Objective:To investigate the iodine nutrition status of pregnant women in Zhejiang Province, explore the impact of salt industry system reform on iodine nutrition level of pregnant women, and provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods:From 2016 to 2021, a multi-stage stratified sampling method was used to select 100 pregnant women from 90 counties (cities, districts) in Zhejiang Province each year as survey subjects. Salt samples were collected from pregnant women's families, and one random urine sample was taken for salt iodine and urinary iodine level testing, respectively.Results:A total of 56 581 samples of household edible salt were collected from pregnant women, with a median salt iodine level of 23.20 mg/kg. Among them, 7 961 were non iodized salt, 45 803 were qualified iodized salt, and 2 817 were unqualified iodized salt. The iodized salt coverage rate was 85.93% (48 620/56 581), and the qualified iodized salt consumption rate was 80.95% (45 803/56 581). The proportion of non iodized salt increased from 10.05% (897/8 928) in 2016 to 15.09% (1 461/9 679) in 2021 (χ 2trend = 95.16, P < 0.001). A total of 56 581 urine samples were collected from pregnant women, with a median urinary iodine level of 130.50 μg/L. Among them, the proportions of urinary iodine levels < 150, 150 - 249, 250 - 499, and ≥500 μg/L were 58.32% (32 996/56 581), 27.24% (15 410/56 581), 12.24% (6 926/56 581), and 2.21% (1 249/56 581), respectively. The median urinary iodine level of pregnant women in inland areas was significantly higher than that in coastal areas ( Z = 19.15, P < 0.001). Furthermore, urinary iodine levels exhibited a non-linear decline as age increased (χ 2regression = 12.65, P < 0.001; χ 2partial = 22.65, P < 0.001) and as pregnancy progressed (χ 2regression = 37.28, P < 0.001; χ 2partial = 18.89, P < 0.001). Conclusions:The overall iodine nutrition status of pregnant women in Zhejiang Province is in a state of iodine deficiency (< 150 μg/L), and there is a greater risk in coastal areas compared to inland areas. However, in the context of the reform of the salt industry system, it is still necessary to strengthen the quality supervision of iodized salt, provide scientific iodine supplementation education, promote specialized iodized salt for pregnant women, and strengthen interventions for prevention and control of iodine deficiency disorders.

Objective:To investigate the risk factors influencing mortality in neonates undergoing continuous renal replacement therapy (CRRT).Methods:This retrospective study included 34 neonates with a corrected age of≤28 days who received CRRT at the Affiliated Children's Hospital of Xiangya School of Medicine, Central South University, from January 2019 to December 2023. The neonates were divided into a mortality group ( n=16) and a survival group ( n=18) based on whether they died during CRRT. Pre-CRRT blood biochemical indices, general condition, CRRT treatment modes, parameters, and related complications were analyzed using t-tests, Wilcoxon signed-rank tests, and Chi-square tests. Logistic stepwise regression analysis was used to screen for risk factors associated with CRRT mortality. Results:The mortality rate among the 34 neonates was 48.6% (16/34), with a median CRRT age of 17 days (range: 2-33 days). Eleven neonates (32.3%) were preterm, with the youngest gestational age being 27 weeks and the lowest weight before CRRT initiation being 1 700 g. The mortality group had lower urine output 6-12 hours before CRRT initiation and lower critical illness scores compared to the survival group [0.05 (0.02-1.00) ml/(kg·h) vs. 0.50 (0.20-1.05) ml/(kg·h), (64.50±7.10) scores vs. (77.67±3.65) scores, Z or t values were 10.97 and 3.91, respectively]. However, the vasoactive inotropic score (VIS), proportion of coma, and levels of blood potassium, alanine aminotransferase, aspartate aminotransferase, blood ammonia, blood lactic acid, and activated partial thromboplastin time (APTT) were higher in the mortality group compared to the survival group [ (86.88±15.80) scores vs. (55.56±24.31) scores, 11/16 vs. 1/18, (7.02±1.73) mmol/L vs. (5.88±1.53) mmol/L, 274.55(132.50-664.98) U/L vs. 31.10(19.03-110.70) U/L, 688.20 (449.73-3 618.13) U/L vs. 96.65 (44.15-439.00) U/L, 232.75 (70.33-1 310.85) μmol/L vs.77.70 (49.78-919.05) μmol/L, (11.17±3.36) U/L vs. (7.99±2.67) U/L, and (99.57±39.74) s vs. (60.97±31.25) s, with t, χ2, or Z values of－4.39, 14.81,－2.03,－2.72,－11.81,－3.89,－3.06, and－3.17, respectively] (all P<0.05). Logistic regression analysis revealed that pre-treatment VIS value ( OR=1.150, 95% CI: 1.035-1.278), and blood ammonia level ( OR=1.004, 95% CI: 1.002-1.009) were independent risk factors for mortality (both P<0.05). Conclusions:Neonatal CRRT mortality is associated with pre-treatment VIS scores and blood ammonia levels. Attention should be paid to a rapid decreases in urine output, the intensity of vasopressor support, and elevated levels of blood ammonia, blood lactic acid, transaminases, and APTT at the initiation of treatment.

