OBJECTIVE: To summarize the research and clinical application progress of foot lengthening surgery. METHODS: Relevant research literature on foot lengthening surgery in recent years at home and abroad was reviewed, and a summary was made from aspects such as the types of lengthening surgery, the types of foot diseases treated by clinical application, effectiveness, and complications. RESULTS: Bone defects and shortening deformities of the foot are relatively common clinically. As an innovative treatment method, foot lengthening surgery has gradually attracted attention, mainly including the Ilizarov technique and one-stage bone grafting lengthening surgery. The former promotes bone regeneration based on the tension-stress principle and is widely used in the treatment of calcaneal defects and congenital metatarsal brachymetatarsia, achieving good curative effects. However, there are also complications such as pin-tract infection, joint stiffness and contracture, non-union and delayed union of bone, re-fracture, and alignment deviation. The latter has a short treatment cycle, but the lengthening length is limited. Bone graft resorption and soft tissue complications are its main complications. CONCLUSION Foot lengthening surgery will develop towards the direction of personalization, intelligence, and precision. With the help of multi-center research, biological materials, and intelligent technologies, the effectiveness and safety will be further improved to better restore the function and appearance of the foot.
Humans ; Bone Transplantation/methods* ; Bone Lengthening/methods* ; Ilizarov Technique ; Osteogenesis, Distraction/methods* ; Foot Deformities/surgery* ; Postoperative Complications ; Treatment Outcome ; Foot/surgery*

Objective:To analyze the clinical outcomes of total ankle arthroplasty (TAA) using the INBONE Ⅱ prosthesis in patients ≤50 years old with end-stage ankle arthritis.Methods:A retrospective analysis was conducted of the consecutive patients who had undergone TAA using the INBONE Ⅱ prosthesis between September, 2016 and August, 2021 at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical University. There were 12 males and 16 females with an age of (46.0±4.0) years and a body mass index of (24.9±3.3) kg/m 2. The clinical outcomes recorded and compared between pre-surgery and the last follow-up were tibial articular surface (TAS) angle, talar tilt (TT) angle, tibial lateral surface (TLS) angle, ankle plantarflexion angle, ankle dorsiflexion, ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, MOS item short form health survey (SF-36), foot function index (FFI), and visual analog scale (VAS) for pain. Patient satisfaction by 5-point Likert scale and complications were recorded. Results:All patients were followed up for (49.8±15.3) months. Except for plantar flexion and TAS, for all patients at the last follow-up, TT angle [0.4° (0, 0.6°)], FFI [20.0 (7.3, 48.0) points], and VAS pain score [2.0 (1.0, 2.8) points] were significantly reduced compared with the preoperative values [1.6° (0.3°, 4.4°), (99.9±40.6) points, and 6.0 (4.0, 6.8) points], while TLS angle (86.3°±2.8°), ankle dorsiflexion (13.5°±5.4°), ankle ROM (34.7°±7.9°), AOFAS ankle-hindfoot score [82.0 (74.0, 89.0) points], and SF-36 score [122.5 (112.8, 130.2) points] were all significantly higher than the preoperative values [78.9°±5.7°, 10.3°±8.0°, 31.1°±12.0°, (49.9±3.2) points, and 97.7(89.8, 101.6) points] (all P<0.05). The rate of patient satisfaction at the last follow-up was 89.3% (25/28). No serious postoperative complications occurred and no revision surgery was required. Conclusion:TAA using the INBONE Ⅱ prosthesis has shown good clinical outcomes and a high rate of patient satisfaction in younger patients ≤50 years old with end-stage ankle arthritis.

Objective:To analyze the functional outcomes of arthrodesis for the first metatarsophalangeal joint.Methods:A retrospective study was conducted to analyze the 21 patients who had undergone arthrodesis for the first metatarsophalangeal joint at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital from August 2013 to October 2019. The cohort included 6 males and 15 females. One patient underwent bilateral surgery, 10 cases the left side surgery and 10 cases the right side surgery. Their ages averaged (63.1±9.2) years. There were 12 cases of simple hallux valgus, 5 cases of rheumatoid arthritis combined with hallux valgus, and 4 cases of gout combined with hallux valgus. The visual analog scale (VAS) pain score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, foot function index (FFI) score, hallux valgus angle (HVA), and intermetatarsal angle (IMA) were compared between preoperation and the last follow-up. The proximal phalangeal inclination angle (PPIA) was measured postoperatively. Postoperative satisfaction was evaluated using the Coughlin rating scale. Complications were documented.Results:All patients were followed up for 71.0 (69.8, 75.0) months. In all patients at the last follow-up, VAS [1(0, 3) points], FFI [4.8 (1.6, 8.6) points], HVA [23.4° (14.3°, 28.5°)], and IMA (9.6°±3.2°) were significantly lower than the preoperative values [4 (3, 7) points, 30.4 (16.7, 46.8) points, 43.5° (31.5°, 48.2°), and 13.0°±4.5°], and the AOFAS forefoot score [80.0 (70.8, 90.0) points] was significantly higher than the preoperative one [46.0 (32.8, 55.3) points] ( P<0.05). The postoperative PPIA was 7.7°±10.1°. According to the Coughlin rating scale, 12 cases were rated as excellent, 5 as good, 2 as fair, and 3 as poor. All patients reported relief from painful plantar calluses, most ones experienced complete resolution of plantar calluses, and some ones had stiffness of the metatarsophalangeal joint after fusion. Conclusion:Arthrodesis for the first metatarsophalangeal joint is a reliable treatment for degenerative changes in the metatarsophalangeal joint, because it can well restore the postoperative foot function, significantly relieve pain, and lead to high patient satisfaction.

