Objective To investigate effectiveness of simplified all-arthroscopic Broström technique in treatment of chronic lateral ankle instability in adolescents. Methods A clinical data of 21 adolescent patients with chronic lateral ankle instability, who met the selection criteria and were admitted between June 2023 and May 2024, was retrospectively analyzed. There were 18 males and 3 females with an average age of 16.0 years (range, 13-18 years). There were 9 cases of left ankle joint injury and 12 cases of right ankle joint injury. Anterior talofibular ligament (ATFL) injury was diagnosed by arthroscopy in all patients. There were 11 cases of cartilage injury, 5 cases of avulsion fractures, and 6 cases of ankle impingement syndrome. The time from first sprain to operation ranged from 3-60 months (mean, 12.0 months). The ATFL was repaired and the ankle joint stability was restored by simplified all-arthroscopic Broström technique. Visual analogue scale (VAS) score, Tegner score, American Orthopaedic Foot and Ankle Society (AOFAS) score, Karlsson ankle function scale (KAFS) score, Foot and Ankle Outcome Score (FAOS) were used to evaluate ankle pain and function. MRI was used to evaluate the ligament healing. Results All patients were followed up 8-15 months (mean, 12.6 months). After operation, 1 patient suffered from superficial peroneal nerve injury, 1 patient developed anterior scar impingement on the ankle, 2 patients had superficial wound infection, and 1 patient suffered from sprain again. The VAS score, Tenger score, AOFAS score, KAFS score, and FAOS score significantly improved when compared with the preoperative scores (P<0.05). MRI examination showed the ligament healing and good tension. Conclusion For adolescent patients with chronic lateral ankle instability, using simplified all-arthroscopic Broström technique to repair ATFL can effectively alleviate ankle pain, improve stability, and achieve good effectiveness.
Objective To investigate the short-term effectiveness of ultrasound-guided closed reduction by Kirschner wire provocation technique in the treatment of Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents. Methods Between May 2019 and May 2022, 41 patients with Salter Harris types Ⅰ and Ⅱ distal tibial epiphyseal fractures were admitted, all of whom had periosteal entrapment on preoperative MRI, and 38 cases (92.7%) were confirmed to have periosteal entrapment by intraoperative ultrasound. There were 24 males and 14 females, the age ranged from 6.8 to 15.7 years, with an average of 10.7 years; and there were 20 cases of Salter Harris type Ⅰ and 18 cases of type Ⅱ. The time from injury to operation was 22-76 hours, with an average of 28.4 hours. The preoperative imaging examination showed excellent alignment in 4 cases, good in 20 cases, and poor in 14 cases. The ultrasound guided Kirschner wire provocation technique for closed reduction and percutaneous Kirschner wire internal fixation were performed. The operation time, intraoperative fluoroscopy frequency, fracture healing time, and complications were recorded. Anteroposterior and lateral X-ray films of the affected ankle joint were taken before operation, at 3 months after operation, and at last follow-up to observe the healing of the fracture, and anteroposterior X-ray films of the whole length of both lower limbs were taken to evaluate the alignment of the force lines of the affected limbs. The range of motion (ROM), visual analogue scale (VAS) score, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used to evaluate ankle function. The mechanical lateral distal tibia angle (mLDTA) and the anatomic anterior distal tibia angle (aADTA) were measured. Results The operation time ranged from 17 to 52 minutes, with an average of 22.6 minutes, and the intraoperative fluoroscopy frequency ranged from 3 to 11 times, with an average of 4.2 times. X-ray examination during operation and at 2 days after operation showed that anatomical reduction was achieved. All patients were followed up 10-24 months, with an average of 16.4 months. All fractures healed in 6.1-7.2 weeks, with an average of 6.3 weeks; no fracture displacement occurred, and the patients recovered to their pre-injury level of motion at 6 months after operation. Needle tail irritation occurred in 2 cases at 4 weeks after operation, and they recovered after symptomatic treatment. During the follow-up, there was no serious complication such as incision deep infection, bone nonunion, delayed union, and malunion. At last follow-up, the patients’ alignment were all excellent, and the difference was significant when compared with preoperative one (Z=–7.471, P<0.001). The VAS score, AOFAS ankle-hindfoot score, dorsiflexion-plantar flexion ROM, varus-valgus ROM, mLDTA, and aADTA significantly improved at 3 months after operation and last follow-up when compared with preoperative ones (P<0.05). ConclusionUltrasound-guided closed reduction by Kirschner wire provocation technique for treating Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents is minimally invasive and safe.