Objective:To analyze the iodine nutrition status and its related factors among adults aged 18 years and above in Zhejiang Province in 2022.Methods:A multistage stratified sampling method was used to select 4 320 adults aged 18 years and above from 16 on-site survey sites in Zhejiang Province for the study. A questionnaire was used to investigate the general demographic information and personal dietary characteristics of the study participants. Household edible salt and urine samples were collected to detect salt iodine content and urinary iodine level by using direct titration and cerium arsenate-catalyzed spectrophotometry, respectively, to evaluate the iodine nutritional status according to the standard. The multiple-ordered logistic regression model was used to analyze the factors influencing the urinary iodine concentration.Results:The age of the 4 320 study participants was (51.19±15.33) years, with males accounting for 44.44% (1 920). About 40.16% of adults (1 735) were from coastal areas and 56.37% (2 435) from urban areas. The salt iodine content, M ( Q1, Q3), of the 4 320 household edible salt samples was 21.10 (0.00, 24.16) mg/kg, including 1 662 non-iodized salt samples, 182 unqualified iodized salt samples and 2 476 qualified iodized salt samples. The rate of iodized salt coverage was 61.53%, and the rate of qualified iodized salt consumption was 57.31%. There was a statistically significant difference in the proportion of qualified iodized salt in adult households among different regions ( P<0.001), with the proportion of non-iodized salt gradually decreasing from coastal to inland areas ( χ 2trend=618.458, P<0.001). The urinary iodine concentration M ( Q1, Q3) was 137.60 (86.85, 210.60) μg/L in 4 320 adult urine samples, with the urinary iodine levels of<100, 100-199, 200-299, and≥300 μg/L accounting for 31.64% (1 367), 40.56% (1 752), 17.66% (763), and 10.14% (438), respectively. There was a nonlinear positive correlation between household salt iodine content and urinary iodine level in adults aged 18 years and above by using the χ 2 test for trend ( χ 2regression=231.10, P<0.001 and χ 2skew=28.81, P<0.001). Urinary iodine concentrations were higher in men than in women ( P=0.029) and higher in adults in rural areas than in urban areas ( P<0.001). There were statistically significant differences in the distribution of iodine nutritional status among adults of different ages, regions, and urban and rural areas (all P<0.001). The proportion of those with urinary iodine levels<100 μg/L gradually increased with age ( χ 2trend=37.493, P<0.001), and gradually decreased from coastal areas to inland areas ( χ 2trend=71.381, P<0.001). The results of the multiple-ordered logistic regression model analysis showed that compared with adults aged 18 to 44 years and male adults, those aged 45 to 59 years and female adults had lower urinary iodine levels, with OR (95% CI) of 0.75 (0.68-0.83) and 0.85 (0.76-0.95), respectively. Compared with adults in coastal and urban adults, those in sub-coastal, inland and rural adults had higher levels of urinary iodine, with OR (95% CI) of 1.89 (1.63-2.19), 2.02 (1.72-2.37) and 1.46 (1.28-1.66), respectively. Conclusion:The overall iodine nutrition level of adults aged 18 years and above in Zhejiang Province in 2022 is generally appropriate. However, there is a potential risk of iodine deficiency among adults in coastal areas.

