Journal of Foot & Ankle Surgery最新文献

{"title":"Impact of preoperative pes planus on orthopaedic implant removal following first metatarsophalangeal joint arthrodesis: A retrospective analysis","authors":"William B. Dyke MD ,&nbsp;Nicholas Bank MD ,&nbsp;Bradley J. Lauck BA ,&nbsp;Stephen Himmelberg MD ,&nbsp;R. Justin Mistovich MD ,&nbsp;Trapper A. Lalli MD","doi":"10.1053/j.jfas.2024.12.005","DOIUrl":"10.1053/j.jfas.2024.12.005","url":null,"abstract":"<div><div><span><span>First metatarsophalangeal (MTP) joint fusion is a frequently employed surgical treatment option for </span>hallux rigidus and </span>hallux valgus<span>. Implant-related complications are common, necessitating further investigation into predisposing factors. The altered mechanics of pes planus may influence surgical outcomes; however, its direct impact on implant removal rates post-fusion remains unclear.</span></div><div>We retrospectively analyzed the TriNetX US Collaborative Network database to identify patients undergoing first MTP joint arthrodesis by ICD-10 and CPT coding, the data was stratified by preoperative pes planus status. Implant removal rates were compared between pes planus (PP) and non-pes planus (noPP) cohorts. Odds ratios (OR) were calculated to assess associations.</div><div>Patients in the PP cohort exhibited significantly higher rates of subsequent hardware irritation (OR 1.30, 95 % CI 1.010-1.675), and hardware removal (OR 1.27, 95 % CI 1.007-1.604) compared to patients in the noPP cohort.</div><div>Our findings highlight patients with preoperative pes planus have significantly increased likelihood of implant irritation, removal, and reoperation following first MTP joint arthrodesis surgery. Biomechanical alterations associated with pes planus likely contribute to accelerated implant wear and compromise fusion stability leading to higher rates of future surgery.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 507-510"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the costs of midfoot arthrodesis: A retrospective cohort study","authors":"William Newton MD ,&nbsp;Andrew Rowley MD ,&nbsp;Cody Ashy MD ,&nbsp;Caroline P. Hoch MPH ,&nbsp;Joshua L. Morningstar BS ,&nbsp;Christopher E. Gross MD ,&nbsp;Daniel J. Scott MD, MBA","doi":"10.1053/j.jfas.2025.04.001","DOIUrl":"10.1053/j.jfas.2025.04.001","url":null,"abstract":"<div><div><span>This retrospective cohort study<span> aims to determine the economic cost of midfoot arthrodesis<span> when treating midfoot arthritis, identifying the major driving forces of cost. A retrospective analysis was conducted on midfoot arthrodesis cases in South Carolina from 2012 to 2020 using the South Carolina Revenue and Fiscal Affairs (SCRFA) database. Patient cases were identified by ICD-9, ICD-10, or CPT code, yielding a total of 1,313 cases included in our analysis. Patients undergoing midfoot arthrodesis were primarily female (71.1 %), Caucasian (74.6 %), insured through commercial insurance (40.2 %) or Medicare (37.3 %), and had a mean age of 54.27 years (range 4-86). The mean total cost per midfoot arthrodesis was $54,307.08 (range $9,433.05-$120,664.29) and the mean length of stay was 1.26 (range 1-6) days. Total charges trended upward from $42,857 in 2012 to $58,643.43 in 2020. Upon analysis, the largest contributors to this cost were supplies ($27,888.28), operating room costs ($15,876.80), and anesthesia costs ($3,866.70). Notably, surgeon fees were a comparatively minor contributor ($670.49). The mean total cost per midfoot arthrodesis was $54,307.08, with supplies and operating room costs exceeded 80 % of the mean total costs. With professional service (physician) fees accounting for only 1.2 % of costs, hospital systems, hospital administrators, and surgeons should consider improving their understanding of ways to reduce surgical costs, supply negotiation, and transitioning to more </span></span></span>outpatient surgery as means to improve the value of midfoot arthrodesis care.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 660-664"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rejection rate, modifications, and turnaround time for patient specific instrumentation plans in total ankle replacement","authors":"Jason George DeVries DPM, FACFAS,&nbsp;Brandon M. Scharer DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.007","DOIUrl":"10.1053/j.jfas.2025.03.007","url":null,"abstract":"<div><div>Patient specific instrumentation (PSI) in total ankle replacement (TAR) has been reported to be accurate and time saving. However, there has been criticism regarding accuracy and an overreliance on the preoperative plan. This is a retrospective review of a single surgeon's PSI plans from 2016-2024. We report rejection rates, modifications, and turnaround time. A total of 101 plans were reviewed and found an overall rejection rate of 17.8 %, with 18 reports rejected. Average