Loss Measurements Research Articles

Effectiveness of auditory measures in the diagnosis of cochlear synaptopathy and noise-induced hidden hearing loss: a case–control study

Abstract Background Cochlear synaptopathy is a disorder where auditory perceptual impairments, such as speech perception in noise and tinnitus, may not be accurately reflected by audiometric thresholds, even if the audiogram appears normal. It is proposed that the connections between hair cells and the auditory nerve are more susceptible to sound and aging damage than the cochlea’s hair cells. Cochlear synaptopathy can be present in ears with normal audiograms and undamaged hair cells, leading to hidden hearing loss. This study aims to construct electrophysiological and behavioral auditory parameters associated with persons exposed to loudness and having normal audiograms and auditory complaints to identify hidden hearing loss. Results A case–control study was done with forty participants with a documented history of exposure to loud sounds and various auditory complaints, compared to a control group of forty persons who had all been confirmed to have normal audiograms. The chosen behavioral core tests comprised the speech intelligibility in noise test (SPIN), gaps detection in noise (GIN test), and pitch pattern sequence test (PPS). The electrophysiological measures utilized in the study were the auditory brainstem response test (ABR) and electrocochleography (ECochG). The SPIN, PPS, and GIN test results demonstrated statistically significant disparities between the control and case groups. The amplitude ratio of wave I to wave V in ABR and the ratio of EcochG AP to SP demonstrated a statistically significant variance between the two groups. The SPIN test exhibited the highest AUC, signifying its superior diagnostic capability in identifying hidden hearing loss. Conclusion The present study has shown that the SPIN, as a behavioral test, and the EcochG AP amplitude measure, as an electrophysiological test, provide the greatest auditory diagnostic capability for identifying cochlear synaptopathy. Wave I amplitude in the auditory brainstem response (ABR) and the SP/AP ratio in electrocochleography (EcochG) are promising non-behavioral measures of cochlear synaptopathy or hidden hearing loss.

Treatment of Cigarette Butts: Biodegradation of Cellulose Acetate by Rot Fungi and Bacteria

This study demonstrated the biodegradation of two different brands of cigarette butts (CBs), which are primarily composed of cellulose acetate, by four distinct microorganisms. These included the white rot fungus Pleurotus ostreatus, the brown rot fungus Lentinus lepideus, and the bacteria Bacillus cereus and Pseudomonas putida. After 31 days of treatment, weight loss measurements revealed a mass loss of 24–34%, where B. cereus exhibited the greatest efficacy in terms of mass loss for both brands of CBs. Fourier-Transform Infrared Spectroscopy (FTIR), confocal microscopy, and scanning electron microscopy (SEM) confirmed changes in the surface of the CBs, attributable to structural wear and material breakdown, indicating effective biodegradation by the evaluated microorganisms. Furthermore, the analyses confirmed changes in the surface of the CBs, attributable to structural wear and material breakdown, indicating effective biodegradation by the evaluated microorganisms.

Retention of nickel, cobalt and chromium in skin at conditions mimicking intense hand hygiene practices using water, soap, and hand-disinfectant in vitro

BackgroundDuring the COVID-19 pandemic, increased hand hygiene practices using water, soap and hand disinfectants, became prevalent, particularly among frontline workers. This study investigates the impact of these practices on the skin’s ability to retain the allergenic metals nickel, cobalt, and chromium. The study constitutes three parts: (I) creating an impaired skin barrier, (II) exposing treated and untreated skin to nickel alone, and (III) in co-exposure with cobalt and chromium.MethodsUsing full-thickness skin from stillborn piglets, in vitro experiments were conducted to assess retention of metals in skin at conditions mimicking intense hand hygiene practices. Treatment of skin with varying concentrations of sodium lauryl sulphate (SLS), to impair its barrier integrity was assessed. This was followed by exposure of treated and untreated skin to the metals, that were dissolved in Milli-Q water, 0.5% SLS, and ethanol respectively.ResultsResults showed that pre-treatment with 5% SLS impaired the skin barrier with regards to the measure of trans epidermal water loss (TEWL). Metal amounts retained in the skin were generally higher in treated than untreated skin. The highest amounts of metal retained in skin were observed for exposure to nickel in ethanol. Co-exposure to nickel, cobalt, and chromium in 0.5% SLS resulted in the highest amounts of total metal retention.ConclusionsThe in vitro findings highlight the increased risk of metal retention in skin due to an impaired barrier. The SLS concentration used in the current study corresponds to those used in many hand hygiene products. Hence, occupational settings with frequent exposure to water, soap and disinfectants need to consider protective measures not only for the irritant exposures themselves but also simultaneous exposure to allergenic metals.

