Chirurgia narzadow ruchu i ortopedia polska

Publisher: Polskie Towarzystwo Ortopedyczne; Polskie Towarzystwo Ortopedyczne i Traumatologiczne

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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: 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: 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: Outcomes assessment of distal radius fractures treatment includes objective parameters (range of motion, grip strength) and subjective measures e.g. pain level and hand function during daily-activities. Subjective questionnaires are used for evaluation, which allows assessing patients' perspective determinants. The important factor in the evaluation of distal radius fracture treatment is health related quality of life. The quality of life assessment questionnaires and studies on results of fracture treatment were shown based on presented literature. Both included the quality of life measuring elements. For the overall fractures treatment assessment, the importance of this factor has been highlighted.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:183-6.
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    ABSTRACT: Background This publication compares the results of physiotherapy after total hip replacement in two groups, each consisting of 50 subjects, differing in age by 10 years Material and Methods A group of 100 patients after total hip replacement was divided into two subgroups consisting of 50 subjects each, with mean age difference of 10 years. The first group included patients aged 47-60 years, the other 61-69 years. Patients were assessed at 6 weeks and reevaluated at 10 weeks after surgery during a 4-week in-hospital rehabilitation program. The study was based on a questionnaire, physical examination, 6-minute walking test and a test on stabilometric platform. Results In the younger group we observed easier and faster resolution of pain in the operated joint. In group II, which included patients aged 61 to 69 years, improvement in hip joint mobility was less pronounced than in the younger group. Six-minute walking test showed less improvement in walking distance in group II than group I. Among group II patients we noted less pronounced increase in weight bearing on the operated limb (by 2%, while 4% improvement was noted in group I), while final degree of weight-bearing was greater in group II than in group I and amounted to 48%. Conclusions Younger patients recover faster, hip pain subsides easier, hip function returns more readily and to a greater extent. During a 4-week course of in-hospital rehabilitation older patients may regain hip function in a manner that brings them closer to the younger group.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:109-13.
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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: Background: Calcaneal fracture is a most common bony injury of the hindfoot. In constitutes 60% of foot fractures and 1-2% of all fractures. According to current literature 75% of these fractures involve articular surfaces, which makes them especially difficult to treat. Intraarticular fractures often result in permanent disability impairing foot function and ambulation, sometimes due to inadequate treatment method. According to literature, in developed countries open reduction and internal plate fixation is standard treatment of intraarticular calcaneal fractures. This treatment poses a risk of impaired wound healing and is appropriate for selected group of patients without additional risk factors. Other patients are treated with minimally invasive methods. Proponents of minimally invasive techniques apply distraction, which makes most intraarticular calcaneal fractures amenable to this method. Case Report: This paper presents a minimally invasive treatment technique for intraarticular (depression type according to Essex-Lopresti, IIA accordind to Sanders) calcaneal fracture in 63-years old man. External fixator (Monotube) is used for intraoperative distraction. Posterior facet is reduced with additional maneuvers. Results: With this technique we were able to reduce posterior faced, correct varus alignment and restore Böhler's angle. With restoration of shape of calcaneal bone optimal functional result can be expected. At six moths follow-up very good result was observed.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:193-9.
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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: Current state of knowledge in a matter of septic complications after procedures with orthopaedic device implantation with particular consideration of THA and TKA is presented in the paper. Implant biocompatibility phenomenon as well as systemic reaction to its presence is also discussed. Algorithm for prophylactics of septic complications followed in Orthopaedic Department of PMEC in Otwock is introduced. Article is based on clinical observations of Orthopaedic Department's PMEC team.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:207-11.
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    ABSTRACT: Background Ceramic-on-ceramic articulation presents advancement in the development modern of hip prostheses. It is particularly important for young patients, in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning. The aim of this study was to assess the effect of total cementless hip replacement using an implant with a ceramic insert embedded in a metal cup and large prosthetic head constituting a ceramic-on-ceramic system in patients with hip osteoarthritis. Material and Methods During years 2012-2013 there were 26 total hip replacements in 24 patients with use of integrated ceramic cup at Department of Orthopedic and Traumatology of the Central Clinical Hospital of Ministry of Interior, Warsaw. We assessed clinical and radiological outcomes of this procedure using HHS (Harris Hip Score), WOMAC (The Western Ontario and McMaster Universities Arthritis Index) and NRS (Numeric Rating Scale) scores. Results : In our study group patients presented with a significant degree of improvement in passive range of motion in the hip joint and no postoperative complications were noted. Significant statistical improvement was noted after surgery in each of the following scales HHS (50.84 vs. 87.16), WOMAC (51.01 vs. 91.88) and NRS (6.8 vs. 0.45). There were no signs of early or radiological evidence of loosening and implant migration among our patients. Conclusions Cementless total hip arthroplasty using an acetabular component with a ceramic insert embedded in metal and a large prosthetic head (a ceramic-on-ceramic system) is an effective and a noteworthy method of treatment of hip osteoarthritis in young people.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:259-64.
