In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both ...In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.展开更多
BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present...BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present in the foot.We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain.He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test.He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention.Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus.The decision was made for excision of the osteochondroma,and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients.While most are benign with a very low risk of malignant transformation,surgical excision can yield excellent results and significant pain relief in symptomatic patients.展开更多
BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain as...BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain asymptomatic.Os subcalcis is an accessory bone at the plantar aspect of the calcaneus,which is located just posterior to the insertion of the plantar fascia.Focal bone formation at the calcaneal plantar pole with heel pain has rarely been reported.CASE SUMMARY A 55-year-old man presented to our clinic with left plantar heel pain and a progressive swelling for 8 years.X-ray,computer tomography and magnetic resonance imaging showed a large os subcalcison the plantar side of the calcaneus,located at the insertion of the plantar fascia.He underwent surgical excision of the lesion.Microscopically the bony trabeculae were intermingled with fat and covered with cartilage.CONCLUSION This is a rare case with accessory os subcalcis leading to heel pain.It highlights the awareness of os subcalcis and helps avoid future misdiagnosis of heel pain.展开更多
Nine percent to 27% of cardiac catheterizations today showed either angiographic normal coronary arteries or minimal atherosclerosis. 1,2 Given the expense of cardiac catheterization and the desire to use this val... Nine percent to 27% of cardiac catheterizations today showed either angiographic normal coronary arteries or minimal atherosclerosis. 1,2 Given the expense of cardiac catheterization and the desire to use this valuable resource for therapeutic rather than diagnostic purpose, there is a strong impetus to develop non-invasive means of accurately detecting significant coronary artery stenosis.……展开更多
We present an audit of public awareness, freedom of choice and health behavior change relating to high heel wear subsequent to a major public awareness campaign in the summer of 2017. Substantial reductions in workpla...We present an audit of public awareness, freedom of choice and health behavior change relating to high heel wear subsequent to a major public awareness campaign in the summer of 2017. Substantial reductions in workplace high heel wear were found, whereby increasingly those who wear high heels regularly at work have freely chosen to do so, although certain issues of social expectations remain in certain sectors. Largely, freedom of choice has greatly increased in workplaces in line with increased public and employer awareness.? However, high heel wear has not substantially reduced in social settings, and progress has not been made with social expectation and explicit requirement to wear high heels at social events.展开更多
Skin integrity breakdown and pressure ulcer formation on the heel are predictable and preventable healthcare occurrences. By minimizing surface contact pressures that can cause heel capillary occlusion, heel off-loadi...Skin integrity breakdown and pressure ulcer formation on the heel are predictable and preventable healthcare occurrences. By minimizing surface contact pressures that can cause heel capillary occlusion, heel off-loading devices help mitigate the risk of decubitus ulceration. The purpose of this study is to investigate the efficacy of six off-loading methods commonly used in clinical settings to decrease heel contact pressure. Pressure mapping is used to evaluate contact pressure at the heel for underweight, normal weight, and overweight simulations. Based upon averages across four trials, it is shown that all devices reduce heel contact pressure when compared to no off-load- ing. The PRUventor™ boot exhibits significantly lower average pressure values than other off-load- ing strategies tested, suggesting that the PRUventor™ is the most effective off-loading device. From the analysis of the experimental data and comparison to similar data for respective off-loading alternatives, it is concluded that the PRUventor™ boot is an effective heel off-loading device for use in clinical settings.展开更多
In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and advers...In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.展开更多
This prospective, open-label, single-arm investigation evaluated the performance of a multifunctional foot cream used twice daily for 8 weeks in the combined treatment of mild/moderate tinea pedis interdigitalis (TPI)...This prospective, open-label, single-arm investigation evaluated the performance of a multifunctional foot cream used twice daily for 8 weeks in the combined treatment of mild/moderate tinea pedis interdigitalis (TPI) and heel cracks, calluses and/or dry feet in 46 adult subjects. All subjects showed reductions in the severity of symptoms of both TPI (53.7% reduction) and heel cracks, calluses and/or dry feet (51.6% reduction), beginning already after 2 weeks of treatment, with reduction continuation and improvement after 4 and 8 weeks of treatment. Negative mycological cultures were obtained post-treatment in 85.7% of subjects, while 35.7% of subjects also obtained mycological cure (negative mycological culture + negative KOH test). Post-treatment questionnaires showed improved quality of life, good treatment tolerability, easy use, and that 69% of subjects would recommend the product. The results reveal that the foot cream is safe and effective in the combined treatment of TPI and heel cracks, calluses and/or dry feet.展开更多