turnaround time was 29:07 hours. When comparing the 1st half of the study period to the second half, a statistically significant increase in rejection rate was found, 0 % to 45 %, p &lt; 0.0001. In addition, there was a higher rate of rejection on more complicated stemmed implants or revision implants compared to low profile implants. This report shows there is not a blind trust of the engineer's plan, and with experience with PSI rejection rate increases. Also, the engineer's understanding of complicated cases is addressed with higher rates of rejection in complicated cases. This report refutes charges that surgeons that use PSI for TAR are overly reliant on CT-derived engineer produced plans. Further studies with national data or multiple surgeons should be undertaken to explore this further.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 516-520"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of pathogens in deep surgical site infections following sinus tarsi approach calcaneal fracture surgery via open reduction internal fixation or primary arthrodesis - Implications for prophylaxis and treatment","authors":"Robin Eelsing ,&nbsp;Jens A. Halm ,&nbsp;Noam Nieboer ,&nbsp;Caspar J. Hodiamont ,&nbsp;Tim Schepers","doi":"10.1053/j.jfas.2025.04.004","DOIUrl":"10.1053/j.jfas.2025.04.004","url":null,"abstract":"<div><div><span>High rates of surgical site infections<span><span> (SSI) have been reported after calcaneal fracture surgery. The aims of the current study were to re-evaluate the rate of deep SSIs after </span>ORIF<span> of displaced intra-articular calcaneal fractures via the sinus tarsi approach, to identify different types of bacteria in the first obtained cultures and to determine the accuracy of the initially started (empiric) antibiotics prior to the results of the cultures. A search was performed from August 2012 to December 2023 using the specific surgical code for this procedure. Besides subject and surgery characteristics, the occurrence of deep SSI, the causative pathogens, and subsequent treatment strategies were documented. A total of 391 patients were screened for wound complications, among these patients fifteen deep SSI were found after a sinus tarsi approach (STA) (3.4%). The median age of patients was 57 (IQR 22) years, the majority of these patients identified as male (n=13, 87%) and were smokers (n=10, 67%). The most prevalent microorganisms were </span></span></span><span><span>Staphylococcus aureus</span></span> (present in 73.3% of cultures) and <span><span>Enterobacter cloacae</span><em> complex</em></span> (present in 53.3% of cultures). Eight patients had infections with multiple species of microorganisms. Given the fact that an <em>Staphylococcus aureus</em> and/or <em>Enterobacter cloacae complex</em><span> were present in more than half of the cultures, we recommend targeting empiric antibiotic<span> treatment at both gram-positive and gram-negative microorganisms once a deep SSI is suspected after calcaneal fracture surgery.</span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 597-601"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subscription Information","authors":"","doi":"10.1053/S1067-2516(25)00216-9","DOIUrl":"10.1053/S1067-2516(25)00216-9","url":null,"abstract":"","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Page A2"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does central-splitting or complete detachment provide better clinical results in surgical treatment of Haglund's disease? A 2 to 6 years retrospective comparative follow-up study","authors":"Piyanuch Musikachart,&nbsp;Theerawoot Tharmviboonsri,&nbsp;Bavornrit Chuckpaiwong,&nbsp;Penpun Lertwattanachai,&nbsp;Thos Harnroongroj","doi":"10.1053/j.jfas.2025.04.006","DOIUrl":"10.1053/j.jfas.2025.04.006","url":null,"abstract":"<div><div>A central-splitting and complete detachment of the Achilles tendon are common surgical approaches in Haglund's disease surgery. The objective of this study was to compare the 2- to 6-year clinical and radiographic outcomes between central-splitting and complete Achilles tendon detachment. The study involved patients with Haglund's disease who underwent surgery at our institution from 2018 to 2023. Demographic data and preoperative visual analogue scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) for Activities of Daily Living (ADL) were collected. At the final follow-up, postoperative VAS for pain, FAAM for ADL, and plantar-flexion strength was evaluated. Postoperative imaging was analyzed using the parallel pitch line and the Chauveaux-Liet angle to evaluate the ‘radiographic complete bone removal’. A total of 77 patients were recruited; 35 treated using central-splitting and 42 using the complete detachment approach. There was no statistically significant difference in demographic characteristics among the groups. The result demonstrated that FAAM for ADL was statistically significant higher in central splitting detachment as mean 87.4 (SD = 4.2) vs 82.4 (SD = 6.4), <em>p</em> &lt; 0.0001. There was no statistically significant difference for the VAS for pain, plantar-flexion strength, radiographic complete bone removal and complications. Central-splitting detachment could provide a significantly better functional outcome compared to complete detachment of Achilles tendon for the Haglund's disease surgery during 2 to 6 years of follow-up.