Objective:To investigate the iodine nutrition status of pregnant women in Zhejiang Province, explore the impact of salt industry system reform on iodine nutrition level of pregnant women, and provide scientific basis for prevention and treatment of iodine deficiency disorders.Methods:From 2016 to 2021, a multi-stage stratified sampling method was used to select 100 pregnant women from 90 counties (cities, districts) in Zhejiang Province each year as survey subjects. Salt samples were collected from pregnant women's families, and one random urine sample was taken for salt iodine and urinary iodine level testing, respectively.Results:A total of 56 581 samples of household edible salt were collected from pregnant women, with a median salt iodine level of 23.20 mg/kg. Among them, 7 961 were non iodized salt, 45 803 were qualified iodized salt, and 2 817 were unqualified iodized salt. The iodized salt coverage rate was 85.93% (48 620/56 581), and the qualified iodized salt consumption rate was 80.95% (45 803/56 581). The proportion of non iodized salt increased from 10.05% (897/8 928) in 2016 to 15.09% (1 461/9 679) in 2021 (χ 2trend = 95.16, P < 0.001). A total of 56 581 urine samples were collected from pregnant women, with a median urinary iodine level of 130.50 μg/L. Among them, the proportions of urinary iodine levels < 150, 150 - 249, 250 - 499, and ≥500 μg/L were 58.32% (32 996/56 581), 27.24% (15 410/56 581), 12.24% (6 926/56 581), and 2.21% (1 249/56 581), respectively. The median urinary iodine level of pregnant women in inland areas was significantly higher than that in coastal areas ( Z = 19.15, P < 0.001). Furthermore, urinary iodine levels exhibited a non-linear decline as age increased (χ 2regression = 12.65, P < 0.001; χ 2partial = 22.65, P < 0.001) and as pregnancy progressed (χ 2regression = 37.28, P < 0.001; χ 2partial = 18.89, P < 0.001). Conclusions:The overall iodine nutrition status of pregnant women in Zhejiang Province is in a state of iodine deficiency (< 150 μg/L), and there is a greater risk in coastal areas compared to inland areas. However, in the context of the reform of the salt industry system, it is still necessary to strengthen the quality supervision of iodized salt, provide scientific iodine supplementation education, promote specialized iodized salt for pregnant women, and strengthen interventions for prevention and control of iodine deficiency disorders.

Objective:To analyze the iodine nutrition status of children and adolescents and influencing factors in Zhejiang Province, providing scientific basis for optimizing iodine deficiency disorders (IDD) prevention and control strategies.Methods:In June 2022, a multistage stratified sampling method was used to divide 16 counties (cities, districts, abbreviated as counties) in Zhejiang Province into three categories based on their geographical locations (average distance from the coastline): coastal areas (including Dinghai District, Jiaojiang District, Sanmen County, Cixi City and Lucheng District), sub-coastal areas (including Wuxing District, Haining City, Linping District, Fuyang District and Fenghua District), and inland areas(including Suichang County, Changshan County, Shengzhou City, Jindong District, Dongyang City and Yongjia County). One county was selected from each category, and one township (street) was selected from each county. Two administrative villages (neighborhood committees) were selected from each township (street). Ten households including all children and adolescents aged 6-17 in each household were selected from each administrative village (neighborhood committee). Demographic information and personal dietary characteristics were collected via questionnaires, while household salt and a random urine sample were tested for iodine level. Trend analysis was conducted using a χ 2trend test, and a multivariate logistic stepwise regression model was used to analyze the influencing