Attenuation of bulk waves using locally resonant soil-coupled metabarriers

Abstract Low frequency ground-borne vibrations generated by transport infrastructure are one of the most serious causes of disturbance to the general population. One possibility to reduce this problem is to use the wave filtering properties of elastic metamaterials. However, their integration in the soil complicates the prediction of their response, and the influence of soil-structure interaction needs to be correctly evaluated for an efficient design. The aim of this work is to experimentally evaluate the efficiency of metamaterial trench barriers set in soil in attenuating vibrations, using low-frequency local resonance mechanisms. A lab scale model is proposed comprising different resonating structures and a cylindrical encasement is adopted to couple the structure to the soil. The influence of various parameters is evaluated, such as metamaterial structure, geometrical characteristics of the resonator, and constituent materials. Finite Element simulations are used to develop a suitable design, analysing mode shapes and resonance frequencies of structures with and without the surrounding encasement. Experimental modal analysis is then performed on the corresponding fabricated samples, providing both model validation and out-of-soil mechanical characterization. Finally, vibration transmission loss measurements are performed in a setup in which different resonant metamaterial barriers are embedded into the soil sample, allowing the evaluation of barrier performance. Results indicate that the metamaterial structures provide good attenuation of vibrations in selected intervals in the low to high frequency range (1–5 kHz), demonstrating the feasibility of the approach in a scaled sample. Preliminary data regarding the structures providing preferable design characteristics is also obtained. These results can be useful for the design of trench barriers scaled to large dimensions in more realistic applicative settings.

Sustainable enhancement of wool fibers using Hymenocrater platystegius flower and natural dyes for improved Insect-Repellent and color properties

This study investigates the application of Hymenocrater platystegius flower as a natural mothproofing agent for wool fibers and examines the effects of aluminum mordanting on the dyeing properties of wool treated with various natural dyes. Wool fibers were treated with Hymenocrater platystegius flower powder and aluminum salts, followed by dyeing with Madder, Reseda lutea, Indigo, or Walnut shell dyes using different mordanting methods. FTIR analysis revealed the characteristic absorption bands and confirmed the interactions between the wool fibers and the treatment agents. The insect-repellent properties were assessed by weight loss measurements after exposure to Anthrenus verbasci larvae, showing significant improvements in treated samples, particularly with the combination of Hymenocrater platystegius and aluminum mordanting. GC–MS analysis of the essential oil identified as α-Pinene, Trans-Verbenol, Linalool, and β-Bourbonene as the main constituents, contributing to the insect-repellent effect. The L*a*b* color space analysis demonstrated that aluminum mordanting significantly enhances the color strength and stability of dyed wool, with pre-mordanting generally providing better results. The study further evaluated the washing and light fastness, as well as the mothproofing properties of the dyed wool samples. These results indicate that the weight loss percentages of treated wool fiber after washing are slightly higher than before washing, but the difference is not significant. Overall, the use of aluminum mordant in conjunction with Hymenocrater platystegius flower powder not only improves the color characteristics of wool dyed with natural dyes but also provides effective mothproofing properties, making it a viable and eco-friendly option for textile applications.

N, S-Codoped Carbon Quantum Dots with High Inhibition Efficiency: Implications for Corrosion Mitigation of Carbon Steel in Acidic Environments.