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 608-612"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the patient acceptable symptom state (PASS) for PROMIS after Hallux Rigidus correction surgery","authors":"Allison L. Boden MD ,&nbsp;Stone R. Streeter BS ,&nbsp;Seif El Masry BS ,&nbsp;Grace M. DiGiovanni BA ,&nbsp;Matthew S. Conti MD ,&nbsp;Scott J. Ellis MD","doi":"10.1053/j.jfas.2025.03.008","DOIUrl":"10.1053/j.jfas.2025.03.008","url":null,"abstract":"<div><div><span><span>It is unclear which patient reported outcome metric correlates best with clinical improvement. The patient acceptable symptom state (PASS) incorporates the patient's subjective outcome experience into the outcome measurement. This study aims to establish PASS thresholds using Patient-Reported Outcome Measurement Information System (PROMIS) scores in patients undergoing hallux rigidus (HR) correction. A retrospective review of prospectively collected data identified 144 patients who were treated surgically for HR between February 2019 and March 2021, had preoperative and 2-year postoperative PROMIS scores, and had responses to two distinct PASS anchor questions. PASS thresholds were determined using the maximum </span>Youden Index. Differences in demographic and surgical characteristics between patients who met or did not meet the PASS thresholds were compared using independent samples T-tests and Pearson Chi-Square tests. Overall, 70 % of patients met the PASS thresholds. Patients with better baseline PROMIS scores were more likely to meet the postoperative PASS thresholds for every PROMIS domain (</span><em>p</em> &lt; 0.05). Patients who did not undergo first metatarsophalangeal (MTP) fusion were more likely to reach the PASS threshold for the Physical Function domain (<em>p</em> = 0.045). For the Pain Intensity domain, younger patients were more likely to meet the thresholds (<em>p</em><span><span> = 0.005). Patient sex, BMI, and use of either cheilectomy or Akin/Moberg </span>osteotomy during surgery did not impact a patient's likelihood of meeting the PASS thresholds. After surgical intervention for HR, it may not be necessary for patients to reach normal physical function or pain levels in order to reach an acceptable postoperative symptom state.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 521-525"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of surgery for ankle osteoarthritis on locomotive syndrome","authors":"Kanu Shimokawa MD,&nbsp;Hidenori Matsubara MD, PhD,&nbsp;Satoshi Kato MD, PhD,&nbsp;Toshifumi Hikichi MD,&nbsp;Yuki Fushitani MD,&nbsp;Yusuke Nakazawa MD,&nbsp;Satoru Demura MD, PhD","doi":"10.1053/j.jfas.2025.05.001","DOIUrl":"10.1053/j.jfas.2025.05.001","url":null,"abstract":"<div><div><span><span>Locomotive syndrome (LS) is characterized by a decline in locomotor function due to musculoskeletal disorders<span>. However, few studies have explored its association with ankle osteoarthritis (AOA) or surgical impact. This study evaluated LS and its improvement following </span></span>corrective osteotomy<span> (CO) or arthrodesis for AOA and compared outcomes between procedures. LS stages, ranging from 0 (healthy) to 3 (most declined), were assessed preoperatively and at 12 months postoperatively using the stand-up test (ability to rise from different heights), two-step test (maximum stride length over two strides), and GLFS-25 (self-reported locomotor function). Pre- and postoperative comparisons and group differences were analyzed, with </span></span><em>p</em> &lt; 0.05 considered significant. Forty patients were included. All patients had a preoperative LS stage 1 to 3, with a prevalence of LS stage 3 of 57.5 %. At 12 months after surgery, the prevalence of LS stage 1 to 3 was 95.0 %, but the prevalence of LS stage 3 decreased to 30.0 %. At least one LS stage improved postoperatively in 19 patients (47.5 %). There was no significant difference between pre- and post-operative stand-up test results (<em>p</em> = 0.74), but the two-step test and GLFS-25 improved significantly postoperatively (two step: <em>p</em> = 0.01, GLFS-25: <em>p</em> &lt; 0.001). The GLFS-25 improved significantly postoperatively in both groups (corrective osteotomy: <em>p</em> = 0.001, Arthrodesis: <em>p</em> = 0.01); however, the two-step test improved significantly postoperatively only in the corrective osteotomy group (corrective osteotomy: <em>p</em> = 0.02, Arthrodesis: <em>p</em> = 0.44). In conclusion, ankle osteoarthritis may be a factor affecting LS, and corrective osteotomy tended to be more effective in improving the two-step test.