Objective: Researchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.
Methods: We provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department.
J Orthop Surg Res
December 2024
Background: Deep venous thrombosis of the lower extremity is a common and fatal complication of hip fracture in the elderly. However, there is a lack of targeted laboratory diagnostic methods. Although traditional laboratory indicators can provide some reference, the diagnostic efficiency is relatively limited This study aimed to investigate the diagnostic accuracies of thromboelastography (TEG) combined with traditional coagulation parameters for early diagnosis of newly occurring lower extremity deep vein thrombosis (DVT) in elderly patients with hip fractures.
View Article and Find Full Text PDFThe Schwann cell (SC) is essential in peripheral nerve regeneration by reprogramming into a stem-like "repair Schwann cell" (rSC) phenotype; however, maintaining the rSC stemness remains an unmet challenge. Chirality is a fundamental factor controlling cell fate, and its potential role in regulation of SC reprogramming has long been ignored and remains poorly understood. Herein, inspired by natural chiral components in the SC microenvironment, chiral hydrogel nerve conduits are prepared by supramolecular assembly of l/d-phenylalanine derivatives (l/d-Phe) in polymeric chitosan-gelatin conduits.
View Article and Find Full Text PDFJOURNAL/nrgr/04.03/01300535-202507000-00031/figure1/v/2024-09-09T124005Z/r/image-tiff FK506 (Tacrolimus) is a systemic immunosuppressant approved by the U.S.
View Article and Find Full Text PDFBackground: Peripheral nerve injury is a challenging orthopedic issue in clinical management that often leads to limb dysfunction or even disability in severe cases. A thorough exploration of the repair process of peripheral nerve injury and the underlying mechanism contributes to formulate more effective therapeutic strategies.
Methods: In the present study, we established a sciatic nerve transection injury model in Sprague-Dawley (SD) rats.
JOURNAL/nrgr/04.03/01300535-202408000-00036/figure1/v/2023-12-16T180322Z/r/image-tiff Macrophages play an important role in peripheral nerve regeneration, but the specific mechanism of regeneration is still unclear. Our preliminary findings indicated that neutrophil peptide 1 is an innate immune peptide closely involved in peripheral nerve regeneration.
View Article and Find Full Text PDFOsteoarthritis (OA) is a chronic joint disease characterized by synovitis and joint cartilage destruction. The severity of OA is highly associated with the imbalance between M1 and M2 synovial macrophages. In this study, a novel strategy is designed to modulate macrophage polarization by reducing intracellular reactive oxygen species (ROS) levels and regulating mitochondrial function.
View Article and Find Full Text PDFObjective: Chinese physicians developed the Tibial Transverse Transport (TTT) technique to treat diabetic foot ulcers with more than 90% effective rate. But this method still could not avoid the in-hospital death of patients. This study adopted a case-control study to explore the risk factors of in-hospital death in elderly patients with chronic ischemic diabetic foot after receiving TTT treatment.
View Article and Find Full Text PDFObjective: Traditional lateral soft tissue release (LSTR) was conducted by an additional dorsal first web incision, as the malformed thick scar and neuritis were common after surgery. A new method of lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) should be recommended. The objective is to investigate the clinical effectiveness and safety of scarf + Akin osteotomy (SAO) combined with lateral soft tissue release in a single medial incision via dorsal flap over the first metatarsal (LSTR-SMI-DFFM) for moderate to severe hallux valgus.
View Article and Find Full Text PDFObjective: To explore the efficacy of antibiotic bone cement (ABC) combined with the modified tibial transverse transport (mTTT) on the treatment of severe diabetic foot with infection.
Methods: A retrospective cohort study was conducted of 243 patients with TEXAS grade 3/4 stage D diabetic foot ulcers from December 2016 to December 2019. A total of 115 patients treated with mTTT were classified as the mTTT group (78 male and 37 female, mean age: 70.
Failure mode and effects analysis (FMEA) has been widely used for potential risk modeling and management. Expert evaluation is used to model the risk priority number to determine the risk level of different failure modes. Dempster-Shafer (D-S) evidence theory is an effective method for uncertain information modeling and has been adopted to address the uncertainty in FMEA.
View Article and Find Full Text PDFBackground: Although rotation scarf + Akin osteotomy has been described for correcting hallux valgus deformity, the treatment efficacy of rotation scarf + Akin osteotomy for severe hallux valgus should be further studied. The purpose of our study was to evaluate the outcomes of rotation scarf + Akin osteotomy on severe hallux valgus.
Methods: We conducted a retrospective study of patients with hallux valgus who underwent surgery using rotation scarf + Akin osteotomy in our hospital between June 2014 and January 2020.