The environmental friendliness, economic feasibility, and high efficiency of carbon quantum dots (CQDs) render them as highly promising candidates for corrosion inhibitors. The present study proposed the fabrication of nitrogen- and sulfur-codoped CQDs via an one-step hydrothermal method using l-cysteine and 4-aminosalicylic acid as precursors. The structure, particle size, and surface ligands of the prepared CQDs were determined through spectroscopy and transmission electron microscopy characterization. Subsequently, the inhibition performance of the CQDs on carbon steel in a 0.5 M sulfuric acid solution was evaluated through weight loss measurement, electrochemical methods, and surface analysis. The CQDs exhibited remarkable inhibition efficiencies of 97.9% at 293 K and 98.9% at 313 K, with a concentration of 150 ppm. In addition, the obtained CQDs demonstrated a combined physisorption and chemisorption adsorption behavior, which complied with the Langmuir adsorption isotherm. These findings provide insight into the inhibition mechanism and highlight the potential of codoped CQDs for corrosion mitigation applications in acidic environments.

Design, synthesis, and evaluation of a pyrazole-based corrosion inhibitor: a computational and experimental study

By employing a synergistic blend of experimental and theoretical methodologies, we investigated the corrosion inhibition efficacy of a synthesized pyrazole derivative (BM-01) in a solution of hydrochloric acid (1 M). We utilized molecular dynamics (MD) simulations, scanning electron microscopy (SEM), density functional theory (DFT), complexation, plus electrochemical impedance spectroscopy (EIS). We conducted weight loss (WL) measurements from 298 to 328 K. Inhibition efficacy reached a maximum at a BM-01 concentration of 10−3 M, achieving 90.0% (EIS), 90.40% (WL), and 90.38% (potentiodynamic polarization (PDP)). SEM unveiled the shielding of the carbon-steel surface from acid-induced damage by BM-01. The Langmuir adsorption isotherm exhibited a robust fit with a low sum of squares, standard deviation, and a high correlation coefficient. PDP findings indicated that BM-01 acted as a mixed-type inhibitor, predominantly favoring the cathodic process, suggesting potential corrosion-mitigation properties. Theoretical analyses involving DFT, MD simulations, and radial distribution function were conducted to postulate a mechanism and identify an inhibitory layer. Theoretical outcomes aligned closely with experimental data, thereby reinforcing the validity of our findings.

Initially reactive and concentrated generalized fluid wavy flow with the applications of disorder theory and magnetic field: A computational study

The wavy flow of generalized fluid namely, Cross fluid is mathematically formulated on a gravitationally affected vertical wavy surface with significant physical effects which is the main theme of this work. This particular dynamics of chemically reactive materials is further explored with an irreversible process. A significant heat transfer is measured through thermal resistance during the consideration of entropy optimization. Since entropy generation is associated with the mechanical systemenergy loss is more helpful in monitoring the entropy production in different engineering and industrial processes. Specifically, such irreversibility process appearance causing a noticeable low efficiency in the relevant practical sectors. For better performance in the minimization of friction on the wavy surface, flow is dissipated in terms of heat. However, the measure of loss in terms of work is introduced in the form of thermal radiation, viscous dissipation, magnetic field, and first-order chemical reaction. Additionally, the expected pressure drooping on the wavy surface is another goal of the entire study. The non-linear mathematical equations are determined by following the maximum viscosity approach. Relevant and important results are portrayed to show the various features of the newly developed work. The significant findings are approximated via one of the collocation methods while using MATLAB software. The Richardson number and buoyancy parameter enhanced the flow speed of the materials. The heat transfer rate is decreased by both Eckert number and wavy amplitude and the chemical reaction factor enhanced the mass transfer rate. The heat energy of the materials is escalated with the help of electromagnetic wave radiation and temperature ratio factor. Strengthening the chemical reaction factor declined the mass flow during the typical motion of the liquid. In the last, a comparison is provided to show the accuracy of the numerical approach.

