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*

"Tendon Constraining Bone"is an essential theory in osteology and traumatology of traditional Chinese medicine,originating from the statement in Suwen(Plain Questions)that"convergent tendon controlling bones and joints".Since the Yuan and Ming dynasties,the theory of"Tendon Constraining Bone"was formed based on the understanding of anatomical relationships and the need for pathogenesis interpretation,developed by medical practitioners such as ZHU Danxi and ZHANG Jie.The"Tendon Constraining Bone"theory summarizes the physiological connections between tendons and bones and between tendons and zang-fu organs and meridians.Tendons and bones are structurally connected and functionally related,reflected in sturdy bones and tough tendons,upright bones and soft tendons with smoothly-flowing qi and blood,all tendons being related to joints,and thews being related to bones.Tendons and bones are related by meridians and zang-fu organs,specifically reflected in the Yangming channel governing the nourishment of tendons,liver governing tendons,kidneys governing bones,Taiyang channel governing tendons,and Shaoyang channel governing bones.The abnormality of"Tendon Constraining Bone"is the general pathogenesis of various tendon and bone diseases,and it can be caused by changes in the tendon and bone structure,nourishment deficiency,or the pathogenic qi retention.The pathological manifestations of abnormal"Tendon Constraining Bone"are manifested in form and state.Abnormalities in form can manifest as tendon rupture,bone fractures,tendon dislocation,and bone dislocation,whereas abnormalities in state can manifest as tendon urgency,bone pain,tendon laxity,and bone softness.The"Tendon Constraining Bone"theory has influenced the development of treatment principles such as combining motion and quiescence,paying equal attention to bone and flesh,and combining internal and external treatment.This theory has guided the application of basic treatment method such as connecting and rectifying tendons and bones,smoothing tendons and relieving bones,and nourishing tendons and strengthening bones.Therefore,the"Tendon Constraining Bone"theory can significantly guide tendon and bone disease diagnosis and treatment.

Background: This study compares the difference in the clinical and radiologic outcomes when minimally invasive plate osteosynthesis (MIPO) technique is performed with or without using a positional screw in the treatment of humeral shaft fractures. Methods: From January 2010 to January 2021, a retrospective study was conducted on a total of 63 patients who underwent the MIPO technique for the treatment of humeral shaft fractures. We divided these patients into 2 groups: in group I, patients underwent MIPO without a positional screw; in group II, patients underwent MIPO with a positional screw. We compared functional outcomes including the American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, Simple Shoulder Test, range of motion before and after surgery, operation time, blood loss, and complications. And we compared radiologic outcomes including pre- and postoperative anteroposterior (AP) and lateral displacement of the fracture and union time on plain radiographs. Results: The average patient age was 64.6 ± 15.1 years (range, 25–88 years). Group I consisted of 30 patients (10 men and 20 women), and group II consisted of 33 patients (11 men and 22 women). Between the 2 groups, there was no statistically significant difference in sex, body mass index, functional scores, AP and lateral displacement of the fracture on postoperative x-ray, operation time, and blood loss. In group II, a faster bony union was obtained than that in group I (4.6 vs. 6.4 months). Complications included 2 cases of transient radial nerve palsy in both groups and metallic failures (2 in group I and 1 in group II). Conclusions When performing MIPO for humeral shaft fractures, adding a positional screw could be more stabilizing than bridge plating without a positional screw, leading to faster bony union. A positional screw might help control interfragmentary movement without inhibiting essential interfragmentary movement for fracture healing.

Background: This study compares the difference in the clinical and radiologic outcomes when minimally invasive plate osteosynthesis (MIPO) technique is performed with or without using a positional screw in the treatment of humeral shaft fractures. Methods: From January 2010 to January 2021, a retrospective study was conducted on a total of 63 patients who underwent the MIPO technique for the treatment of humeral shaft fractures. We divided these patients into 2 groups: in group I, patients underwent MIPO without a positional screw; in group II, patients underwent MIPO with a positional screw. We compared functional outcomes including the American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, Simple Shoulder Test, range of motion before and after surgery, operation time, blood loss, and complications. And we compared radiologic outcomes including pre- and postoperative anteroposterior (AP) and lateral displacement of the fracture and union time on plain radiographs. Results: The average patient age was 64.6 ± 15.1 years (range, 25–88 years). Group I consisted of 30 patients (10 men and 20 women), and group II consisted of 33 patients (11 men and 22 women). Between the 2 groups, there was no statistically significant difference in sex, body mass index, functional scores, AP and lateral displacement of the fracture on postoperative x-ray, operation time, and blood loss. In group II, a faster bony union was obtained than that in group I (4.6 vs. 6.4 months). Complications included 2 cases of transient radial nerve palsy in both groups and metallic failures (2 in group I and 1 in group II). Conclusions When performing MIPO for humeral shaft fractures, adding a positional screw could be more stabilizing than bridge plating without a positional screw, leading to faster bony union. A positional screw might help control interfragmentary movement without inhibiting essential interfragmentary movement for fracture healing.