factors of urinary iodine levels. Results:A total of 755 children and adolescents aged 6-17 were selected, including 387 males (51.26%) and 368 females (48.74%), with an age of (11.24 ± 3.32) years. There were 269 children and adolescents in coastal areas (35.63%) and 409 children and adolescents in urban areas (54.17%). A total of 755 household salt samples were collected, with a median salt iodine concentration of 21.80 mg/kg. These included 263 non-iodized salt samples, 38 unqualified iodized salt samples, and 454 qualified iodized salt samples. The coverage rate of iodized salt was 65.17% (492/755), and the consumption rate of qualified iodized salt was 60.13% (454/755). The distribution of salt iodine quality among children and adolescents in different geographical locations showed statistically significant differences (χ 2 = 111.95, P < 0.001), with the proportion of non-iodized salt gradually decreasing from coastal areas to inland areas (χ 2trend = 90.17, P < 0.001). A total of 755 urine samples were collected, with a median urinary iodine concentration of 186.60 μg/L. The proportions of urinary iodine < 100, 100-199, 200-299, and ≥300 μg/L were 16.95% (128/755), 37.62% (284/755), 24.37% (184/755), and 21.06% (159/755), respectively. The χ 2trend test revealed a nonlinear positive correlation between salt iodine level and urinary iodine level (χ 2regression = 21.98, P < 0.001; χ 2partial = 6.96, P < 0.001). The frequency distribution of urinary iodine in children and adolescents from different geographical locations and between urban and rural areas showed statistically significant differences (χ 2 = 29.63, 16.56, P < 0.001). Among them, the proportion of children and adolescents with urinary iodine < 100 μg/L gradually decreasing from coastal areas to inland areas (χ 2trend = 6.15, P = 0.013). The results of multivariate logistic regression analysis revealed that sub-coastal regions, inland regions, and urban-rural regions ( OR = 1.57, 1.53, 1.64, 95% CI: 1.11-2.24, 1.03-2.27, 1.17-2.32, P < 0.05) were significantly associated with urinary iodine levels in children and adolescents aged 6-17. Conclusions:In 2022, the iodine nutrition of children and adolescents in Zhejiang Province is generally suitable, but there is a risk of iodine deficiency among coastal children and adolescents. Geographic location and urban/rural areas are influencing factors on iodine nutrition status of children and adolescents in Zhejiang Province.

Objective To explore the application effect of personalized osteotomy guide plate in high tibial osteotomy for patients with knee osteoarthritis(KOA).Methods A total of 99 patients with KOA who underwent open wedge high tibial osteotomy(OWHTO)in our hospital from January 2022 to January 2023 were selected and randomly divided into a study group(50 cases)and a control group(49 cases)using a random number table method.The control group received traditional medial OWHTO treatment,and the study group received a combination of medial OWHTO and personalized osteotomy guide plate treatment.The indexes of operation and postoperative rehabilitation,serum inflammatory stress factor[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),cortisol(Cor),adrenocorticotropin(ACTH)],anatomical structure of knee joint[tibial plateau posterior Angle(PTSA),proximal medial tibial Angle(MPT A),hip knee ankle Angle(HKA)],knee function,ACL shape and function,postoperative complications were compared between the two groups.Results The amount of bleeding,the number of intraoperative fluoroscopy,and the postoperative drainage volume in the study group were(138.69±24.03)ml,(4.83±1.07)times,and(228.95±38.72)ml,respectively,which were all less than those in the control group(154.28±27.16)ml,(7.15±1.14)times,and(271.61±42.19)ml.In the study group,the operation time,incision length,and hospitalization time were(40.96±7.28)min,(8.96±0.85)cm,and(10.73±2.05)d,respectively,which