Chirurgia narzadow ruchu i ortopedia polska

Publisher: Polskie Towarzystwo Ortopedyczne; Polskie Towarzystwo Ortopedyczne i Traumatologiczne

Description

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  • Other titles
    Chirurgia narza̜dów ruchu i ortopedia polska, Chirurgia organum motus et orthopaedica Polonica, Acta Societatis Orthopaedicae Polonicae
  • ISSN
    0009-479X
  • OCLC
    1778072
  • Material type
    Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract We present a review of the current literature and the author's opinion regarding Septic arthritis in the pediatric age group. The etiopathogenesis, clinical features, the laboratory parameters for diagnosis and monitoring of treatment, radiological features, are discussed along-with the debatable issues pertaining to the choice of antibiotics, their duration, and the need and mode of surgical drainage and mobilization of the joint.
    Chirurgia narzadow ruchu i ortopedia polska 01/2014; 79:23-29.
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    ABSTRACT: Abstract Systemic and chronic diseases frequently affect function of many organs and systems, not only those from which they derive. The hand is a very complicated structure in the human body and its normal activity is related to undisturbed function of many factors. Therefore, the hand is frequently exposed to harmful effects of systemic diseases. The article reports on disorders and functional disturbances of the hand that, more frequently than in an average population, accompany selected systemic diseases: rheumatoid arthritis, gout, and scleroderma. Hand diseases related to diabetes are a subject of a separate paper. This study reviews typical disorders involving hand structures: joints, tendons and nerves. Their prevention and management is described.
    Chirurgia narzadow ruchu i ortopedia polska 01/2014; 79:30-6.
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    ABSTRACT: Abstract Background: Galeazzi fractures are a rare injury to occur in adults, which are typically associated with high energy trauma. To our knowledge, the reported cases in the literature have only been associated with motor vehicle accidents, falls from a height, or athletic endeavors. The application of the force in the setting of a Galeazzi fracture has been disputed, but it is believed to occur with the wrist in hyperextension and pronation. Case Report: We describe a 27-year-old male who presented with multiple gunshot wounds that included his right forearm. The injury sustained to his right forearm resulted in a Galeazzi fracture, which after open reduction and internal fixation, demonstrated subluxation of the distal radioulnar joint in pronation. Conclusions: We provide a novel mechanism of a Galeazzi fracture that demonstrates a method for sustaining the fracture pattern without the wrist in the typical position of hyperextension and pronation.
    Chirurgia narzadow ruchu i ortopedia polska 01/2014; 79:5-9.
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    ABSTRACT: Background We present a case series of 3 patients who underwent a novel technique of tight rope fixation for Neer type II distal clavicle fracture. Material and Methods 2-3 cm incision was made lateral to the fracture site moving inferomedially. Part of the distal end of clavicle was exposed close to fracture site and further dissection was carried out to reveal the coracoid process. Tight rope fixation of the distal ends of clavicle and coracoid was performed to achieve satisfactory fracture reduction on x-ray. Results 4 weeks of sling with gentle pendulum movement were followed by active shoulder movement exercises. Radiographic union was reached at 6 weeks' time, while the patients achieved proper shoulder functionality 3 months following the operation. Conclusions Neer type II distal clavicle fractures are characterized by disruption of the coracoclavicular ligament with wide proximal fragment displacement. Overall, type II distal clavicle fractures have a 20-30% nonunion rate if treated non-surgically. Various techniques have been described for the treatment of these fractures, including hook plate and nailing. Tight rope fixation provides proper apposition of the fracture fragments for union by maintaining a reduced coracoclavicular interval.
    Chirurgia narzadow ruchu i ortopedia polska 01/2014; 79:19-22.
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    ABSTRACT: In many countries, including Poland, carpal tunnel syndrome is considered to be a disease of possible occupational etiology. This review presents information about work-related risk-factors which comprise the use of handheld vibrating machinery, forceful gripping of objects with hands, repetitive and frequent manual tasks and forced postures of the wrist (flexion/extension). However, the character of the job is only one of possible several factors leading to the development of the disease, as its etiology is multifactorial. Conditions to be taken into consideration when recognizing a case as occupational carpal tunnel syndrome were shown to include: coexistence of predisposing diseases (diabetes), constitutional factors (obesity), character, level and duration of the exposure to harmful stimuli during the workday as well as total duration of work upon exposure. Consideration of these circumstances provides adequate ground for recognizing a particular case as occupational. Nonetheless, even accepting the disease as occupational should be temporary, as surgical carpal tunnel release is an effective method of treatment and should allow the patient to return to previously performed work.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:121-126.