Intra-articular impacted fragment (IAIF) was considered as the articular surface fragment resulting from impact and compressive forces. Malreduction of IAIF in posterior malleolar fractures was associated with the cause of talus subluxation and long-term arthritis. The effect of IAIF on ankle pressure and stress has not been studied, and it's difficult to do this in cadaver bone.
View Article and Find Full Text PDFObjective: Wallerian degeneration is a pathological process closely related to peripheral nerve regeneration following injury, and includes the disintegration and phagocytosis of peripheral nervous system cells. Traditionally, morphological changes are observed by performing immunofluorescence staining after sectioning, which results in the loss of some histological information. The purpose of this study was to explore a new, nondestructive, and systematic method for observing axonal histological changes during Wallerian degeneration.
View Article and Find Full Text PDFLower extremity nerve transposition repair has become an important treatment strategy for peripheral nerve injury; however, brain changes caused by this surgical procedure remain unclear. In this study, the distal stump of the right sciatic nerve in a rat model of sciatic nerve injury was connected to the proximal end of the left sciatic nerve using a chitin conduit. Neuroelectrophysiological test showed that the right lower limb displayed nerve conduction, and the structure of myelinated nerve fibers recovered greatly.
View Article and Find Full Text PDFBackground: Ischemic diabetic foot ulcer is one of the terminal complications of diabetes. The high amputation rate, recurrence rate, and treatment cost have caused a huge burden on patients and society. This study designed the modified tibial transverse transport (mTTT) technology to treat diabetic ischemic diabetic foot ulcers in patients with type 2 diabetes and investigated the effectiveness and safety of this technique.
View Article and Find Full Text PDFPeripheral nerves have a limited capacity for self-repair and those that are severely damaged or have significant defects are challenging to repair. Investigating the pathophysiology of peripheral nerve repair is important for the clinical treatment of peripheral nerve repair and regeneration. In this study, rat models of right sciatic nerve injury were established by a clamping method.
View Article and Find Full Text PDFPeripheral nerve injury repair has been considered a difficult problem in the field of trauma for a long time. Conventional surgical methods are not applicable in some special types of nerve injury, prompting scholars to seek to develop more effective nerve translocation repair technologies. The purpose of this study was to explore the functional state of neurons in injured lower limbs after translocation repair, with a view to preliminarily clarify the molecular mechanisms underlying this process.
View Article and Find Full Text PDFSmall-molecule polypeptide neutrophil peptide 1 (NP-1) was reported to promote the regeneration of the sciatic nerve after denervation, but the mechanisms underlying this effect of NP-1 are unclear. Here, we established a Sprague-Dawley rat model of crush injury to study the effect of a single intermuscular injection of NP-1 on the repair of injured peripheral nerves and elucidate the possible underlying mechanism. 39 rats were randomly selected to join this study and divided into the blank control group (normal group, n=9), experimental group (NP-1 group, n=15), and negative control group (NS group, n=15).
View Article and Find Full Text PDFPeripheral nerve injury is a common refractory disease in the clinic that often leads to dysfunction of movement and sensation. Different from other tissue injuries, peripheral nerve injury needs a longer time for regeneration. Therefore, effective drug therapy is needed to promote nerve regeneration in the treatment of peripheral nerve injury.
View Article and Find Full Text PDFNeutrophil peptide 1 belongs to a family of peptides involved in innate immunity. Continuous intramuscular injection of neutrophil peptide 1 can promote the regeneration of peripheral nerves, but clinical application in this manner is not convenient. To this end, the effects of a single intraoperative administration of neutrophil peptide 1 on peripheral nerve regeneration were experimentally observed.
View Article and Find Full Text PDFBackground: Heel pain is one of the most common complaints in foot and ankle clinic, and one of the leading causes of heel pain is plantar fasciitis.
Methods: A retrospective analysis was carried out in 31 cases (39 feet) of patients with intractable plantar fasciitis. In the enrolled 26 cases, 16 patients (19 feet) received open plantar fascia release, and the other 15 patients (20 feet) received percutaneous radiofrequency ablation.
World J Clin Cases
September 2019
Background: Synovial sarcoma (SS), a rare malignant soft tissue tumor whose histological origin is still unknown, often occurs in limbs in young people and is easily misdiagnosed.
Case Summary: We report a 24-year-old man who sought treatment for plantar pain thought to be caused by a foot injury that occurred 4 years prior. Currently, he had been seen at another hospital for a 1-wk history of unexplained pain in the left plantar region and was treated with acupuncture, a kind of therapy of Chinese medicine, which partly relieved the pain.
During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining.
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