Objective:To analyze the clinical outcomes of total ankle arthroplasty (TAA) using the INBONE Ⅱ prosthesis in patients ≤50 years old with end-stage ankle arthritis.Methods:A retrospective analysis was conducted of the consecutive patients who had undergone TAA using the INBONE Ⅱ prosthesis between September, 2016 and August, 2021 at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical University. There were 12 males and 16 females with an age of (46.0±4.0) years and a body mass index of (24.9±3.3) kg/m 2. The clinical outcomes recorded and compared between pre-surgery and the last follow-up were tibial articular surface (TAS) angle, talar tilt (TT) angle, tibial lateral surface (TLS) angle, ankle plantarflexion angle, ankle dorsiflexion, ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, MOS item short form health survey (SF-36), foot function index (FFI), and visual analog scale (VAS) for pain. Patient satisfaction by 5-point Likert scale and complications were recorded. Results:All patients were followed up for (49.8±15.3) months. Except for plantar flexion and TAS, for all patients at the last follow-up, TT angle [0.4° (0, 0.6°)], FFI [20.0 (7.3, 48.0) points], and VAS pain score [2.0 (1.0, 2.8) points] were significantly reduced compared with the preoperative values [1.6° (0.3°, 4.4°), (99.9±40.6) points, and 6.0 (4.0, 6.8) points], while TLS angle (86.3°±2.8°), ankle dorsiflexion (13.5°±5.4°), ankle ROM (34.7°±7.9°), AOFAS ankle-hindfoot score [82.0 (74.0, 89.0) points], and SF-36 score [122.5 (112.8, 130.2) points] were all significantly higher than the preoperative values [78.9°±5.7°, 10.3°±8.0°, 31.1°±12.0°, (49.9±3.2) points, and 97.7(89.8, 101.6) points] (all P<0.05). The rate of patient satisfaction at the last follow-up was 89.3% (25/28). No serious postoperative complications occurred and no revision surgery was required. Conclusion:TAA using the INBONE Ⅱ prosthesis has shown good clinical outcomes and a high rate of patient satisfaction in younger patients ≤50 years old with end-stage ankle arthritis.

Objective:To analyze the functional outcomes of arthrodesis for the first metatarsophalangeal joint.Methods:A retrospective study was conducted to analyze the 21 patients who had undergone arthrodesis for the first metatarsophalangeal joint at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital from August 2013 to October 2019. The cohort included 6 males and 15 females. One patient underwent bilateral surgery, 10 cases the left side surgery and 10 cases the right side surgery. Their ages averaged (63.1±9.2) years. There were 12 cases of simple hallux valgus, 5 cases of rheumatoid arthritis combined with hallux valgus, and 4 cases of gout combined with hallux valgus. The visual analog scale (VAS) pain score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, foot function index (FFI) score, hallux valgus angle (HVA), and intermetatarsal angle (IMA) were compared between preoperation and the last follow-up. The proximal phalangeal inclination angle (PPIA) was measured postoperatively. Postoperative satisfaction was evaluated using the Coughlin rating scale. Complications were documented.Results:All patients were followed up for 71.0 (69.8, 75.0) months. In all patients at the last follow-up, VAS [1(0, 3) points], FFI [4.8 (1.6, 8.6) points], HVA [23.4° (14.3°, 28.5°)], and IMA (9.6°±3.2°) were significantly lower than the preoperative values [4 (3, 7) points, 30.4 (16.7, 46.8) points, 43.5° (31.5°, 48.2°), and 13.0°±4.5°], and the AOFAS forefoot score [80.0 (70.8, 90.0) points] was significantly higher than the preoperative one [46.0 (32.8, 55.3) points] ( P<0.05). The postoperative PPIA was 7.7°±10.1°. According to the Coughlin rating scale, 12 cases were rated as excellent, 5 as good, 2 as fair, and 3 as poor. All patients reported relief from painful plantar calluses, most ones experienced complete resolution of plantar calluses, and some ones had stiffness of the metatarsophalangeal joint after fusion. Conclusion:Arthrodesis for the first metatarsophalangeal joint is a reliable treatment for degenerative changes in the metatarsophalangeal joint, because it can well restore the postoperative foot function, significantly relieve pain, and lead to high patient satisfaction.