Prevalence of Hearing Loss and Hearing Aid Use Among Persons Living With Dementia in the US

Dementia and hearing loss are prevalent and represent public health priorities, but little is known about the prevalence of hearing loss among persons living with dementia at a population level. To estimate the prevalence of hearing loss and hearing aid use among a nationally representative sample of persons living with dementia. In this cross-sectional study, we analyzed data from Medicare beneficiaries who participated in round 11 of the National Health and Aging Trends Study (NHATS). The analytic sample included participants who had complete audiometric data and a dementia classification, and survey weights were applied to yield nationally representative estimates. Data were collected from June to November 2021, and analyzed from October 12, 2023, to February 27, 2024. Audiometric measures of hearing loss and self-reported hearing aid use. National prevalence estimates of possible and probable dementia and hearing loss were estimated by applying NHATS survey weights of sex and age to the population aged 71 years or older based on the US Census Bureau's 2020 American Community Survey data. The analytic sample comprised 2613 NHATS participants (74.6% aged 71-79 years and 25.4% aged ≥80 years; 52.9% female). Overall prevalence of hearing loss among participants with dementia was estimated at 79.4% (95% CI, 72.1%-85.3%). The prevalence of hearing loss increased with age, from 61.1% (95% CI, 37.7%-80.2%) among participants aged 71 to 74 years to 94.2% (95% CI, 88.8%-97.0%) among those aged 85 years or older. Among participants with hearing loss, 21.7% (95% CI, 16.2%-28.3%) reported hearing aid use. In this cross-sectional study, the findings suggest that hearing loss is highly prevalent among individuals with dementia, with a low prevalence of hearing aid use. These findings reveal a potential opportunity for intervention.

On the principle of reciprocity in inelastic electron scattering.

In electron microscopy the principle of reciprocity is often used to imply time reversal symmetry. While this is true for elastic scattering, its applicability to inelastic scattering is less well established. From the second law of thermodynamics, the entropy for a thermally isolated system must be constant for any reversible process. Using entropy and statistical fluctuation arguments, it is shown that, while reversibility is possible at the microscopic level, it becomes statistically less likely for higher energy transfers. The implications for reciprocal imaging modes, including energy loss and energy gain measurements, as well as Kainuma's reciprocal wave model are also discussed.

Exploring NRB Biofilm Adhesion and Biocorrosion in Oil/Water Recovery Operations Within Pipelines.

Microbially influenced corrosion represents a critical challenge to the integrity and durability of carbon steel infrastructure, particularly in environments conducive to biofilm formation by nitrate-reducing bacteria (NRB). This study investigated the impact of NRB biofilms on biocorrosion processes within oil/water recovery operations in Algerian pipelines. A comprehensive suite of experimental and analytical techniques, including microbial analysis, gravimetric methods, and surface characterization, were employed to elucidate the mechanisms of microbially influenced corrosion (MIC). Weight loss measurements revealed that carbon steel samples exposed to injection water exhibited a corrosion rate of 0.0125 mm/year, significantly higher than the 0.0042 mm/year observed in crude oil environments. The microbial analysis demonstrated that injection water harbored an average of (4.4 ± 0.56) × 106 cells/cm2 for sessile cells and (3.1 ± 0.25) × 105 CFU/mL for planktonic cells, in stark contrast to crude oil, which contained only (2.4 ± 0.34) × 103 cells/cm2 for sessile cells and (4.5 ± 0.12) × 102 CFU/mL for planktonic cells, thereby highlighting the predominant role of injection water in facilitating biofilm formation. Contact angle measurements of injection water on carbon showed 45° ± 2°, compared to 85° ± 4° for crude oil, suggesting an increased hydrophilicity associated with enhanced biofilm adhesion. Scanning electron microscopy further confirmed the presence of thick biofilm clusters and corrosion pits on carbon steel exposed to injection water, while minimal biofilm and corrosion were observed in the crude oil samples.

Does Omega-3 supplementation increase profuse postpartum hemorrhage? A hospital-based register study.