Objective To evaluate the effect of mindfulness therapy on sleep problems in adolescents. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chongqing VIP and SinoMed for relevant randomized controlled trials on mindfulness intervention to improve adolescents’ sleep. The retrieval time was from the establishment of the databases to October 21, 2022. The results were meta-analysed with RevMan 5.4 software. Results A total of 11 randomized controlled trials were included, with a total sample size of 870 cases. The types of mindfulness therapy include mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness meditation, group mindfulness sleep intervention, body scanning and other mindfulness technologies. The duration of single intervention was different. The included studies showed that the mindfulness intervention can effectively improve the sleep problems of adolescents and the accompanying daytime sleepiness, anxiety, depression and other negative emotions compared with the control intervention. Meta-analysis of six studies showed that the sleep quality of adolescents in the mindfulness intervention group was improved [mean difference=−1.21, 95% confidence interval (−1.58, −0.83), P<0.00001]. Conclusion Mindfulness therapy has a good effect on improving adolescents’ sleep problems, but whether it can achieve long-term benefits still needs to be further evaluated by high-quality, multicenter long-term follow-up trials.
Objective To summarize the current management of anterior cruciate ligament (ACL) injury in children and adolescents, in order to provide reference for the management of ACL injury in children and adolescents. MethodsThe relevant literature at home and abroad in recent years was extensively accessed to summarize the management status of ACL injury in children and adolescent. Results The number of ACL injury in children and adolescents is increasing every year. The diagnosis of ACL mainly depends on symptoms and signs. Rehabilitation, physeal-sparing techniques, partial transphyseal techniques, all-epiphyseal techniques, and transphyseal techniques are used to treat ACL injury in children and adolescents. Conclusion Dynamic monitoring of knee joint in children and adolescents should be strengthened. The best treatment for ACL injury in children and adolescents is selected according to the patients’ actual age, bone age, Tanner stage, and physiological conditions such as menstruation, body growth speed, and other characteristics.
Foot shape and size are important for footwear design and production. Information about important foot characteristics helps not only to improve shoe comfort but to maintain the proper physiological development of the feet. What’s more, plenty of studies have suggested that the shape of the shoe must closely resemble the shape of the foot to create a properly fitted shoe. This means that the differences between various populations should be considered and that footwear should be designed according to the measurements of users. Childhood and adolescent are important periods of human growth. During these periods, foot shape changes with human growth and can be influenced by extrinsic factors. Therefore, the foot shape characteristics of children and adolescents should be investigated. The results from these investigations can contribute to developing appropriate shoe for children and adolescents, improving perceived comfort of children shoes and preventing pedopathy among children and adolescents. This review aims to discuss measuring methods of foot shape, types of foot shape, and factors influencing foot shape. The results of the review can provide recommendations for investigating growth development of foot shape and useful information for consumers and shoe manufacturers.
Objective To investigate the prevalence and related factors of primary palmar hyperhidrosis in adolescents in Yangzhou. Methods On-site questionnaire survey was performed on students selected by cluster random sampling from the two colleges and two high or middle schools, with each class as a unit. Data were collected through the questionnaire to make the diagnosis and severity grading. Results A total of 3 487 copies of the questionnaire were distributed in the survey and 3 299 were finished, among which 3 083 were effective with an effective rate of 88.41%. Among them, 1 358 respondents were males and 1 725 were females; 933 were middle school students, 809 high school students, and the remaining 1 341 college students. According to the diagnostic criteria, 104 respondents were diagnosed with palmar hyperhidrosis with an overall prevalence of 3.37%. There were 60 (4.41%) males and 44 (2.55%) females. Although the prevalence of palmar hyperhidrosis in males was higher than that of females (χ2=8.130, P<0.05), severe palmar hyperhidrosis was more often to be observed in females than in males, and females were also more likely to have hyperhidrosis in other parts of the body. In addition, the age of the first onset of the disease was mainly 10 to 20 years old and 36.54% of the patients had a family history. Conclusion The prevalence of palmar hyperhidrosis in adolescents in Yangzhou was 3.37%, and there is a significant difference in the gender. The palmar hyperhidros is often accompanied by hyperhidrosis symptoms of other parts of body, and the disease shows an obvious genetic predisposition.