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    ABSTRACT: A permanent on-call service for hand amputations (Replantation Service) was established in 2010 of the initiative of the Council of Polish Society for Surgery of the Hand. It is run by three qualified hand centres in Trzebnica, Poznań and Szczecin. Organization of this system, rules of activity and spectrum of cases admitted to replantation units was presented. A scheme of referral of amputations was shown and the main problems that appeared during almost three-year activity of the Service were discussed. Medico-legal and ethical implications arising from these problems were shown and organization of replantation service in other European countries was outlined. Establishing of the Replantation Service constituted a significant progress in the organization of the management of upper limb amputations. Thanks to that, over the period of three years, more than 200 patients were saved from severe disability, receiving a chance to regain an amputated limb.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:71-6.
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    ABSTRACT: Proprioception, or kinesthesia, is the sense of orientation responsible for perception of body and relative position of its parts. Kinaesthesia is received by receptors located in muscles and tendons. In this study a set of proprioception developing exercises was presented. Proprioception should be restored in case of musculoskeletal and neurological disorders. Proprioception training can also be used as a prophylaxis before starting various sporting activities. Proprioception developing exercises have significant meaning for the elderly, who are at risk of balance disorders. These exercises help developing motor memory and at the same time protect from falls.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:5-27.
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    ABSTRACT: Background: The assessment of the impact aerobic exercises on bone mineral density in breast cancer women during endocrine therapy (ET). Material/Methods: The study included 53 women (mean 44.3 ±SD 4.9) during breast cancer treatment. This was a nonrandomized, prospective clinical study. The following examinations of the assessment of bone in the DEXA were measured: the bone mineral density of the neck of a femur (FN), lumbar region L1-L4, and total body (TB) as well as defining of T-score and Z-score. The examinations were conducted for all the patients according to the schedule: before the beginning of ET, after 6 months of ET and after 12 months of ET (after 6 month aerobic training). Results: After the first 6 months of ET without regular physical exercise the following results were noted: the BMD mean value of FN, in the L1-L4 spine region and in TB were significant lower than the initial value. After 6 month aerobic training, in the 12th month of the follow up, the BMD mean value of FN was 1.1% (p>0.05) lower, while in the L1-L4 spine region it was 5.6% (p<0.05) lower, and in TB 2.7% (p<0.05) lower in comparison to the values in the sixth month of the observation. Conclusions: That even short course of ET is related to changes in bone mineral density. The introduction of aerobic exercises caused a slowdown in negative changes in bones.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:47-51.
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    ABSTRACT: This paper presents the technique used in anterior cruciate ligament(ACL) reconstruction using the ring finger flexor digitorum superficialis tendon (FDS IV). The biologic material used in autografts and allografts is subject of controversy. Due to this some authors suggest using synthetic materials. All the authors agree that the use of biological material harvested from the vicinity of the knee joint can cause further dysfunction of this joint(weakening) It would seem that use of a biological material harvested from another part of body would be the optimal solution for ACL reconstruction. In our opinion the ring finger flexor digitorum superficialis tendon meets this criteria. Its parameters (length, strength, shape) are comparable to currently used biological materials. From experience in hand surgery we know that the harvesting of FDS IV(loss of FDS IV function) does not cause significant loss of function in the hand. It seems that the FDS IV is very well suited for ACL reconstruction. This paper presents the technique used in ACL reconstruction using FDS IV augmented with a synthetic material.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:105-7.
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    ABSTRACT: Amputations, or the removal of limbs at different levels, have been performed since the ancient times. The first reports of amputations originate from the ancient ruins in Egypt, where primitive prosthetic toes were found in the tombs of the Pharaohs. In Europe, during the period of ancient Greece and Rome, various examples of amputations were described on amphoras and mosaics. During the middle ages, the body was marginalized and replaced by the worship of human spirituality. As a result reports of amputations from that time period are scarce. True development of amputation and prosthetic techniques took place during the Renaissance and centuries that followed. Present-day indications for amputation are similar to those utilized in the ancient times. The greatest development of limb amputation techniques and prosthetic methods began in the 20th century and continues to this day. Despite the development of new techniques in prosthetics, many solutions have their roots in designs originating in the ancient times and differ only in their structural design.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:155-166.
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    ABSTRACT: Background: Fractures in people over the age of 65, especially pertrochanteric fractures of the femur, present a growing medical problem. Surgical treatment of such fractures should be performed in the shortest possible time after the accident. Efforts were made to answer the question what contributes to the reduction in mortality after pertrochanteric fractures. Material/Methods: This work presents a comparative analysis of two populations treated surgically due to pertrochanteric fractures at the District Hospital of Orthopedic and Trauma Surgery in Piekary Slaskie during years 1988-1992 and 2005-2008. Patient mortality was used as an indicator of treatment quality. In the first group of 118 patients hospitalized in years 1988-1992, there were 48 deaths reported during 12 months after the surgery. In the second studied population of 244 patients (operated in years 2005-2008), 54 deaths were noted in the 12-month period after the surgery. There was a reduction in mortality from 40.6% to 22.3% over those 15 years. Conclusions: Introducing mortality as an indicator in the comprehensive assessment of treatment quality will intensify its monitoring in both the hospital as well as the out-of-hospital period of care. It will also reveal the individuality and social importance of geriatric fractures.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:65-9.
