ObjectiveTo investigate the effectiveness of the Evans lateral lengthening calcaneal osteotomy (E-LLCOT) in treatment of talocalcaneal coalition (TCC) with hindfoot valgus deformity.MethodsBetween January 2014 and October 2017, 10 patients (13 feet) of TCC with hindfoot valgus deformities underwent E-LLCOTs. There were 6 males (8 feet) and 4 females (5 feet) with an age of 13-18 years (mean, 15.8 years). The disease duration was 10-14 months (mean, 11.5 months). The foot deformity was characterized by hindfoot valgus, forefoot abduction, and collapse of the medial arch. Pain site was the tarsal sinus in 4 feet, TCC in 5 feet, and ankle joint in 4 feet. There were tightness of the gastrocnemius in 3 cases (4 feet) and Achilles tendon in 7 cases (9 feet) on Silverskiold test. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 46.54±9.08 and visual analogue scale (VAS) score was 6.54±0.88 after walking 1 kilometer. The AOFAS ankle-hindfoot score and VAS score were adopted to evaluate the postoperative function of the foot. The talar-first metatarsal angle (T1MT), talonavicular coverage angle (TCA), talar-horizontal angle (TH), calcaneal pitch angle (CP), and heel valgus angle (HV) were measured after operation.ResultsAll incisions healed by first intention. All patients were followed up 12-30 months (mean, 18 months). At last follow-up, the AOFAS ankle-hindfoot score and VAS score were 90.70±6.75 and 1.85±0.90, respectively, showing significant differences when compared with preoperative scores (t=−23.380, P=0.000; t=35.218, P=0.000). X-ray films showed that the osteotomy healed at 2-4 months (mean, 3 months) after operation. At last follow-up, the T1MT, TCA, TH, and HV were significantly lower than preoperative ones (P<0.05), and the CP was significantly higher than preoperative one (P<0.05). During the follow-up, the pain did not relieve obviously in 1 patient (1 foot), and the cutaneous branch of the sural nerve injured in 1 patient (1 foot).ConclusionFor TCC with severe hindfoot valgus deformity, E-LLCOT can effectively correct deformity and relieve pain.
In post-coronavirus disease 2019 era, people’s style of work and life have undergone major changes. The sedentary style of work and life, such as long-time office work, online meetings, home eating, online social interactions, and reduced range of activities, affect people’s physical and mental health. Neck and shoulder pain is one of the common symptoms. By combining the clinical practice experience of orthopedic medical experts in West China Hospital of Sichuan University, and reviewing a large number of literatures, this article summarized the definition, incidence, hazards, causes, evaluation and prevention of neck and shoulder pain in post-coronavirus disease 2019 era. It aimed to provide experience for the prevention and treatment of neck and shoulder pain in post-coronavirus disease 2019 era.
With the continuous deepening of the practice related to the concept of enhanced recovery after surgery, patients with cervical spondylosis have higher expectations and requirements for postoperative rehabilitation. In order to improve the rehabilitation of patients with cervical spondylosis, and increase patient satisfaction, the orthopedics team of West China Hospital of Sichuan University has formulated a program for early ambulation after anterior cervical spine surgery based on the concept of enhanced recovery after surgery. This article introduces the program from the definition, background, feasibility, significance, and specific content of early ambulation for patients undergoing anterior cervical spine surgery, and aims to provide experience and reference for future clinical practice.
At present, the 2019-nCoV epidemic situation is in severe and complex period. In order to prevent the virus from invading and infecting, it is very important and urgent for medical personnel to protect themselves. However, in the process of using protective equipment by medical personnel, the performance of device related pressure injuries (DRPI) caused by pain, numbness, redness, and even breakage caused by the equipment has seriously endangered the health of medical personnel. This article, based on Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide 2019, references, and clinical experiences of wound specialists in West China Hospital of Sichuan University, summarize the preventive and protective measures of West China Hospital for medical personnel to prevent DRPI, so as to provide clinical preventive measurements for medical personnel.