A Kocialkowski

University of Nottingham, Nottingham, ENG, United Kingdom

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Publications (12)30.7 Total impact

  • A Kocialkowski, J K Webb
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    ABSTRACT: Survival analysis of 70 patients with metastatic extradural tumours of the spine is presented. The indication for surgery was rapidly progressive cord compression as a initial manifestation of a malignant disease in 28 cases (40%), a preoperatively known malignant tumour in 28 patients (40%), relapse of cord compression after previous successful radiotherapy in 10 cases (14%), instability in 3 patients (4%) and uncontrolled pain in 1 patient. In 53 procedures (76%) the level of compression was in the thoracic spine, in 9 procedures in the cervical spine (13%) and in 8 procedures in the lumbar spine (11%). All patients had developed a neural deficit before surgery. Fourteen patients (20%) were able to walk prior to surgery, 47 (67%) were paraparetic, and 9 (13%) were paraplegic. Eleven patients died in the first 2 weeks following surgery and out of 59 patients who survived, 39 patients (66%) were able to walk, 11 were paraparetic (19%), and 9 were still paraplegic (15%). Bowel and bladder dysfunction was present in 37 cases (53%) before surgery and in 16 cases (27%) after surgery. Normal sphincter control was regained after 43 (73%) procedures. Persistent back pain was present in 60 patients (86%) before surgery and in 13 patients (22%) after surgery. The mean survival time for all 70 patients was 45.6 weeks. There were 11 early deaths (16%), another 51 patients died from disseminated disease (88%), and 8 patients are still alive (11%) with a mean survival of 133 weeks. A statistically significantly shorter survival was found in patients with lung metastases when compared with the survival of patients with breast metastases and the overall survival of patients with other metastatic tumours.
    European Spine Journal 06/1992; 1(1):43-8. · 2.47 Impact Factor
  • W A Wallace, A Kocialkowski
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    ABSTRACT: Three cases of malignant tumors involving the scapula were treated primarily with a radical subtotal scapulectomy. Humeral head stabilization was achieved by fusion of the preserved neck of both the scapula and the glenoid to the chest wall, with good functional and cosmetic results.
    Journal of Shoulder and Elbow Surgery 05/1992; 1(3):167-72. · 2.32 Impact Factor
  • A Kocialkowski, S P Frostick, W A Wallace
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    ABSTRACT: A 28-year-old woman with fascioscapulohumeral muscular dystrophy was treated with a one-stage bilateral scapulothoracic fusion. At operation, cortical allografts with screw fixation for anchorage were used, supplemented with autologous cancellous bone. A proper balance and symmetry of the shoulder girdle can be restored more easily when fusion is performed bilaterally at the same time.
    Clinical Orthopaedics and Related Research 01/1992; · 2.79 Impact Factor
  • A Kocialkowski, P H Ramberg, W Angus Wallace
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    ABSTRACT: Four cases of a localized metastatic renal cell carcinoma within the proximal humerus are reviewed. In three of these cases radiation therapy resulted in relief of bone pain but did not control progression of the secondary tumor. In one case palliative radiation treatment combined with intramedullary nailing resulted in the total destruction of the whole humerus by secondary tumor during the 10-month period before the patient died. In the other three cases aggressive surgical treatment was performed. This treatment consisted of an en bloc resection of the proximal humerus, with reconstruction of the proximal humerus with a long-stem Neer humeral head replacement prosthesis. To obtain a good functional result, the soft tissues were reconstructed onto on intercalary allograft in one case; artificial rotator cuffs were used in two cases. After a mean follow-up period of 20 months, all three patients who underwent aggressive treatment hod painless shoulders, with fair function and no recurrence of carcinoma. En bloc resection with reconstruction of the proximal humerus is on effective method of avoiding limb oblation and contrailing painful solitary lesions from metastatic renal cell carcinoma.
    Journal of Shoulder and Elbow Surgery 01/1992; 1(1):56-62. · 2.32 Impact Factor
  • A Kocialkowski, W A Wallace, L Harvey
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    ABSTRACT: The proximal humerus of a 21-year-old man was reconstructed with a frozen allograft combined with a Neer shoulder prosthesis. At graft retrieval one year later, the proximal end of the allograft had revascularized with some osteogenic activity, but distally neither vascular ingrowth nor osteogenic activity was seen. Allografts should not be used unsupported because of their potential weakness with time. Intramedullary stems should be used to support functional allografts which primarily facilitate soft-tissue reattachment.
    Clinical Orthopaedics and Related Research 12/1991; · 2.79 Impact Factor
  • ANDRZEJ KOCIALKOWSKI, SIMON P. FROSTICK, W. ANGUS WALLACE
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    ABSTRACT: A 2 8-year-old woman with fascioscapulohumeral muscular dystrophy was treated with a one-stage bilateral scapulothoracic fusion. At operation, cortical allografts with screw fixation for anchorage were used, supplemented with autologous cancellous bone. A proper balance and symmetry of the shoulder girdle can be restored more easily when fusion is performed bilaterally at the same time. (C) Lippincott-Raven Publishers.
    Clinical Orthopaedics and Related Research 11/1991; 273. · 2.79 Impact Factor
  • A Kocialkowski, W A Wallace
    Injury 02/1991; 22(1):63-5. · 2.46 Impact Factor
  • Source
    A Kocialkowski, W A Wallace
    Journal of Bone and Joint Surgery - British Volume 02/1991; 73(1):180-1. · 2.69 Impact Factor
  • A Kocialkowski, W A Wallace
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    ABSTRACT: We report a series of 22 displaced fractures of the proximal humerus treated by percutaneous Kirschner wire stabilization. Poor results (69 per cent) in the older age group of patients is a reflection of the severity of the fracture and the difficulties of closed reduction. Reduction in a poor position in this series has led to a poor range of movement. Good functional results can only be expected with a good reduction. Experience of migration with smooth K-wires has resulted in a strong recommendation for the use of threaded pins.
    Injury 08/1990; 21(4):209-12. · 2.46 Impact Factor
  • A Kocialkowski, W A Wallace, H G Prince
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    ABSTRACT: This prospective study was carried out to determine the efficacy, benefits and safety of an artificial bone grafting material. The material used was a mixture of porous calcium phosphate ceramic with the addition of bovine fibrillar collagen and autogenous bone marrow. This mixture has been used successfully as a bone graft in 11 patients with delayed and non-union of long bones.
    Injury 06/1990; 21(3):142-4. · 2.46 Impact Factor
  • A Kocialkowski, C L Colton, R H Gregson
    Injury 06/1990; 21(3):189-90. · 2.46 Impact Factor
  • Source
    A Kocialkowski, W A Wallace
    Journal of Bone and Joint Surgery - British Volume 06/1990; 72(3):520. · 2.69 Impact Factor