To report the methods and effect of axial pattern flap on lower limb in repairing deep wounds of heels by using color Doppler flow imaging (CDFI) technique so as to solve the ever before problems that the vessel can n...To report the methods and effect of axial pattern flap on lower limb in repairing deep wounds of heels by using color Doppler flow imaging (CDFI) technique so as to solve the ever before problems that the vessel can not be displayed in designing axial flap.Methods Suitable axial flaps on lower limbs were selected according to the character of the wounds.There were 25 flaps including 10 cases of the distal-based sural neurovascular flap,nine medial sole flap and six medial leg flap.All the axial pattern flaps were designed on the basis of traditional design ways before operation;then,CDFI appliance with high resolution was used to examine the starting spot,exterior diameter,trail and length of the flap’s major artery.The flaps were redesigned according to the results of CDFI and transferred to cover the wounds.In the meantime,both the results of operation and examination were compared.Results The major artery’s starting spot,exterior diameter,trail and anatomic layers were displayed clearly,in consistency with the results of operation.The flaps survived completely and recovered well,with perfect appearance,color and arthral function.Conclusion CDFI is a simple,macroscopic and atraumatic method for designing the axial pattern flap on lower limb,can provide more scientific and accurate evidence for preoperative determination of flap transplantation and is worthy of clinical application.10 refs,4 figs,2 tabs.展开更多
英语中的“heel”,就是汉语里的“脚后跟”,无可争议。但成语“the heel of Achilles”(或“Achilles’s heel”),在《新英汉词典》里的释义是“唯一致命的弱点”,一般也可译成“致命弱点'、“要害”、“可乘之隙”,都与“脚后跟”...英语中的“heel”,就是汉语里的“脚后跟”,无可争议。但成语“the heel of Achilles”(或“Achilles’s heel”),在《新英汉词典》里的释义是“唯一致命的弱点”,一般也可译成“致命弱点'、“要害”、“可乘之隙”,都与“脚后跟”不相干。有例句为证:展开更多
An experimental analysis has been conducted to study the process of fluid accumulation for different borehole trajectories.More specifically,five heel angles have been experimentally realized to simulate the borehole ...An experimental analysis has been conducted to study the process of fluid accumulation for different borehole trajectories.More specifically,five heel angles have been experimentally realized to simulate the borehole trajectory of the sloping section of the formation.The fluid-carrying capacity,pressure drop and fluid discharge volatility have been investigated for these conditions and,accordingly,the relationship between heel angle and wellbore pressure drop fluid-carrying capacity has been determined.The results show that while the reasonable roll angle can increase the pressure loss in the wellbore,it is beneficial to drainage.In terms of pressure loss and liquid-carrying capacity,when the heeling angle is 50°,the latter is increased while the former becomes very high,which indicates that when drilling and completing wells on site,a 50°roll angle should be avoided.It is found that the main reason for the increase of the total pressure drop in the wellbore is the increase of the local pressure loss in the inclined section.From the perspective of drainage stability,when there is heeling in the inclined section of the horizontal well,the fluctuation of the wellbore drainage tends to be enhanced.Through the comparison of the Beggs-Brill(B-B)and Mukherjee-Brill liquid holdup methods,it is found that B-B method better predicts liquid holdup.A new method for calculating the pressure drop in the inclined section in the presence of lateral inclination is obtained by taking into account the pressure drop in the curved section.Through comparison with experimental data,it is found that the error is within 20%,and the prediction accuracy is high.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditio...BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases.Therefore,there is a need for alternative treatment methods.CASE SUMMARY This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot.The patient had a history of renal failure and was undergoing regular hemodialysis.Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery,left peroneal artery and left posterior tibial artery.Following evaluation by a multidisciplinary team,the patient was diagnosed with type 2 DFUs(TEXAS 4D).Traditional treatments were deemed unsuitable,and the patient was treated with endovascular surgery in the affected area,in addition to supportive medical treatment,local debridement,and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment.After four months,the wound had completely healed,and the patient was able to walk with a walking aid.CONCLUSION This study demonstrates a new treatment method for DFUs was successful,using angioplasty,skin grafts,and negative pressure.展开更多
基金supported by the Research Grant Council of Hong Kong (PolyU5317/05E, PolyU5331/07E, PolyU5352/08E)
文摘In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.