ObjectiveTo analyze and compare the disease burden, trends, and influencing factors of lung cancer in adolescents and young adults (AYAs) in China and globally from 1990 to 2021, providing a reference for the prevention and treatment of lung cancer in China. MethodsIndicators of lung cancer disease burden in different genders and age groups in 204 countries or regions from 1990 to 2021 were retrieved and standardized from GBD 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change (AAPC) of the standardized rates of lung cancer in AYAs in China and globally from 1990 to 2021; changes in incidence, mortality, and disability-adjusted life years (DALYs) rates due to population growth, aging, and epidemiological changes were analyzed; differences in lung cancer disease burden in AYAs in different socio-demographic index (SDI) regions were analyzed; and the influencing factors of lung cancer in AYAs in China and globally were explored. ResultsFrom 1990 to 2021, the age-standardized incidence rate (ASIR) (AAPC=−0.18%, P<0.001), age-standardized mortality rate (ASMR) (AAPC=−0.62%, P<0.001), and age-standardized DALYs rate (AAPC=−0.62%, P<0.001) of lung cancer in AYAs in China showed a downward trend, consistent with the global trend, but the decline in China was relatively small. During this period, the age-standardized rates of various indicators of lung cancer in males in China and globally were higher than those in females, and the burden of lung cancer in Chinese males was heavier. However, due to the significant downward trend in males, the gap in lung cancer burden between males and females was narrowing. At the same time, from 2013 to 2021, the ASIR [annual percent change (APC)=2.01%, P<0.001], ASMR (APC=1.46%, P<0.001), and standardized DALYs rate (APC=1.46%, P<0.001) in China showed an upward trend. From 1990 to 2021, among the main influencing factors for the incidence, mortality, and DALYs rates of lung cancer in Chinese AYAs, the contribution of aging was upward-pushing, while the increase in global indicators was mainly attributed to population growth. The global burden of lung cancer in AYAs was overly concentrated in high SDI regions. Although the gap in lung cancer burden between high SDI and low SDI regions was narrowing, it remained widespread. Globally, smoking, environmental PM2.5, insufficient fruit intake, second-hand smoke, and indoor air pollution were prominent risk factors. ConclusionFrom 1990 to 2021, the global and Chinese AYAs lung cancer incidence and mortality rates generally show a downward trend, but the female lung cancer burden relatively increases, especially in young women without a history of smoking. Continued efforts are needed to reduce the burden of lung cancer in AYAs, especially the specific risk for young women.
ObjectiveTo analyze research status of influencing factors related to sun-protection problems in children and adolescents, and systematically review the influencing factors. MethodsWe electronically searched the following databases including The Cochrane Library, PubMed, Web of Knowledge, Ovid, EBSCO, EMbase, CBM, CNKI, VIP and WanFang Data to collect cross-sectional studies on sun-protection problems in children and adolescents up to December 2012. The criteria for cross-sectional studies recommended by AHQR was applied in the assessment of included studies. Then, qualitative analysis methods were used to systematically summarize information and results of the included studies. ResultsA total of 10 studies were included. The results showed that, the influencing factors of sun-protection behaviour in children and adolescents included gender, age, skin colour, eye colour, the mass media information, school health education, etc., of which, researches on gender, grade, light skin, eye colour were relatively more. ConclusionAt present, there are many studies about influencing factors related to sun-protection problems in children and adolescents while the target influencing factors differ in regions.