Objective:To analyze the clinical data of patients with end-stage ankle and hindfoot ar-thropathy who underwent tibiotalocalcaneal(TTC)arthrodesis by the same surgeon,explore the short-and mid-term clinical results,complications and functional improvement,and discuss the clinical progno-sis and precautions of TTC arthrodesis.Methods:Retrospective analysis was made on the clinical data of 40 patients who underwent TTC arthrodesis by the same surgeon from March 2011 to December 2020.In this study,23 males and 17 females were included,with an average age of(49.1±16.0)years.All the patients underwent unilateral surgery.The clinical characteristics,imaging manifestations,main diagno-sis and specific surgical techniques of the patients were recorded.The clinical outcomes were evaluated by comparison of the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and visual analogue scale(VAS)between pre-operation and at the last follow-up.The fusion healing time,symptom improvement(significant improvement,certain improvement,no improvement or deterioration)and postoperative complications were also recorded.Results:The median follow-up time was 38.0(26.3,58.8)months.The preoperative VAS score was 6.0(4.0,7.0),and the AOFAS score was 33.0(25.3,47.3).At the last follow-up,the median VAS score was 0(0,3.0),and the AOFAS score was 80.0(59.0,84.0).All the significantly improved compared with their preoperative corre-sponding values(P＜0.05).There was no wound necrosis or infection in the patients.One patient suf-fered from subtalar joint nonunion,which was syphilitic Charcot arthropathy.The median bony healing time of other patients was 15.0(12.0,20.0)weeks.Among the included patients,there were 25 cases with significant improvement in symptom compared with that preoperative,8 cases with certain improve-ment,4 cases with no improvement,and 3 cases with worse symptoms than that before operation.Con-clusion:TTC arthrodesis is a reliable method for the treatment of the end-stage ankle and hindfoot ar-thropathy.The function of most patients was improved postoperatively,with little impact on daily life.The causes of poor prognosis included toe stiffness,stress concentration in adjacent knee joints,nonunion and pain of unknown causes.

Ultraviolet radiation affects human health. On the one hand, moderate amounts of UV radiation can promote human health and have the effect of promoting vitamin D production; but on the other hand, excessive UV radiation can also cause adverse effects on human skin and eyes, such as causing skin photoaging, skin cancer, electrophthalmia and cataracts to occur. Therefore, the measurement of ultraviolet radiation is extremely important. This paper mainly reviews the health effects of ultraviolet radiation and the progress of measurement standards in the workplace, and puts forward suggestions on the revision of the existing standards from five aspects including use new measuring instruments and methods, improve the existing measuring instruments, specify the number of measurements, expand the scope of application of the standards and consider the influence of the sun on the measurement of artificial ultraviolet radiation, so as to provide reference for the revision of new standards.

Ultraviolet radiation affects human health. On the one hand, moderate amounts of UV radiation can promote human health and have the effect of promoting vitamin D production; but on the other hand, excessive UV radiation can also cause adverse effects on human skin and eyes, such as causing skin photoaging, skin cancer, electrophthalmia and cataracts to occur. Therefore, the measurement of ultraviolet radiation is extremely important. This paper mainly reviews the health effects of ultraviolet radiation and the progress of measurement standards in the workplace, and puts forward suggestions on the revision of the existing standards from five aspects including use new measuring instruments and methods, improve the existing measuring instruments, specify the number of measurements, expand the scope of application of the standards and consider the influence of the sun on the measurement of artificial ultraviolet radiation, so as to provide reference for the revision of new standards.

BACKGROUND: The blood oxygen saturation is an important physiological parameter of human hfe; it can be affected by multiple factors due to the imbalance of oxygen supply and consumption, and consequently, the normal physical metabolism is affected. The existing manufacturing techniques are complex and are used with higher demands. OBJECTIVE: To investigate the accuracy of the novel reflecting oximeter designed on the basis of reflecting principle in monitoring the variance of blood oxygen saturation with the change of its concentration. DESIGN: To introduce the structure, working principle and design of the reflecting oximeter and make comparative study with adult rabbits as the subjects. SETTING: Cardiopolmonary Bypass Department of Cardiovascular disease hospital of the Chinese Academy of MedicalSciences. MATERIALS: The study was performed at the Departments of Anesthesiology and Cardiopulmonary Bypass of the Cardiovascular Disease Hospital,Chinese Academy of Medical Sciences from August to October in 2001.Ten adult rabbits were selected. METHODS: The oximeter consists of a converter, a driver, a central processing mould and liquid-crystal monitor. It is characterized by the onethree optical cable connected with reflecting probe, postcentral management system and digital displayer. This oxmeter was developed basing on the basis of fixed relationship between blood oxygen saturation and radiant absorbency (or reflecting). In this study,cardiovascular-pulmonary bypass was established on rabbits that were then exposed to oxygen and NO mixture supply of different concentrations,and then the corresponding blood oxygen saturations were determined with the new oximeter and compared with series-wound Baite saturation meter and blood-gas analysis. MAIN OUTCOME MEASURES: The blood oxygen saturation at different concentrations determined with the reflecting oximeter and Baite saturation meter. RESULTS: At the same oxygen concentration, the blood oxygen saturation determined with the new measure was not significantly different from that determined with Baite blood oxygen saturation meter(P＞0.05 ). CONCLUSION: The variance of blood oxygen saturation with the change of oxygen concentration can be detected by the reflecting oximeter with the result similar to that by Baite blood oxygen saturation meter.