文摘BACKGROUND Heel pain is a common orthopaedic complaint,and if left untreated can be a source of chronic morbidity.Accurate diagnosis can be challenging,owing to the complex anatomy and multiple pain generators present in the foot.We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain.He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test.He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention.Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus.The decision was made for excision of the osteochondroma,and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients.While most are benign with a very low risk of malignant transformation,surgical excision can yield excellent results and significant pain relief in symptomatic patients.
基金Supported by The Gusu Talents Project,No.GSWS2020069.
文摘BACKGROUND The accessory bones are common bone variations around the feet and ankles,which usually originate from nonunion of the secondary ossification center adjacent to the main bone mass,and most of them remain asymptomatic.Os subcalcis is an accessory bone at the plantar aspect of the calcaneus,which is located just posterior to the insertion of the plantar fascia.Focal bone formation at the calcaneal plantar pole with heel pain has rarely been reported.CASE SUMMARY A 55-year-old man presented to our clinic with left plantar heel pain and a progressive swelling for 8 years.X-ray,computer tomography and magnetic resonance imaging showed a large os subcalcison the plantar side of the calcaneus,located at the insertion of the plantar fascia.He underwent surgical excision of the lesion.Microscopically the bony trabeculae were intermingled with fat and covered with cartilage.CONCLUSION This is a rare case with accessory os subcalcis leading to heel pain.It highlights the awareness of os subcalcis and helps avoid future misdiagnosis of heel pain.
文摘 Nine percent to 27% of cardiac catheterizations today showed either angiographic normal coronary arteries or minimal atherosclerosis. 1,2 Given the expense of cardiac catheterization and the desire to use this valuable resource for therapeutic rather than diagnostic purpose, there is a strong impetus to develop non-invasive means of accurately detecting significant coronary artery stenosis.……
文摘We present an audit of public awareness, freedom of choice and health behavior change relating to high heel wear subsequent to a major public awareness campaign in the summer of 2017. Substantial reductions in workplace high heel wear were found, whereby increasingly those who wear high heels regularly at work have freely chosen to do so, although certain issues of social expectations remain in certain sectors. Largely, freedom of choice has greatly increased in workplaces in line with increased public and employer awareness.? However, high heel wear has not substantially reduced in social settings, and progress has not been made with social expectation and explicit requirement to wear high heels at social events.
文摘Skin integrity breakdown and pressure ulcer formation on the heel are predictable and preventable healthcare occurrences. By minimizing surface contact pressures that can cause heel capillary occlusion, heel off-loading devices help mitigate the risk of decubitus ulceration. The purpose of this study is to investigate the efficacy of six off-loading methods commonly used in clinical settings to decrease heel contact pressure. Pressure mapping is used to evaluate contact pressure at the heel for underweight, normal weight, and overweight simulations. Based upon averages across four trials, it is shown that all devices reduce heel contact pressure when compared to no off-load- ing. The PRUventor™ boot exhibits significantly lower average pressure values than other off-load- ing strategies tested, suggesting that the PRUventor™ is the most effective off-loading device. From the analysis of the experimental data and comparison to similar data for respective off-loading alternatives, it is concluded that the PRUventor™ boot is an effective heel off-loading device for use in clinical settings.
文摘In the clinical practice of orthopedics,geriatric patients are prone to form and exhibit complex and diverse clinical complications during long-term bedridden treatment.This can result in poor survival rate and adverse final clinical outcomes.Hence,it is essential to select appropriate methods for nursing intervention and health-care support for long-term bedridden geriatric orthopedic patients.It is of great significance to support and guarantee patients to obtain the best clinical results.This article focuses on the topic of interventional health effects of traditional Chinese medicine negative-heeled shoes in orthopedic bedridden patients,and two specific aspects were selected for a brief explanation.