were all shorter than those in the control group[(52.31±10.12)min,(9.51±1.03)cm,and(12.16±2.37)d],with statistically significant differences(P＜0.05).The levels of serum CRP,TNF-α,Cor,and ACTH in the study group on the 3rd day after the operation were(31.36±4.68)mg/L,(26.71±3.84)ng/ml,(241.28±27.45)ng/ml,and(18.65±3.01)pmol/L,respectively,which were lower than those in the control group[(35.07±5.16)mg/L,(30.29±4.15)ng/ml,(279.65±30.12)ng/ml,and(21.73±3.28)pmol/L,respectively],and the differences were statistically significant(P＜0.05).The Hospital for Special Surgery(HSS)knee score and Knee Society Score(KSS)of the study group at 12 months after surgery were(81.24±6.85)points and(78.26±6.14)points,respectively,which were higher than those of the control group[(78.08±6.42)points and(75.53±5.82)points,respectively],with statistically significant differences(P＜0.05);at the 12th month after surgery,the width of the ACL body in the study group was(5.68±0.71)mm,which was greater than that in the control group[(5.12±0.64)mm].The amount of anterior tibial displacement was(5.81±0.43)mm,which was smaller than that in the control group(6.19±0.41)mm,and the differences were statistically significant(P＜0.05);the incidence of postoperative complications in the study group was 4.00％,which was lower than that in the control group(18.37％),and the difference was statistically significant(P＜0.05).Conclusion The combined treatment of medial OWHTO and personalized osteotomy guide plate can reduce surgical trauma in patients with KOA,lower the incidence of complications,facilitate patient recovery,while maintaining the morphology and function of the ACL,and improving prognosis.

Objective To assess the prognostic value of serum lysine hydroxylase 3(PLOD3)and cytokeratin 19 fragment(CYFRA21-1)in predicting the efficacy of three-dimensional brachytherapy in patients with pulmonary metastases.Methods A total of 102 patients with lung metastases who underwent three-dimensional brachytherapy at our hospital were selected as the lung metastasis group from August 2021 to August 2023.During the same period,a control group consisting of 60 healthy individuals who underwent physical examinations was selected.The lung metastasis group was further divided into an effective group(n=66)and an ineffective group(n=36)based on therapeutic outcomes.Enzyme-linked immunosorbent assay was employed to measure the levels of serum PLOD3 and CYFRA21-1.Multiple logistic regression analysis was conducted to identify factors influencing the efficacy of three-dimensional brachytherapy in the lung metastasis group.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum PLOD3 and CYFRA21-1 for treatment efficacy.Results The levels of serum PLOD3 and CYFRA21-1 in the case group were(34.47±6.17)μg/L,(27.85±5.14)μg/L,respectively,which exhibited significantly higher values compared to those observed in the control group(7.26±2.21)μg/L,(9.31±2.46)μg/L(P<0.05).A positive correlation was found between serum PLOD3 and CYFRA21-1 in the Lung metastasis group(r=0.667,P=0.000).Logistic regression analysis revealed that multiple metastatic lesions along with elevated serum levels of PLOD3 and CYFRA21-1 were identified as risk factors for the efficacy of three-dimensional brachytherapy in patients with lung metastases(P<0.05).Furthermore,when combined with three-dimensional brachytherapy,the area under the curve(AUC)for serum PLOD3 and CYFRA21-1 was calcu-lated as 0.868,demonstrating a superior performance compared to individual measurements of either serum PLOD3 alone(AUC=0.815)or CYFRA21-1 alone(P<0.05).Conclusions The levels of serum PLOD3 and CYFRA21-1 are elevated in patients with lung metastases,exhibiting a significant correlation with the efficacy of three-dimensional brachytherapy.The combined utilization of these two biomarkers demonstrates a robust predictive value for treatment efficacy in patients suffering from lung metastases.