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    ABSTRACT: Background: The aim of the study was to compare vitamin D concentration in patients treated due to delayed bone union and non-union (pseudoarthrosis) and patients with normal fracture healing. Material/Methods: A retrospective case-control study was conducted. We enrolled 35 patients with inexplicable (standard and correct surgery, closed fracture, no comorbid metabolic diseases) fracture healing impairment, and 35 patients assigned by age and measurement season. Vitamin D (as 25OHD) concentration was measured in all patients. Results: Vitamin D deficiency was reported in 86% of examined patients. No difference was shown between groups in deficiency prevalence. Conclusions: Previous studies indicated decreased vitamin D concentration in patients with impaired fracture healing. However, these studies did not include control groups. No difference was demonstrated between patients with normal fracture healing and those with impaired bone union in terms of vitamin D deficiency prevalence.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:1-3.
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    ABSTRACT: Background Rotator cuff (RC) tear is one of the most common disorders affecting the shoulder. Acromioclavicular (AC) joint arthritis is an equally common pathology of the shoulder. The coexistence of both disorders is common, although RC tear is more frequently the cause of shoulder pain than AC joint arthritis. The purpose of this study was to compare the results of arthroscopic treatment of RC tear and simultaneous resection of symptomatic AC joint with arthritis. Material and Methods We retrospectively evaluated 40 patients who underwent arthroscopic RC repair between January 2008 and December 2009. Patients were divided into two groups. The first group consisted of 20 patients with symptomatic arthritis of AC joint, specifically painful joint palpation test and painful cross-body adduction test. The control group included 20 patients with asymptomatic degenerative changes of AC joint. The first group of patients underwent RC resection and AC joint repair; the second group had an isolated RC repair. Follow-up period lasted from 44 to 68 months, an average of 54.4 months. Results Analysis using chi-squared test for independence has shown no statistically significant difference in terms of subjects' gender or age in both groups. No significant difference in terms of pain intensity (VAS) was observed before and after surgery in either group. Significant reduction in pain intensity after surgery was observed in both groups, the AC joint resection group (p<0.001) and the without joint resection group (p<0.001). An increase in Constant's scale score was recorded in both groups after the surgery. Analysis has shown that patients who had undergone AC joint resection, had lower scores on a Constant's scale (p<0.022) before the surgery than those who were not resected. There were no statistically significant differences between the two groups after the surgery. Conclusions Supplementary resection of a painful AC joint with arthritis during RC tear repair provides good, long-term outcomes. In contrast to patients with asymptomatic AC joint arthritis, the coexistence of a torn RC and symptomatic AC joint with arthritis, can worsen shoulder function in the preoperative period.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:229-234.
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    ABSTRACT: Background The objective of the study was to perform a clinical, comparative assessment of the degree of postural deformities before and after the treatment of idiopathic scoliosis in patients treated with SpineCor brace compared to the control group. Material and Methods A group of 90 children with idiopathic scoliosis (including 74 girls) at the average age of 12.2 was subject to prospective observation. Average pre-treatment Cobb angle was 24.9° in the thoracic spine and 25.8° in the lumbar spine. The group actively treated with the SpineCor brace consisted of 45 children, while the control group consisted of the remaining 45 children with the natural course of the disease. Results Both groups did not differ significantly in terms of age, gender, height, body weight, Risser sign of skeletal maturity and baseline clinical and radiological parameters of scoliosis. Significant reduction of rib hump was observed upon 2-year SpineCor brace treatment (P=0.04) compared to the group treated by physiotherapy only (P=0.91). Similarly, improvement in lumbar prominence was observed in the actively treated group (P=0.009), with a trend towards worse results in the control group (P=0.07) In the group treated with the SpineCor brace, significant reduction in pectoral and hamstring muscle contractures as well as reduction in shoulder asymmetry and reduction in anterior and posterior vertical deviation were observed. Conclusions Treatment using the SpineCor dynamic brace leads to a clinical improvement in posture, particularly to reduction in rib hump, lumbar prominence and muscular contractures.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:85-89.
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    ABSTRACT: Distal radioulnar joint instability most commonly accompanies fractures of the distal radius and is directly caused by lesion of the triangular fibrocartilage complex, which is the major structure responsible for congruity of the distal radioulnar joint. Acute instability accompanying fractures of the distal radius usually does not require separate management, if the fracture itself is firmly fixated. Chronic instabilites causing persistent pain and wrist dysfunction are treated by arthroscopic reinsertion of the torn attachments of the triangular fibrocartilage. If not possible, radioulnar functional tenodesis is performed using palmaris longus tendon graft, thus restoring joint stability.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:77-84.