binding energy≤−5.0 kcal/mol)between specific active components in Sanhuang Oil(e.g.,coptisine,phellodendrine,baicalein)and key targets associated with diabetic foot ulcers(e.g.,EGFR,AKT1,STAT3).In vivo experimental results demonstrated that the wound healing rate was significantly higher in Sanhuang Oil-treated groups compared to the model group(P<0.001).HE staining revealed that the high-dose Sanhuang Oil group exhibited more pronounced epithelial tissue coverage over the wound,reduced inflammatory cell infiltration,and increased collagen deposition and fibroblast proliferation.transcriptomic analysis identified Pdk4,Ttn,Csrp3,Actn2,Myoz2,Tnnc2,Myod1,Myog,Myot,and Myf6 as key regulatory proteins involved in promoting wound healing.Conclusion:Sanhuang Oil promotes wound healing in diabetic ulcer mice,potentially by mitigating inflammation and regulating key targets such as Pdk4 to enhance fibroblast function.These findings provide novel insights into the multi-target,multi-pathway mechanism of Sanhuang Oil for treating diabetic foot ulcers.
基金supported by the Fund for 2023 Heilongjiang Provincial Health Commission Science and Technology Plan(No.20230404070193).
文摘Exposure to cold environments significantly elevates the risk of sports-related foot and ankle injuries.Low temperatures induce stiffness in muscles,tendons,and ligaments,reduce tissue elasticity,and diminish overall joint flexibility.At the same time,frozen or hardened ground surfaces heighten impact forces while impairing the body's shock-absorption and adaptive response mechanisms.As a result,injuries such as ankle sprains(ligament tears),tendonitis,and stress fractures become more prevalent.Prevention is therefore essential and should focus on comprehensive warm-up routines,use of thermal and supportive equipment-including ankle braces-selection of footwear with adequate traction,and timely replacement of damp socks after exercise to maintain foot warmth and dryness.
文摘Objective: To analyze the effectiveness of musculoskeletal ultrasound in diagnosing rotator cuff injuries. Methods: A total of 80 patients with suspected rotator cuff injuries who were admitted and diagnosed between January 1, 2020, and December 31, 2024, were selected. Musculoskeletal ultrasound was performed on these patients, and the diagnostic efficacy of musculoskeletal ultrasound was evaluated by comparing the results with those of MRI. Results: The detection rates of musculoskeletal ultrasound for the location and extent of injury were similar to those of MRI (p > 0.05). Based on the MRI diagnosis results, the diagnostic accuracy rate of musculoskeletal ultrasound was 92.50%, with a sensitivity of 93.06% and a specificity of 87.50%. The morphological and signal characteristics, as well as ultrasound indicators, of patients with positive musculoskeletal ultrasound results differed significantly from those of patients with negative results (p < 0.05). Conclusion: Musculoskeletal ultrasound can effectively detect the location and extent of rotator cuff injuries, comprehensively assess the damage, and demonstrate high diagnostic efficacy. Furthermore, the morphological and signal characteristics, as well as ultrasound indicators, of musculoskeletal ultrasound can serve as diagnostic criteria for rotator cuff injuries, improving disease detection efficiency.
文摘[Objectives]To investigate the clinical effects of implementing structured phased rehabilitation training,in addition to conventional rehabilitation,on shoulder joint function and pain alleviation in patients with rotator cuff injuries managed conservatively.[Methods]Eighty patients diagnosed with rotator cuff injury were selected and randomly assigned to either the control group or the experimental group,each comprising 40 individuals.The control group received conventional rehabilitation treatment,whereas the experimental group underwent phased rehabilitation training in addition to the conventional treatment for 6 weeks.Assessments were conducted prior to treatment,6 weeks following treatment,and 8 weeks after the completion of treatment(follow-up period).The visual analogue scale(VAS)was employed to evaluate pain intensity,the Constant-Murley score was utilized to assess shoulder joint function,and the shoulder joint range of motion was measured.[Results]Prior to treatment,no statistically significant differences were observed between the two patient groups across all measured indicators(P>0.05).Following 6 weeks of treatment and throughout the follow-up period,both groups exhibited significant reductions in VAS scores compared to baseline measurements,alongside improvements in Constant-Murley scores and shoulder joint range of motion(P<0.05).Furthermore,the magnitude of improvement in the experimental group was significantly greater than that in the control group(P<0.05).[Conclusions]Phased rehabilitation training can enhance shoulder joint function and alleviate pain in patients with rotator cuff injuries beyond the effects of conventional rehabilitation treatment,demonstrating notable clinical application value.
基金supported by the National Key Research and Development Program of China(2025YFA1309100)the distinguished Young Scientist Fund of NSFC(82125016)+6 种基金the National Natural Science Foundation of China Key Program(82230061)supported by the National Natural Science Foundation of China,Special Program(82341216)the Zhejiang Provincial Natural Science Foundation of China(LHDMD22H100002)supported by the National Key Research and Development Program of China(2021YFA1101803 and 2021ZD0203304)supported by the Jiangsu Science and Technology Project(Social Development)(BE2019669)the National Natural Science Foundation of China(82071046,82100540)supported by the 111 Program(D20036).