Objective To assess the prognostic value of serum lysine hydroxylase 3(PLOD3)and cytokeratin 19 fragment(CYFRA21-1)in predicting the efficacy of three-dimensional brachytherapy in patients with pulmonary metastases.Methods A total of 102 patients with lung metastases who underwent three-dimensional brachytherapy at our hospital were selected as the lung metastasis group from August 2021 to August 2023.During the same period,a control group consisting of 60 healthy individuals who underwent physical examinations was selected.The lung metastasis group was further divided into an effective group(n=66)and an ineffective group(n=36)based on therapeutic outcomes.Enzyme-linked immunosorbent assay was employed to measure the levels of serum PLOD3 and CYFRA21-1.Multiple logistic regression analysis was conducted to identify factors influencing the efficacy of three-dimensional brachytherapy in the lung metastasis group.Receiver operating characteristic(ROC)curves were used to assess the predictive value of serum PLOD3 and CYFRA21-1 for treatment efficacy.Results The levels of serum PLOD3 and CYFRA21-1 in the case group were(34.47±6.17)μg/L,(27.85±5.14)μg/L,respectively,which exhibited significantly higher values compared to those observed in the control group(7.26±2.21)μg/L,(9.31±2.46)μg/L(P<0.05).A positive correlation was found between serum PLOD3 and CYFRA21-1 in the Lung metastasis group(r=0.667,P=0.000).Logistic regression analysis revealed that multiple metastatic lesions along with elevated serum levels of PLOD3 and CYFRA21-1 were identified as risk factors for the efficacy of three-dimensional brachytherapy in patients with lung metastases(P<0.05).Furthermore,when combined with three-dimensional brachytherapy,the area under the curve(AUC)for serum PLOD3 and CYFRA21-1 was calcu-lated as 0.868,demonstrating a superior performance compared to individual measurements of either serum PLOD3 alone(AUC=0.815)or CYFRA21-1 alone(P<0.05).Conclusions The levels of serum PLOD3 and CYFRA21-1 are elevated in patients with lung metastases,exhibiting a significant correlation with the efficacy of three-dimensional brachytherapy.The combined utilization of these two biomarkers demonstrates a robust predictive value for treatment efficacy in patients suffering from lung metastases.

Objective To explore the application effect of personalized osteotomy guide plate in high tibial osteotomy for patients with knee osteoarthritis(KOA).Methods A total of 99 patients with KOA who underwent open wedge high tibial osteotomy(OWHTO)in our hospital from January 2022 to January 2023 were selected and randomly divided into a study group(50 cases)and a control group(49 cases)using a random number table method.The control group received traditional medial OWHTO treatment,and the study group received a combination of medial OWHTO and personalized osteotomy guide plate treatment.The indexes of operation and postoperative rehabilitation,serum inflammatory stress factor[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),cortisol(Cor),adrenocorticotropin(ACTH)],anatomical structure of knee joint[tibial plateau posterior Angle(PTSA),proximal medial tibial Angle(MPT A),hip knee ankle Angle(HKA)],knee function,ACL shape and function,postoperative complications were compared between the two groups.Results The amount of bleeding,the number of intraoperative fluoroscopy,and the postoperative drainage volume in the study group were(138.69±24.03)ml,(4.83±1.07)times,and(228.95±38.72)ml,respectively,which were all less than those in the control group(154.28±27.16)ml,(7.15±1.14)times,and(271.61±42.19)ml.In the study group,the operation time,incision length,and hospitalization time were(40.96±7.28)min,(8.96±0.85)cm,and(10.73±2.05)d,respectively,which were all shorter than those in the control group[(52.31±10.12)min,(9.51±1.03)cm,and(12.16±2.37)d],with statistically significant differences(P＜0.05).The levels of serum CRP,TNF-α,Cor,and ACTH in the study group on the 3rd day after the operation were(31.36±4.68)mg/L,(26.71±3.84)ng/ml,(241.28±27.45)ng/ml,and(18.65±3.01)pmol/L,respectively,which were lower than those in the control group[(35.07±5.16)mg/L,(30.29±4.15)ng/ml,(279.65±30.12)ng/ml,and(21.73±3.28)pmol/L,respectively],and the differences were statistically significant(P＜0.05).The Hospital for Special Surgery(HSS)knee score and Knee Society Score(KSS)of the study group at 12 months after surgery were(81.24±6.85)points and(78.26±6.14)points,respectively,which were higher than those of the control group[(78.08±6.42)points and(75.53±5.82)points,respectively],with statistically significant differences(P＜0.05);at the 12th month after surgery,the width of the ACL body in the study group was(5.68±0.71)mm,which was greater than that in the control group[(5.12±0.64)mm].The amount of anterior tibial displacement was(5.81±0.43)mm,which was smaller than that in the control group(6.19±0.41)mm,and the differences were statistically significant(P＜0.05);the incidence of postoperative complications in the study group was 4.00％,which was lower than that in the control group(18.37％),and the difference was statistically significant(P＜0.05).Conclusion The combined treatment of medial OWHTO and personalized osteotomy guide plate can reduce surgical trauma in patients with KOA,lower the incidence of complications,facilitate patient recovery,while maintaining the morphology and function of the ACL,and improving prognosis.