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    ABSTRACT: Background Knee infection after anterior cruciate ligament reconstruction is a very serious complication. The aim of the paper is to present our experience relating diagnosis and management of this complication with concomitant graft salvage. Material and Methods The study included 5 patients diagnosed with acute knee infection after anterior cruciate ligament arthroscopic reconstruction with hamstring with Rigid Fix graft fixation system. The treatment involved intravenous and oral antibiotic therapy combined with arthroscopic debridement and through drainage insertion. All patients were males with a mean age of 29 years. Evaluation was performed in reference to clinical symptoms of infection, laboratory tests results and effectiveness of the applied management. Mean observation period was 9.1 years (range from 7.2 to 10.5 years). Results Management that we undertook led to successful infection treatment with concomitant graft retention without the necessity to inspect the fixation site. There was no recurrence of infection during the 9.1 years of observation. Conclusions 1. Plain monitoring of patient body temperature in the morning and in the afternoon at fixed times with the elimination of the effect of anti-inflammatory drugs on the temperature values enables early detection of acute knee infection after ACL reconstruction and rapid implementation of appropriate management. 2. Targeted antibiotic therapy combined with arthroscopic debridement and through drainage is an effective means of treatment of acute knee infection after anterior cruciate ligament arthroscopic reconstruction with hamstring without sacrificing the graft. 3. The conducted studies indicate that the primary source of infection is the knee joint and, consequently, there is no need to inspect graft fixation sites as long as the clinical symptoms from these sites do not cause suspicions of infection.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:235-238.
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    ABSTRACT: The incidence of carpal tunnel syndrome in pregnant women reported in the literature varies from 2 to 70%. Hormonal fluctuations, fluid accumulation with tendency to oedemas, nerve hypersensitivity and glucose level fluctuations are factors that predispose pregnant women to the development of symptoms. The syndrome is rarely a matter of concern, as the symptoms are mild and no treatment is needed in majority of patients. The diagnosis is basically clinical and electrodiagnostic or sonographic testing provides no meaningful diagnostic aid. If necessary, the treatment starts with wrist splinting in the night, followed by steroid injection in the carpal tunnel. Most women experience symptomatic improvement following delivery or breastfeeding; however, some women may continue to experience symptoms for up to 3 years.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:223-227.
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    ABSTRACT: Background: To compare the diagnostic accuracy of clinical examination and MRI in evaluation of meniscal and ACL injuries using arthroscopic findings as reference standard. Material/Methods: A total of 51 patients with traumatic knee injuries were identified and prospectively followed up with clinical examination, MRI and arthroscopy. Clinical examination and MRI findings were compared with arthroscopic findings. Sensitivity, specificity, PPV, NPV and diagnostic accuracy were calculated with statistical analysis. Results: Out of 24 patients with arthroscopic evidence of medial meniscal injury, clinical examination and MRI correctly identified 20 and 18 patients, respectively. Clinical examination was characterized by better sensitivity and specificity with regard to diagnosis of medial meniscal tear. On arthroscopy, lateral meniscal tear was present in 13 patients; clinical examination and MRI both identified 8 of them correctly. Similarly, out of 9 patients with arthroscopic evidence of ACL tear, clinical examination and MRI correctly identified 7 and 8 patients, respectively. There were only marginal differences in sensitivity and specificity of clinical examination and MRI in diagnosis of lateral meniscal and ACL injury. Conclusions: Careful clinical examination is much better than MRI with regard to the diagnosis of medial meniscus injury and is as reliable as MRI with regard to diagnosis of lateral meniscus injury and ACL tears. MRI should be used to rule out such injuries rather than to diagnose them.
    Chirurgia narzadow ruchu i ortopedia polska 01/2013; 78:59-63.