文摘The regenerative capacities of organs in adult mammals vary significantly.Unlike the liver,which possesses remarkable regenerative potential,the repair of cardiac injuries has long posed a critical medical challenge.Recent studies have highlighted the pivotal role of the immune microenvironment in repairing damage in these tissues,but the key cell types and their mechanisms of action remain incompletely understood.In this study,we established a model of concurrent physical trauma to the hearts and livers of adult mice,revealing that these two injured tissues drive distinct immune microenvironments.The liver primarily accumulates lymphocytes,whereas the heart recruits macrophages and neutrophils.Notably,CD160^(+)CD8^(+)intraepithelial lymphocytes in the liver were found to suppress fibrosis postliver injury and mitigate cardiac fibrosis when delivered via hydrogel patches.Conversely,in response to heart trauma,recruited inflammatory macrophages not only express proinflammatory cytokines but also coexpress CCRL2.While CCRL2 did not directly alter the intensity of the inflammatory response,it facilitated fibroblast proliferation and migration through its interaction with Na^(+)/K^(+)-ATPase on fibroblasts.These findings elucidated the contrasting immune microenvironments between the heart and liver following injury and provided novel insights and strategies for diagnosing and treating cardiac diseases.
文摘Diabetic foot attack(DFA)is the most severe presentation of diabetic foot disease,with the patient commonly displaying severe sepsis,which can be limb or life threatening.DFA can be classified into two main categories:Typical and atypical.A typical DFA is secondary to a severe infection in the foot,often initiated by minor breaches in skin integrity that allow pathogens to enter and proliferate.This form often progresses rapidly due to the underlying diabetic pathophysiology of neuropathy,microvascular disease,and hyperglycemia,which facilitate infection spread and tissue necrosis.This form of DFA can present as one of a number of severe infective pathologies including pyomyositis,necrotizing fasciitis,and myonecrosis,all of which can lead to systemic sepsis and multiorgan failure.An atypical DFA,however,is not primarily infection-driven.It can occur secondary to either ischemia or Charcot arthropathy.Management of the typical DFA involves prompt diagnosis,aggressive infection control,and a multidisciplinary approach.Treatment can be guided by the current International Working Group on the Diabetic Foot/Infectious Diseases Society of America guidelines on diabetic foot infections,and the combined British Orthopaedic Foot and Ankle Society-Vascular Society guidelines.This article highlights the importance of early recognition,comprehensive management strategies,and the need for further research to establish standardized protocols and improve clinical outcomes for patients with DFA.
文摘The prosthesis is an artificial device that can replace an organ of a human body member to restore a compromised function. It is necessary following the removal of a human organ, which can occur as a result of an illness, trauma or congenital malformation. The trans-tibia prosthesis, in particular, allows the amputee patient to recover the impaired function and regain autonomy, while facilitating their daily social integration. The trans-tibia prosthesis consists of a socket, a sleeve, connecting elements and a prosthetic foot. Each of these components plays a very important role. Among these components, the prosthetic foot usually called “SACH foot” is very often replaced due to cracking and therefore has a fairly short lifespan. At the Center for Equipment and Rehabilitation of Kabalaye (CERK), the SACH foot made using polyurethane and wood is imported and is given to patients with reduced mobility. The aim of this article is twofold, on the one hand, to make a social and pathological study of trans-tibia amputees in relation to the use of the SACH foot prosthesis, on the other hand, to compare this foot with a new prosthetic foot proposed and which is manufactured using extruded polystyrene. The result of prosthetic tests carried out on twenty-four amputees showed that the foot manufactured using extruded polystyrene is better in terms of resistance, bulk and adaptability to active amputees.
文摘Hindfoot osteoarthritis(HFOA)leads to pain,impaired function,and reduced quality of life.Conservative management aims to alleviate symptoms and delay surgical interventions such as arthrodesis,particularly in young patients with post-traumatic HFOA.Intra-articular injections of corticosteroids and hyaluronic acid are widely used as alternatives for treating foot and ankle osteoarthritis to provide temporary pain relief and functional improvement.Recently,orthobiologic treatments have gained interest for their potential regenerative effects.This review aims to summarize the current evidence on intra-articular injections for HFOA,highlighting the potential benefits,perspectives,and mechanisms of action of conventional and orthobiologic treatments such as platelet-rich plasma,bone marrow aspirate concentrate,and adipose-derived stem cells.