文摘This prospective, open-label, single-arm investigation evaluated the performance of a multifunctional foot cream used twice daily for 8 weeks in the combined treatment of mild/moderate tinea pedis interdigitalis (TPI) and heel cracks, calluses and/or dry feet in 46 adult subjects. All subjects showed reductions in the severity of symptoms of both TPI (53.7% reduction) and heel cracks, calluses and/or dry feet (51.6% reduction), beginning already after 2 weeks of treatment, with reduction continuation and improvement after 4 and 8 weeks of treatment. Negative mycological cultures were obtained post-treatment in 85.7% of subjects, while 35.7% of subjects also obtained mycological cure (negative mycological culture + negative KOH test). Post-treatment questionnaires showed improved quality of life, good treatment tolerability, easy use, and that 69% of subjects would recommend the product. The results reveal that the foot cream is safe and effective in the combined treatment of TPI and heel cracks, calluses and/or dry feet.
文摘To report the methods and effect of axial pattern flap on lower limb in repairing deep wounds of heels by using color Doppler flow imaging (CDFI) technique so as to solve the ever before problems that the vessel can not be displayed in designing axial flap.Methods Suitable axial flaps on lower limbs were selected according to the character of the wounds.There were 25 flaps including 10 cases of the distal-based sural neurovascular flap,nine medial sole flap and six medial leg flap.All the axial pattern flaps were designed on the basis of traditional design ways before operation;then,CDFI appliance with high resolution was used to examine the starting spot,exterior diameter,trail and length of the flap’s major artery.The flaps were redesigned according to the results of CDFI and transferred to cover the wounds.In the meantime,both the results of operation and examination were compared.Results The major artery’s starting spot,exterior diameter,trail and anatomic layers were displayed clearly,in consistency with the results of operation.The flaps survived completely and recovered well,with perfect appearance,color and arthral function.Conclusion CDFI is a simple,macroscopic and atraumatic method for designing the axial pattern flap on lower limb,can provide more scientific and accurate evidence for preoperative determination of flap transplantation and is worthy of clinical application.10 refs,4 figs,2 tabs.
基金the support provided by the National Natural Science Foundation of China(No.62173049)the Open Fund of the Key Laboratory of Exploration Technologies for Oil and Gas Resources(Yangtze University),Ministry of Education(Grant K2021-17).
文摘An experimental analysis has been conducted to study the process of fluid accumulation for different borehole trajectories.More specifically,five heel angles have been experimentally realized to simulate the borehole trajectory of the sloping section of the formation.The fluid-carrying capacity,pressure drop and fluid discharge volatility have been investigated for these conditions and,accordingly,the relationship between heel angle and wellbore pressure drop fluid-carrying capacity has been determined.The results show that while the reasonable roll angle can increase the pressure loss in the wellbore,it is beneficial to drainage.In terms of pressure loss and liquid-carrying capacity,when the heeling angle is 50°,the latter is increased while the former becomes very high,which indicates that when drilling and completing wells on site,a 50°roll angle should be avoided.It is found that the main reason for the increase of the total pressure drop in the wellbore is the increase of the local pressure loss in the inclined section.From the perspective of drainage stability,when there is heeling in the inclined section of the horizontal well,the fluctuation of the wellbore drainage tends to be enhanced.Through the comparison of the Beggs-Brill(B-B)and Mukherjee-Brill liquid holdup methods,it is found that B-B method better predicts liquid holdup.A new method for calculating the pressure drop in the inclined section in the presence of lateral inclination is obtained by taking into account the pressure drop in the curved section.Through comparison with experimental data,it is found that the error is within 20%,and the prediction accuracy is high.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are common in patients with diabetes,especially those undergoing hemodialysis.In severe cases,these ulcers can cause damage to the lower extremities and lead to amputation.Traditional treatments such as flap transposition and transfemoral amputation are not always applicable in all cases.Therefore,there is a need for alternative treatment methods.CASE SUMMARY This report describes a 62-year-old female patient who was admitted to the hospital with plantar and heel ulcers on her left foot.The patient had a history of renal failure and was undergoing regular hemodialysis.Digital subtraction angiography showed extensive stenosis and occlusion in the left superficial femoral artery,left peroneal artery and left posterior tibial artery.Following evaluation by a multidisciplinary team,the patient was diagnosed with type 2 DFUs(TEXAS 4D).Traditional treatments were deemed unsuitable,and the patient was treated with endovascular surgery in the affected area,in addition to supportive medical treatment,local debridement,and sequential repair using split-thickness skin and tissue-engineered skin grafts combined with negative pressure treatment.After four months,the wound had completely healed,and the patient was able to walk with a walking aid.CONCLUSION This study demonstrates a new treatment method for DFUs was successful,using angioplasty,skin grafts,and negative pressure.