Background: This study compares the difference in the clinical and radiologic outcomes when minimally invasive plate osteosynthesis (MIPO) technique is performed with or without using a positional screw in the treatment of humeral shaft fractures. Methods: From January 2010 to January 2021, a retrospective study was conducted on a total of 63 patients who underwent the MIPO technique for the treatment of humeral shaft fractures. We divided these patients into 2 groups: in group I, patients underwent MIPO without a positional screw; in group II, patients underwent MIPO with a positional screw. We compared functional outcomes including the American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, Simple Shoulder Test, range of motion before and after surgery, operation time, blood loss, and complications. And we compared radiologic outcomes including pre- and postoperative anteroposterior (AP) and lateral displacement of the fracture and union time on plain radiographs. Results: The average patient age was 64.6 ± 15.1 years (range, 25–88 years). Group I consisted of 30 patients (10 men and 20 women), and group II consisted of 33 patients (11 men and 22 women). Between the 2 groups, there was no statistically significant difference in sex, body mass index, functional scores, AP and lateral displacement of the fracture on postoperative x-ray, operation time, and blood loss. In group II, a faster bony union was obtained than that in group I (4.6 vs. 6.4 months). Complications included 2 cases of transient radial nerve palsy in both groups and metallic failures (2 in group I and 1 in group II). Conclusions When performing MIPO for humeral shaft fractures, adding a positional screw could be more stabilizing than bridge plating without a positional screw, leading to faster bony union. A positional screw might help control interfragmentary movement without inhibiting essential interfragmentary movement for fracture healing.

Background: This study compares the difference in the clinical and radiologic outcomes when minimally invasive plate osteosynthesis (MIPO) technique is performed with or without using a positional screw in the treatment of humeral shaft fractures. Methods: From January 2010 to January 2021, a retrospective study was conducted on a total of 63 patients who underwent the MIPO technique for the treatment of humeral shaft fractures. We divided these patients into 2 groups: in group I, patients underwent MIPO without a positional screw; in group II, patients underwent MIPO with a positional screw. We compared functional outcomes including the American Shoulder and Elbow Surgeons score, University of California at Los Angeles score, Simple Shoulder Test, range of motion before and after surgery, operation time, blood loss, and complications. And we compared radiologic outcomes including pre- and postoperative anteroposterior (AP) and lateral displacement of the fracture and union time on plain radiographs. Results: The average patient age was 64.6 ± 15.1 years (range, 25–88 years). Group I consisted of 30 patients (10 men and 20 women), and group II consisted of 33 patients (11 men and 22 women). Between the 2 groups, there was no statistically significant difference in sex, body mass index, functional scores, AP and lateral displacement of the fracture on postoperative x-ray, operation time, and blood loss. In group II, a faster bony union was obtained than that in group I (4.6 vs. 6.4 months). Complications included 2 cases of transient radial nerve palsy in both groups and metallic failures (2 in group I and 1 in group II). Conclusions When performing MIPO for humeral shaft fractures, adding a positional screw could be more stabilizing than bridge plating without a positional screw, leading to faster bony union. A positional screw might help control interfragmentary movement without inhibiting essential interfragmentary movement for fracture healing.

Background: This study aimed to generate a Z score calculation model for coronary artery diameter of normal children and adolescents to be adopted as the standard calculation method with consensus in clinical practice. Methods: This study was a retrospective, multicenter study that collected data from multiple institutions across South Korea. Data were analyzed to determine the model that best fit the relationship between the diameter of coronary arteries and independent demographic parameters. Linear, power, logarithmic, exponential, and square root polynomial models were tested for best fit. Results: Data of 2,030 subjects were collected from 16 institutions. Separate calculation models for each sex were developed because the impact of demographic variables on the diameter of coronary arteries differs according to sex. The final model was the polynomial formula with an exponential relationship between the diameter of coronary arteries and body surface area using the DuBois formula. Conclusion A new coronary artery diameter Z score model was developed and is anticipated to be applicable in clinical practice. The new model will help establish a consensus-based Z score model.

Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.

Identifying risk factors and improving prognostication for mortality among patients with sepsis-associated acute kidney injury (AKI) undergoing continuous kidney replacement therapy (CKRT) is important in improving the adverse prognosis of this patient population. This study aimed to compare the prognostic value of existing systemic inflammation biomarkers and determine the optimal systemic inflammation biomarker in patients with sepsis-associated AKI receiving CKRT. Methods: This multi-center, retrospective, observational cohort study included 1,500 patients with sepsis-associated AKI treated with intensive care and CKRT. The main predictor was a panel of 13 different systemic inflammation biomarkers. The primary outcome was 28-day mortality after CKRT initiation. Secondary outcomes included 90-day mortality after CKRT initiation, CKRT duration, kidney replacement therapy dependence at discharge, and lengths of intensive care unit (ICU) and hospital stays. Results: When added to the widely accepted Acute Physiology and Chronic Health Evaluation II score, platelet-to-albumin ratio (PAR) and neutrophil-platelet score (NPS) had the highest improvements in prognostication of 28-day mortality, where the corresponding increases in C-statistic were 0.01 (95% confidence interval [CI], 0.00–0.02) and 0.02 (95% CI, 0.01–0.03). Similar findings were observed for 90-day mortality. The 28- and 90-day mortality rates were significantly lower for the higher PAR and NPS quartiles. These associations remained significant even after adjustment for potential confounding variables in multivariable Cox proportional hazards models. Conclusion: Of the available systemic inflammation biomarkers, the addition of PAR or NPS to conventional ICU prediction models improved the prognostication of patients with sepsis-associated AKI receiving intensive care and CKRT.