Although Omega-3 is thought to have anticoagulative properties, the potential untoward effects of Omega-3 during pregnancy have not been investigated. No previous studies have been made to specifically assess its effect on postpartum hemorrhage (PPH). Our aim was to determine if an association exists between Omega-3 intake during pregnancy and profuse PPH or massive PPH. Data on all deliveries that occurred at Karolinska University Hospital during the years 2007-2011 (n = 41 139) was collected from the medical record of Obstetrix, maternal health and delivery chart system. Women with reported Omega-3 use in early pregnancy were considered exposed and all other as unexposed. Bivariate and adjusted multivariate analysis was performed on main outcomes. Omega-3 use was associated with 25% increased odds of PPH (adjusted odds ratio (aOR) 1.25, 95% confidence interval [CI] (1.06-1.47)) and a more than doubled odds of massive PPH (aOR 2.36, 95% CI 1.26-4.44). In addition, there was a minor increase in the amount of blood loss. Although few, women on low-dose discontinued terminated at 36th week showed no significant association to blood loss measurements. Our observational findings showed 25% higher odds of PPH and two times higher odds of massive PPH in women who reported using Omega-3 in early pregnancy. Our findings give some support to advocate discontinued use of Omega-3 in late pregnancy.

Precise Reflectance/Transmittance Measurements of Highly Reflective Optics with Saturated Cavity Ring-Down Signals

In this paper, a data processing approach was developed to accurately extract the ring-down time and amplitude of the saturated cavity ring-down (CRD) signal; both were utilized to determine simultaneously the high reflectance and residual transmittance of highly reflective (HR) mirrors with a dual-channel CRD configuration. The influence of saturation was eliminated by deleting the beginning saturated data points of the saturated CRD signal and fitting the remaining non-saturated CRD signal to a single-exponential function. By comparing the reflectance/transmittance measurement results of HR samples obtained via data processing of saturated CRD signals and via single-exponentially fitting non-saturated CRD signals with utilization of neutral density filter(s) to eliminate saturation, it was found that the reflectances obtained with both methods were in excellent agreement, while the residual transmittance obtained with the saturated CRD signal was more accurate than that obtained with the neutral-density-filter-attenuated non-saturated CRD signal. The proposed data processing method eliminated the need to use the neutral density filters, therefore avoiding the adding of the optical density error to the uncertainty of residual transmittance measurement and improving the measurement accuracy. The proposed data processing method also extended the dynamic range of the dual-channel CRD scheme for simultaneous measurement of reflectance, transmittance and optical loss.

Serial intravitreal injections in age-related macular degeneration patients from the dry eye disease perspective: a cross-sectional study

BackgroundTo evaluate the effects of serial intravitreal injections (IVI) on the ocular surface and meibomian glands in patients with neovascular age-related macular degeneration (nAMD).MethodsPatients receiving anti-vascular endothelial growth factor (anti-VEGF) agent injections for unilateral nAMD were included. Untreated fellow eyes served as the control group. All participants followed a pre-IVI asepsis protocol with povidone-iodine (PI). Ocular surface diseases index (OSDI) questionnaire scores, first and average non-invasive tear break-up time (fNITBUT and avgNITBUT), Schirmer-1 test results, corneal staining score (according to Oxford scale), meibomian gland (MG) loss rates of lower and upper eyelids were recorded four weeks after the last IVI.ResultsForty-two nAMD patients with a mean age of 63.3 ± 19.4 were included in the study. The mean OSDI score was 20.3 and the median of IVI number was 9 (6–22). There were no statistically significant difference between treated and untreated fellow eyes regarding fNITBUT (5.6 vs. 4.5, p = 0.872), avgNITBUT (6.2 vs. 7.2, p = 0.968), Shirmer-1 results (7 vs. 7, p = 0.854), corneal staining (0.3 vs. 0.2, p = 0.341), lower and upper MG loss rate (29.3 vs. 28.4, p = 0.162, and 27.1 vs. 26.9, p = 0.476, respectively). Only significant correlation was observed between age with lower and upper MG loss rate (r:0.396, p = 0.042, and r:0.365, p = 0.047).ConclusionThe results of the present study demonstrated that serial IVI of anti-VEGF agents with PI asepsis is well tolerated by nAMD patients in terms of ocular surface, MG loss and DED measurements.

