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Objective To explore the joint contact force, ligament tensile force and force transmission mode of foot internal structure in Down’s syndrome child (DSC) during standing. Methods The finite element models of foot were constructed based on CT image data from one DSC and one typically developing child (TDC). The models were validated by plantar pressure measurement during static standing. To simulate foot force during standing, the ground reaction force and the triceps surae force were applied as the loading condition. Contact pressure of the tibiotalar, talonavicular and calcaneocuboid joints, tensile force of the spring and plantar calcaneocuboid ligaments, and force transmission mode in transverse tarsal joints were calculated and analyzed. Results The finite element models of foot were validated to be reliable. Compared with the TDC, the DSC showed higher contact pressure at the tibiotalar joint and lower contact pressure at the talonavicular joint. The tensile force of spring and plantar calcaneocuboid ligaments of DSC was 10 times and 58 times of TDC, respectively. The forces transmitted through both mediate and lateral columns in DSC were lower than those in TDC. Conclusions Abnormal contact pressure of the tibiotalar joint, larger tensile force of midfoot ligaments and smaller force of the transverse tarsal joint were found in DSC during standing. The abnormal alteration of stress patterns in foot internal structure of DSC should be fully considered in clinical rehabilitation, so as to provide theoretical references for screening and making intervention plans for early rehabilitation, as well as designing individualized orthopedic insoles.
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Objective:To explore the clinical curative effect of foot-ankle balance massage combined with herbal fumigation on acute ankle sprain.Methods:According to random number table method, 62 patients with acute ankle sprain meeting the inclusion criteria in the hospital were divided into control group and observation group between January 2018 and January 2021, 31 in each group. The control group was treated with foot-ankle balance massage, while the observation group added herbal fumigation treatment on the basis of the control group treatment. Both were treated for 7 days. The pain degree was evaluated by Visual Analogue Scale (VAS). The pain sites of ankle joint were evaluated by Kofoed ankle scale. The recovery of ankle and foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS). The levels of plasma substance P, neuropeptide, nerve growth factor (NGF), IL-1β, IL-6 and hs-CRP were detected by enzyme-linked immunosorbent assay. The clinical curative effect was assessed.Results:The differences in total response rate between observation group and control group were statistically significant [96.8% (30/31) vs. 77.4% (24/31)] ( χ 2=5.17, P=0.023). At 1st day, 3rd day and 7th day after treatment, VAS scores in observation group were significantly lower than those in the control group ( t=4.86, 5.19, 3.86, P<0.01), Kofoed scores were significantly higher than those in the control group ( t=2.03, 2.58, 2.46, P<0.05), and AOFAS pain scores were significantly higher than those in the control group ( t=2.61, 2.47, 4.90, P<0.05). After treatment, levels of substance P [(2.94±0.91) mg/L vs. (3.69±0.94) mg/L, t=3.19], neuropeptide [(141.06±16.31) ng/L vs. (165.22±17.63) ng/L, t=3.16] and NGF [(43.65±10.15) ng/L vs. (52.26±10.20) ng/L, t=3.33] in observation group were significantly lower than those in the control group ( P<0.01), and levels of IL-1β, IL-6 and hs-CRP were significantly lower than those in the control group ( t=2.60, 2.64, 2.42, P<0.05). Conclusion:The foot-ankle balance massage combined with herbal fumigation can quickly relieve pain, increase levels of pain substances, reduce levels of inflammatory cytokines and improve curative effect in patients with acute ankle sprains.
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Resumen: Introducción: El pie caído es una condición que suele manejarse con ortesis cortas, normalmente fabricadas en polipropileno. Se ha descrito también su tratamiento con ortesis de silicón, poco estudiadas pero que parecen mejorar el patrón cinemático de la marcha y, dada su comodidad, ser más aceptadas por los pacientes. Nuestro estudio describe cuáles son las características cinemáticas de la marcha y la satisfacción referida por los pacientes al usar una ortesis tobillo pie de silicón y compara dicho patrón con el no uso de la ortesis en casos con pie caído. Material y métodos: Estudio seudoexperimental descriptivo en pacientes con pie caído desde el año 2010 al 2012, en el que se evaluaron las variables cinemáticas del patrón de marcha a partir de laboratorios de marcha y además de la satisfacción de los sujetos con las ortesis de silicón y con el no uso de las mismas. Resultados: Cinco casos con pie caído fueron objeto del estudio. El análisis de marcha de los pacientes que usaron la ortesis constató una mejora de la posición del tobillo en el contacto inicial, en la velocidad promedio de marcha y en la longitud del paso, así como un aumento de la cadencia. Sin embargo, en términos de comodidad en comparación con el no uso de la ortesis, el resultado fue exiguo. Conclusiones: Las ortesis tobillo pie de silicón mejoran la posición del tobillo en el contacto inicial, así como los parámetros temporoespaciales de la marcha.
