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BACKGROUND:Integrated Traditional Chinese and Western Medicine minimaly invasive treatment for halux valgus based on wrapped curtain method with “8”-shaped bandage and sub toe pad external fixation has been used for a long time in the clinic. This method abandons the internal implant fixationandexternal plaster fixation. After surgery, patients could take care of themselves. However, theactivity of the broken end may cause fracture nonunion, which once aroused scholars’ question. Recently, with the continuous improvement of foot biomechanics research, foot finite element model and applications become a reality. OBJECTIVE:To evaluate thestability of osteotomy after the operation of wrapped curtain method with“8”-shaped bandage and sub toe pad external fixation on the basis of static finite element method. METHODS:A young female volunteer with halux valgus was selected, whose body weight was 58 kg, and right foot halux abductor valgus angle was 24°; intermetatarsal angle was 13°; proximal articulator set angle was 7°; distal articulator set angle was 7°. CT was used to scan the right foot. ABAQUS software was applied to establish a finite element model of right foot halux valgus bone, and model of the first metatarsal neck minimaly invasive osteotomy was simulated based on wrapped curtain method with external fixation. Von Mises stress and displacement at the osteotomy endwere calculated. RESULTS AND CONCLUSION:(1) The maximum stress was 0.067 MPa without external fixation, and the maximum stress was 1.258 MPa with the external fixation. Stress was mainly distributed in the outer edge of the osteotomy. (2) The maximum absolute displacement was 0.363 mm without external fixation, and the maximum absolute displacement was 0.716 mm with external fixation. The two largest displacements were both in the Z-axis direction. Statistical analysis confirmed that the four nodes absolute displacement and stress were significantly different (P 0.05). The four nodes relative displacements were statisticaly significant in Z-axis (P< 0.05). (5) These findings suggest that the external fixation based on wrapped curtain method after halux valgus surgery could effectively reduce osteotomy displacement. The moderate stress and elastic fixation are conducive to fracture healing.
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al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. Abstract BACKGROUND:Currently, the material parameters of foot three-dimensional finite element models are almost OBJECTIVE:To preliminarily measure the parameters of foot muscle and tendon materials in Chinese people. RESULTS AND CONCLUSION: Relevant measurement data were harvested from nine samples, including the maximum loading, ultimate strength and elastic modulus test.
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<p><b>OBJECTIVE</b>To investigate the high-risk factors for neonatal incarcerated hernia with intestinal necrosis by logistic regression analysis.</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical data of 131 neonates with incarcerated oblique inguinal hernia containing the intestine. Of the 131 cases, 14 suffered from intestinal necrosis. The high risk factors for neonatal incarcerated hernia with intestinal necrosis were determined by logistic regression analysis.</p><p><b>RESULTS</b>Manual reduction after incarceration (>2 times) (χ2 = 69.289, P<0.01), incarceration history (>2 times) (χ2 = 84.731, P<0.01), and mesentery incarceration (χ2 = 80.233, P<0.01) were the high-risk factors for neonatal incarcerated hernia with intestinal necrosis.</p><p><b>CONCLUSIONS</b>Intestinal necrosis tends to occur in neonates with incarcerated hernia who have incarceration or received manual reduction more than twice and suffer from mesentery incarceration. Manual reduction is prohibited for these cases, which should be surgically treated immediately.</p>
Subject(s)
Female , Humans , Infant, Newborn , Male , Hernia, Inguinal , Intestines , Pathology , Logistic Models , Necrosis , Retrospective Studies , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical application of transumbilical double-hole laparoscopic operation for incarcerated inguinal hernia in the infants.</p><p><b>METHODS</b>Forty-eight cases with incarcerated inguinal hernia (male 39, female 9) aging from 4 months to 3 years (mean 1.2 +/- 0.8 years) received the laparoscopic transumbilical double-hole operation (LTO group) during April.2003 to April.2004. Thirty cases were left side incarcerated inguinal hernia, 12 cases were right side and 6 cases were bilateral. Fifty infants of incarcerated inguinal hernias treated with traditional operation served as controls (TO group). The mean operation time, length of stay, return of bowel function and postoperative complication were compared between the two groups.</p><p><b>RESULTS</b>All cases of both groups recovered without any complication. The operation time, average hospitalization and return of bowel function in LTO were (30 +/- 5) min, (7.8 +/- 0.3) h and (4.4 +/- 0.3) d, respectively, and in TO were (43 +/- 6) min, (23.3 +/- 2.4) h and (6.7 +/- 0.4) d, respectively. There was a significant difference in the two groups (P < 0.05). The patients in both groups were followed up for 3 months to one year. LTO group had no recurrence or atrophy of testis and TO group had one relapse of hernia.</p><p><b>CONCLUSIONS</b>Transumbilical double-hole laparoscopic operation is safe and microinvasive. It is a useful microinvasive procedure in the treatment of incarcerated inguinal hernia for infant.</p>