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 638-643"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative rehabilitation practices and procedures following ankle arthroscopy in France","authors":"Jean-Charles Giunta MD ,&nbsp;Mo Saffarini MEng, MBA, FRSM ,&nbsp;Floris van Rooij MSc ,&nbsp;Ankitha Kumble BSc ,&nbsp;Philippe Beaudet MD","doi":"10.1053/j.jfas.2025.04.002","DOIUrl":"10.1053/j.jfas.2025.04.002","url":null,"abstract":"<div><div>The purpose was to compare the rehabilitation practices and procedures following arthroscopic ankle lateral ligament<span> repair (ALLR) (reconstruction/Broström repair) among high-volume and low-volume surgeons in France. The hypothesis was that there would be no differences in practices and procedures between high-volume and low-volume surgeons. In 2023, an online questionnaire was emailed to members of the francophone arthroscopy<span> society (SFA). Fifty-two surgeons responded, of which 10 (19.2%) were excluded as they did not perform arthroscopic ALLR. The questionnaire focused on four main topics: (i) surgeon experience and technique, (ii) immobilisation, (iii) weight-bearing, and (iv) cryotherapy<span>. Surgeons were divided into high- (≥35 cases/year) and low-volume (&lt;35 cases/year) surgeons, according to the number of ankle arthroscopies performed. A greater proportion of high-volume surgeons prescribe less restrictive immobilisation compared to low-volume surgeons (46% vs 22%). A smaller proportion of high-volume surgeons restrict immediate weight-bearing compared to low-volume surgeons (8% vs 33%). A greater proportion of high-volume surgeons would prescribe crutches only if patients request them, compared to low-volume surgeons (79% vs 50%). A greater proportion of high-volume surgeons prescribe cryotherapy compared to low-volume surgeons, more frequently (87% vs 78%) and immediately following surgery (46% vs 22%). This survey revealed that high-volume surgeons prescribe less restrictive immobilisation and allow earlier weight-bearing following arthroscopic ALLR, compared to low-volume surgeons. The clinical relevance is that low-volume surgeons should gain greater confidence in prescribing less restrictive immobilisation and immediate weight-bearing, based on experience of high-volume peers, which could help improve outcomes of arthroscopic ALLR and reduce healthcare and economic burdens.</span></span></span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 588-591"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the role of fluoroscopy in calcaneal pin placement","authors":"Fatih Barça MD,&nbsp;Ekin Barış Demir MD,&nbsp;Mustafa Fatih Sarı MD,&nbsp;Mutlu Akdoğan MD,&nbsp;Yalım Ateş MD,&nbsp;Halis Atıl Atilla MD","doi":"10.1053/j.jfas.2025.03.017","DOIUrl":"10.1053/j.jfas.2025.03.017","url":null,"abstract":"<div><div><span>Although fluoroscopy-assisted calcaneal pin placement for ankle-spanning external fixation<span><span><span> or skeletal traction was advocated in the literature, evidence for necessity of </span>fluoroscopy<span> for this application is lacking. This study aimed to compare the calcaneal pin locations and complications of patients who underwent pin placement with and without fluoroscopy guidance. In this retrospective cohort study, adult patients that underwent external fixation for </span></span>ankle fractures<span><span> between October 2022 and May 2024 were included. The primary outcome was the rate of the pins that were inside the safe zone. Secondary outcomes were the distance of pins to the tip of medial malleolus and the posteriormost point of </span>calcaneus<span> and complications such as neurovascular deficit and calcaneal fracture. Eighty-two patients (mean age 47±16.4 - min. 18 - max. 89, 54.9 % male) were involved in the study. Forty-five patients (group 1) had their pins placed without fluoroscopy assistance and thirty-seven patients (group 2) with fluoroscopy assistance. Five patients (11.1 %) in group 1 and seven patients (18.9 %) in group 2 had their pins placed outside the safe zone (</span></span></span></span><em>P =</em> 0.320). Distance of the hole from medial malleolus was mean 38.8 ± 7.9 mm for group 1 and 51.3 ± 8.32 mm for group 2 (<em>P</em> &lt; 0.001), and distance from posteriormost point of calcaneus was mean 25.2 ± 6.3 mm for group 1 and 21.4 ± 7.9 mm for group 2 (<em>P</em> = 0.019). No neurovascular complications or calcaneal fracture were seen during follow-up. In conclusion, fluoroscopy guidance does not provide any additional benefit for placing calcaneal pins.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 570-573"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}