Vibroacoustic characterization of small woven fabrics

This study is aimed to analyze the vibroacoustic behaviour of woven fabrics utilized in small acoustic devices for ingress protection. We first concentrate on predicting and describing the vibration behaviour of the woven fabric structure through flip around, since lumped modelling comes first. A vibration experiment is also conducted to measure the motion of the woven fabric structure under external excitation to validate the modelling. The numerical model is then employed to simulate the vibroacoustic behaviour of the woven fabric via transmission loss calculation; the simulation is then compared with transmission loss measurement based on the four-microphone method. This research demonstrates that despite some limitations, both the numerical and lumped models show a good degree of accuracy in predicting the vibration of the woven structure; the numerical model also performs well in vibroacoustic modelling.

Marginal Bone Loss and Clinical Evaluation of Angled Implants: A Retrospective Study

Aim: The volume of the edentulous crest and its proximity to critical anatomical structures are important limiting factors for implant surgery. Surgical procedures with complications can be avoided by placing angled implants. The aim of this clinical study was to evaluate marginal bone loss and the complications of angled implants. Materials and Methods: Fifty-eight dental implants were examined in 32 patients (16 females, 16 males) with cone beam computed tomography (CBCT) images from patients with angled implants and complete edentation. The marginal bone loss in angled implants that were functional for 15 to 30 months was evaluated according to factors such as implant angle, connection type, opposing arch restoration type and planning of superstructure restoration. Marginal bone loss measurements were recorded from CBCT sections. Results: It was determined that 3.44% of the implants placed had an inclination of less than 15°, 75.86% had an inclination between 15° and 30° and 20.68% had an inclination of more than 30°. While there was no marginal bone loss on the mesial and distal surfaces, the average marginal bone loss was 0.66 on the buccal surfaces and 0.93 in the lingual region. Only one of the implants examined failed. No pain or infection was observed in any of the implants examined. Conclusion: According to the results of this retrospective clinical study, further clinical studies with larger sample sizes are needed to evaluate angled implants supported by full arch fixed prostheses as a predictable and valid treatment method in the prosthetic rehabilitation of edentulous jaws.

Evaluating the Impact of Enhanced Recovery After Surgery (ERAS) on Postoperative Outcomes in Pancreatic Cancer Patients: A Historical Control Study

Objective: This study evaluates the impact of the Enhanced Recovery After Surgery (ERAS) program on postoperative outcomes in patients undergoing pancreatic cancer surgery. It compares traditional perioperative care with ERAS-based interventions, focusing on key rehabilitation indicators such as postoperative intestinal function recovery, length of hospital stays, medical costs, and the incidence of complications. Methods: A total of 74 patients were studied, with 37 receiving traditional perioperative care and 37 managed under the ERAS protocol. Data collection included intraoperative indicators such as operation time, fluid input, blood loss, and postoperative recovery measures like first ambulation, pain scores, and complications. Results: The ERAS group demonstrated significantly faster recovery of gastrointestinal function, earlier mobilization, and reduced postoperative pain within the first 12 hours compared to the control group (p<0.05). The incidence of postoperative complications was lower in the ERAS group (13.51% vs. 37.84%, p=0.0166). Furthermore, the ERAS protocol led to a shorter length of hospital stay and lower total medical costs (p<0.0001). Conclusion: The implementation of the ERAS protocol for pancreatic cancer surgery significantly improves recovery outcomes, reduces complications, and lowers healthcare costs. These findings support the broader adoption of ERAS protocols in pancreatic cancer management to optimize clinical and economic outcomes.

Periodontitis and pre-eclampsia among pregnant women in Rwanda: A case-control study.