Abstract: Introduction: The Drop foot is a condition that is usually handled with short orthosis, usually made of polypropylene. It has also been described as being treated with silicon orthosis, little studied but which seem to improve the kinematic pattern of gait and, given its comfort, be more accepted by patients. Our study describes the kinematic characteristics of gait and patient satisfaction when using a silicon foot ankle orthosis, and compares this pattern to the non-use of the orthosis, in patients with a drop foot. Material and methods: Pseudo-experimental descriptive study in patients with dropped feet from 2010 to 2012, in which the kinematic variables of the gait pattern were evaluated from gait laboratories and in addition to the satisfaction of subjects with silicon orthosis and non-use of them. Results: Five patients with a drop foot were the subject of the study. Gait analysis of patients using the orthosis found an improvement in ankle position at initial contact, average walking speed and step length, as well as increased cadence. However, in terms of comfort compared to the non-use of the orthosis, the result was meager. Conclusions: Silicon foot ankle orthosis improve the position of the ankle in the initial contact, as well as the temporo-spatial parameters of the gait.
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Humans , Silicones , Ankle , Biomechanical Phenomena , Range of Motion, Articular , Equipment Design , Gait , Ankle JointABSTRACT
Objective To study stress changes in forefoot intermetatarsal region when wearing high-heeled shoes, so as to provide references for quantitative analysis on inducement mechanism of intermetatarsal neuroma and corresponding treatment strategy. Methods Based on the validated foot-ankle-shoe finite element platform, changes of stress levels and tendency in intermetatarsal region were analyzed for both in balanced standing when wearing 0-3 inch (0, 2.54, 5.08, 7.62 cm) high-heeled shoes and walking when wearing 5.08 cm high-heeled shoes in a gait cycle. Results With the increase of heel height, the stresses in intermetatarsal region were significantly increased, and the stress in the third web space of toes when wearing 7.62 cm high-heeled shoes reached 312% of that when wearing flat shoes (0 cm high-heeled shoes). When walking with 5.08 cm high-heeled shoes, the third web space of toes at push-off instance had the largest stress, reaching 90 kPa, which agreed with the most commonly pathogenic site of intermetatarsal neuroma in clinic. Conclusions Wearing high-heeled shoes can obviously increase the stress in intermetatarsal region. Squeezing by upper extrusion of shoes can result in the largest stresses in the third web space of toes region, which is most likely to cause the development of intermetatarsal neuroma.
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ObjectiveTo identify the reasons of missed diagnosis with ankle sprains by analyzing OAR in order to guide the rational use of OAR.MethodsOutpatient with sprained ankles were recruited from the surgical clinic in Sichuan Luzhou Medical College from Mar.2005 to Mar.2010.OAR was used for clinical diagnosis of ankle sprains.The accuracy of OAR diagnosis was examined within 24 h and at 15 d by X-ray.ResultsIn the 105 cases of ankle sprain,16 cases was diagnosed of fractures by OAR.X-ray results showed I case of missed diagnosis,with the rate of missed diagnosis of 6.2％.While both OAR and X-ray diagnosed 21 cases in 50 patients with sprained foot fractures,with a rate of missed diagnosis of 0.Conclusion OAR diagnosis for ankle sprains and fractures has high success rate although with the possibility of missed diagnosis which needs attention clinically.
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Piezogenic pedal papules are small, occasionally painful, fat herniation, which become apparent when weight is placed on the heel. We present a case of painful piezogenic pedal papules occurring on both heels of 30-year-old female patient without family history. Clinical and histopathological features confirmed diagnosis. Foot-ankle stocking was effective therapy for painful piezogenic pedal papules.