Objective:To explore the clinical effect of precise intraepiphyseal wedge osteotomy for the treatment of congenital hypertrophic epiphysis of the distal phalanx of the thumbs in children.Methods:A retrospective analysis was conducted on the data of children with congenital hypertrophic epiphysis deformity of the distal phalanx of the thumb treated by precisely located intraepiphyseal wedge osteotomy in Dongguan Integrated Traditional Chinese and Western Medicine Hospital from January 2020 to January 2023. Preoperative X-ray films all showed asymmetric thickening of the secondary ossification centers, presenting as triangular, elliptical, unequal trapezoidal, and bipartite epiphyseal fusion shapes respectively. During the operation, precise localization was performed, and wedge osteotomy was conducted at 1.5 mm from the articular surface. The osteotomy angle and volume were adjusted according to the morphology of the hypertrophic epiphysis and the comprehensive condition of the distal and proximal phalanges, with axial over-correction of approximately 10° for fixation. Six months after surgery, the ulnar deviation angle of the distal phalanx with the interphalangeal joint of the thumb, the maximum passive flexion angle, and the thickness of the distal epiphyseal plate on X-ray were followed up. Statistical analysis was conducted using paired t-tests before and after surgery, and P<0.05 was considered statistically significant. Results:A total of 32 children with 34 thumbs were included, aged from 6 months to 8 years old, with an average age of 2.1 years old. There were 27 thumbs accompanied by radial polydactyly, the main and accessory thumbs were clear, and the epiphysis of the distal phalanx of the main thumb was thickened. The lateral deviation angle of the distal phalanx of the thumb before surgery was (35.6±13.2)° (15.0°-67.0°), the maximum passive flexion range was (62.8±7.7)° (38.0°-80.0°), and the maximum thickness of the distal phalanx epiphysis in the X-ray was (3.7±0.9) mm (2.3-5.9 mm). All surgeries of all children were successfully completed, the wounds healed well without redness, swelling or infection. Patients were discharged smoothly. The average follow-up time after surgery was 13 month (rang from 6-22 months), with an average deviation angle of (7.6±5.6)° (1.8°-13.4°) in the distal phalanx with the interphalangeal joint, compared with before surgery, the difference was statistically significant ( t=10.36, P=0.012). Five thumbs had residual ulnar deviation after surgery, with an average deviation of (16.6±2.3)° (12.0°-20.0°), two cases had corrected positive radial deviation (15°, 18°), while the other cases had no significant ulnar deviation in the distal phalanx of the thumb. The average maximum angle of passive flexion of the distal thumb after surgery was (62.9±7.5)° (35.0°-80.0°), compared with before surgery, the difference was not statistically significant ( t=0.16, P=0.359). The average maximum thickness of the distal epiphyses on postoperative X-rays was (1.9±0.5) mm (1.2-3.1 mm), compared with before surgery, the difference was statistically significant ( t=17.04, P=0.012). The epiphyses were flat and round, and the growth lines were normal. Conclusion:Using precise intraepiphyseal wedge osteotomy, combined with postoperative fixation with mild overcorrection for the treatment of congenital hypertrophic epiphysis at distal phalanx of the thumb in children, can achieve satisfactory correction of deviation, significantly shorten and improve the morphology of the epiphysis without affecting the growth plate, and cause minimal impact on joint flexion activity.