文摘BACKGROUND The purpose of this systematic review was to evaluate the clinical and radiological outcomes at short-term follow-up following suture button fixation for the management of ligamentous Lisfranc injuries.AIM To assess the effectiveness of suture button fixation in managing ligamentous Lisfranc injuries through a systematic evaluation of short-term clinical and radiological outcomes.METHODS During March 2024,the PubMed,EMBASE,and Cochrane library databases were systematically reviewed to identify clinical studies examining outcomes following suture button fixation for the management of ligamentous Lisfranc injuries.Data regarding patient demographics,pathological characteristics,subjective clinical outcomes,radiological outcomes,complications,and failure rates were extracted and analyzed.RESULTS Eight studies were included.In total,94 patients(94 feet)underwent suture button fixation for the management of ligamentous Lisfranc injuries at a weighted mean follow-up of 27.2±10.2 months.The American Orthopaedic Foot and Ankle Society score improved from a weighted mean pre-operative score of 39.2±11.8 preoperatively to a post-operative score of 82.8±5.4.The weighted mean visual analogue scale score improved from a weighted mean pre-operative score of 7.7±0.6 preoperatively to a post-operative score of 2.0±0.4.In total,100%of patients returned to sport at a mean time of 16.8 weeks.The complication rate was 5%,the most common complication of which was residual midfoot stiffness(3.0%).No failures nor secondary surgical procedures were recorded.CONCLUSION This systematic review demonstrated that suture button fixation for ligamentous Lisfranc injuries produced improved clinical outcomes at short-term follow-up.In addition,there was an excellent return-to-sport rate(100%)at a weighted mean time of 16.8 weeks.This review highlights that suture button fixation is a potent surgical treatment strategy for ligamentous Lisfranc injuries;however,caution should be taken when evaluating this data in light of the lack of high quality,comparative studies,and short-term follow-up.
基金supported by the Charles Phelps Taft Research Center at the University of Cincinnati
文摘Background:This prospective study explored the effects of endurance running(ER) in minimal versus standard running shoes on the foot’s superficial layer intrinsic muscles and the function of the longitudinal arch.Our hypothesis was that running in minimal shoes would cause hypertrophy in these muscles and lead to higher,stronger,stiffer arches.Methods:The hypothesis was tested using a sample of 33 healthy runners randomized into two groups,a control group shod in traditional running footwear and an experimental group shod in minimal support footwear,whose feet were scanned in an MRI before and after a 12-week training regime.Running kinematics as well as arch stiffness and height were also assessed before and after the treatment period.Results:Analysis of anatomical cross-sectional areas and muscle volumes indicate that the flexor digitomm brevis muscle became larger in both groups by 11%and 21%,respectively,but only the minimally shod runners had significant areal and volumetric increases of the abductor digiti minimi of 18%and 22%,respectively,and significantly increased longitudinal arch stiffness(60%).Conclusion:These results suggest that endurance running in minimal support footwear with 4 mm offset or less makes greater use of the springlike function of the longitudinal arch,thus leading to greater demands on the intrinsic muscles that support the arch,thereby strengthening the foot.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金Supported by the Medical Science and Technology Foundation of Guangdong Province,No.A2024625the Guangzhou Municipal Science and Technology Program Key Projects,No.202103000002the Panyu Science and Technology Planning Project,No.2023-Z04-019.
文摘BACKGROUND Diabetic foot ulcers(DFUs)affect approximately 18.6 million people worldwide every year.Patients with DFU often present with symptoms such as lower limb infections,ulcers,and deep tissue damage.Platelet-rich plasma(PRP)is a concentrated platelet product that can trigger the release of growth factors and cytokines,which stimulate tissue healing and regeneration and thus alleviates DFU.At present,no comprehensive study has been conducted to verify the effect of PRP in both in vitro and clinical settings for treating DFUs.AIM To perform the in vitro and clinical evaluation of PRP combined with endovascular angioplasty in treating diabetic foot.METHODS This study focused on both in vitro and clinical settings.In the in vitro study,human umbilical vein endothelial cells(HUVECs),human dermal fibroblasts(HSFs),and human immortalized keratinocytes(HaCaTs)were treated with PRP.Experiments involving proliferation,migration,tubule formation,and angiogenesis signaling pathways were conducted.In this clinical study,patients who visited the Affiliated Panyu Central Hospital of Guangzhou Medical University from 2020 to 2024 and met enrollment criteria were randomly assigned to 2 groups using prospective block randomization.In the control group,the DFU was treated with endovascular angioplasty and wound debridement.In the PRP+endovascular angioplasty group,PRP was evenly used on the surface of superficial ulcers,followed by endovascular angioplasty to treat vascular occlusion.The key outcomes were measured,including the Rutherford scale,Wagner scale,foot skin temperature,and ulcer repair area before and after treatment.RESULTS In the in vitro study,6%PRP could promote the proliferation and migration of HUVECs,HSFs,and HaCaTs in a high-glucose environment.Additionally,it promoted tubule formation in HUVECs by activating signaling proteins such as Ak strain transforming and extracellular regulated protein kinases 1/2.In the clinical study,a total of 208 patients participated.After 12 months of treatment,the ulcer repair area(14.95±0.16 cm^(2))and ulcer healing rate were improved in the PRP+endovascular angioplasty group than in the control group(P<0.05).CONCLUSION The combination of 6%activated PRP and endovascular angioplasty may improve the microcirculation and tissue repair in DFUs.This study offers a novel treatment option for patients with diabetic foot.