ObjectiveTo evaluate the effectiveness of modified Ilizarov hip reconstruction in the treatment of hip instability.MethodsThe clinical data of 13 young patients with hip diseases treated with modified Ilizarov hip reconstruction between January 2010 and March 2018 were retrospectively analyzed. There were 2 males and 11 females, aged from 14 to 34 years, with an average age of 24.2 years. There were 1 case of hip dysplasia and dislocation due to spinal bifida, 3 cases of hip dysplasia after pyogenic arthritis of the hip, 2 cases of developmental dysplasiaof the hip (DDH) accompanying femoral head necrosis who rejected hip replacement, 6 cases of young DDH refused to undergo hip replacement, and 1 case of bilateral hip dysplasia with dislocation due to sputum cerebral palsy. The disease duration was 2-20 years, with an average of 8.5 years. Preoperative Trendelenburg sign was positive in 12 cases and negative in 1 case. The preoperative Harris score of hip joint was 53.5±8.9 and the unequal length of lower limbs was (46.08±15.73) mm. Postoperative Harris hip score and patients' satisfaction with effectiveness evaluated according to their self scoring were used to assess the effectiveness.ResultsAll 13 patients were followed up 1-5 years, with an average of 2.6 years. Five patients developed postoperative needle infection, which improved after dressing change; 7 patients had limited knee joint activity and improved after knee joint function training. The Trendelenburg sign was negative at 1 year after operation, and the patient’s hip pain symptoms were relieved or disappeared. The Harris hip score of patients at 1 year after operation was 84.5±6.1, which was significantly improved when compared with preoperative one (t=－10.538, P=0.000). According to Harris hip score, the effectiveness results were excellent in 4 cases, good in 5 cases, and fair in 4 cases, with an excellent and good rate of 69.2%. The unequal length of lower limbs was (15.38±7.27) mm, which was significantly better than that before operation (t=11.826, P=0.000). At last follow-up, the patients' satisfaction score was 80%-95%, with an average of 88%.ConclusionModified Ilizarov hip reconstruction can be used to treat young patients with hip disease who are unsuitable or refuse to undergo artificial hip replacement. Its effectiveness is reliable, and it has unique advantages in limb limp improvement and limb shortening correction.
ObjectiveTo summarize the clinicopathological characteristics of papillary thyroid cancer (PTC) in adolescents and analyze the risk factors affecting lateral lymph node metastasis and prognosis. MethodsIn retrospectively, 150 adolescent PTC patients admitted to the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2022 and meeting the inclusion and exclusion criterias were collected as the study subjects (adolescent group), and 100 adult PTC patients were selected as adult group. Statistical analysis was performed with SPSS 25.0 software to compare the clinicopathological characteristics of the patients in the two groups, and to explore the risk factors for lateral lymph node metastasis and recurrence in adolescent PTC patients by using logistic regression and Cox proportional hazards regression models, respectively. ResultsAdolescents with PTC were more prone to extrandular invasion [30.0% (45/150) versus 17.0% (17/100), P=0.020], neck lymph node metastasis [79.3% (119/150) versus 48.0% (48/100), P<0.001], central lymph node metastasis [78.7% (118/150) versus 48.0% (48/100), P<0.001], lateral lymph node metastasis [44.0% (66/150) versus 12.0% (12/100), P<0.001]; and had a greater maximum tumor diameter (1.75 cm versus 0.75 cm, P＜0.001) and higher ratio of greater maximum tumor diameter ＞2 cm [45.3% (68/150) versus 8.0% (8/100), P＜0.001] in adolescent PTC patients. In adolescent PTC patients, extraglandular invasion (OR=2.654, P=0.022), multifoci (OR=4.860, P<0.001) and maximum tumor diameter>2 cm (OR=3.845, P=0.001) were risk factors for lateral lymph node metastasis; lateral lymph node metastasis (RR=10.105, P=0.040) and distant metastasis (RR=7.058, P=0.003) were predictors of postoperative recurrence in adolescent PTC patients. ConclusionsCompared with adult PTC patients, adolescent PTC patients have more aggressive tumors. Adolescent PTC with extraglandular invasion, multilesions, and maximum tumor diameter>2 cm should be considered for lateral lymph node dissection; and adolescent PTC patients with lateral lymph node metastasis and distant metastasis should pay close attention to their recurrence status.