Several studies have indicated that the presence of periodontitis during pregnancy could increase the risk of developing pre-eclampsia, thereby negatively influencing pregnancy outcomes for both the mother and child. Notably, despite the high prevalence of both periodontitis and adverse pregnancy outcomes in Rwanda, there exists a crucial evidence gap concerning the precise relationship between periodontitis and pre-eclampsia. The aim of this study was to assess the association between periodontitis and pre-eclampsia amongst pregnant women in Rwanda. Employing an unmatched 1:2 case-control design, we studied 52 pre-eclamptic and 104 non-pre-eclamptic pregnant women aged ≥18 years at two referral hospitals in Rwanda. Pre-eclampsia was defined as a systolic blood pressure ≥ 140 and diastolic blood pressure ≥ 90 mm Hg, diagnosed after 20 weeks of gestation and proteinuria of ≥300mL in 24 hours of urine collection. Periodontitis was defined as the presence of two or more teeth with one or more sites with a pocket depth ≥ 4mm and clinical attachment loss >3 mm at the same site, assessed through clinical attachment loss measurement. Bivariate analysis and logistic regression were used to estimate Odds ratio (ORs) and 95% confidence interval. The prevalence of periodontitis was significantly higher among women with pre-eclampsia, compared to pregnant women without pre-eclampsia, at 90.4% and 55.8%, respectively (p< 0.001). Pregnant Women with periodontitis were 3.85 times more likely to develop pre-eclampsia after controlling for relevant confounders (adjusted Odds Ratio [aOR] = 3.85, 95%CI = 1.14-12.97, p<0.05). This study results indicates that periodontitis is significantly associated with pre-eclampsia among pregnant women in Rwanda. These findings suggest that future research should explore whether enhancing periodontal health during pregnancy could contribute to reducing pre-eclampsia in this specific population.

Accurate loss measurement of optical bulk materials with pulsed cavity ring-down technique

Accurate loss measurement of optical bulk materials with pulsed cavity ring-down technique

Comparison of third-generation minimally invasive surgery, split-drill osteotomy, and triplanar chevron osteotomy for treating mild to moderate hallux valgus with metatarsalgia in middle-aged women: An observational study.

This retrospective study compared the clinical efficacy of third-generation minimally invasive surgery (3rd-MIS) split-drill osteotomy with soft tissue release to that of triplanar chevron osteotomy (TCO) for treating mild to moderate hallux valgus (HV) with metatarsalgia in middle-aged women. This study compared the efficacy of 3rd-MIS using split-drill osteotomy to that of TCO in treating mild to moderate HV with metatarsalgia in 52 middle-aged women from March 2022 to June 2023. Retrospectively analyzing a total of 52 patients (26 patients per group), we employed 2 distinct surgical methods across 2 groups in this study: the TCO group received a traditional TCO accompanied by soft tissue release, whereas the MIS group underwent a split-drill osteotomy with soft tissue release. The study compared the operation time, onset of weight-bearing, osteotomy healing, blood loss, pre- and postsurgery X-ray measurements, metatarsalgia, and foot function scores. In the TCO group, complications included peri-incisional numbness, elevation of the first metatarsal head with metatarsalgia, and bone hyperplasia with stiffness at the MTPJ in one patient each. In the MIS group, bunions were successfully corrected without significant complications like bone nonunion or avascular necrosis of the metatarsal head, and the metatarsal length was preserved. Significant differences in operation time, weight-bearing onset, healing, and blood loss were detected between groups (P < .05). Preoperatively, there were no significant differences in hallux valgus angle, 1-2 intermetatarsal angle, or distal metatarsal articular angle among the groups (P > .05). Nonetheless, notable postoperative differences were observed (P < .05). Foot function and pain scores, assessed by the American Orthopaedic Foot & Ankle Society and the Visual Analogue Scale, showed significant improvements in both groups following surgery. Both surgical techniques effectively corrected the HV angle without significant changes in the first metatarsal length. The MIS group experienced significantly less pain on the second day postsurgery, as indicated by lower Visual Analogue Scale scores (P < .05). Both techniques were similarly effective in treating metatarsalgia. 3rd-MIS split-drill osteotomy with soft tissue release offers several advantages over TCO techniques for treating mild to moderate HV with metatarsalgia in middle-aged women, such as reduced trauma, quicker healing, smaller scars, and less pain after surgery.