Ortopedia, traumatologia, rehabilitacja最新文献

{"title":"Transiliac Cerclage in Unstable Pelvic Ring Fractures.","authors":"Edgardo S Sanzana,&nbsp;Alvaro C Ojeda,&nbsp;Francisco Gonzalez-Rojas,&nbsp;Gemma Lopez-Carcel,&nbsp;Patricio A Alfaro,&nbsp;Humberto Melo-Aiello","doi":"10.5604/01.3001.0015.9052","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9052","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the outcomes of transiliac cerclage with Dall-Miles cable in the internal fixation of the posterior complex in unstable pelvic ring fractures between January 1995 and December 2014.</p><p><strong>Material and methods: </strong>A study of 42 men injured at work with an average age of 35.2 years (range, 23 to 61) was conducted. The mechanisms of injury were traffic accidents in 25 cases (59.5%), crushing accidents in 12 cases (28.6%), and fall from height in 5 cases (11.9%). Thirty-six cases were polytraumatized patients (85.7%). The patients were evaluated using Majeeds functional score and Mattas radiological criteria.</p><p><strong>Results: </strong>The average follow-up time was 135.8 45.6 months. The clinical outcomes were excellent in 17 cases (40.5%), good in 19 cases (45.2%), fair in 5 cases (11.9%), and poor in 1 case (2.4%). The radiological outcomes were satisfactory in 32 cases (76.2%) and unsatisfactory in 10 cases (23.8%). All fractures were healed. The sequelae were 3 cases (7.2%) of lower limb dysmetria and 3 cases (7.2%) of chronic neuropathic pain.</p><p><strong>Conclusion: </strong>The internal fixation of the sacroiliac complex by Dall-Miles cable cerclage reinforced with small fragment plates should be considered as an alternative method for minimally invasive osteosynthesis in selected cases of unstable pelvic ring fractures.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"24 3","pages":"143-148"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9081288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Work of Janina Sikorska-Tomaszewska, Associate Professor of Medical Sciences, Towards the Development of Rehabilitation in Poland in the Years 1948-1978.","authors":"Sławomir Jandziś,&nbsp;Mariusz Migała","doi":"10.5604/01.3001.0015.9115","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9115","url":null,"abstract":"<p><p>Based on an analysis of archival materials from the private collections of Janina Sikorska-Tomaszewskas family, the Document Repository of Wiktor Dega Memorial Orthopedics and Rehabilitation Hospital in Pozna, articles from daily press and some publications, the authors present the work of Janina Sikorska-Tomaszewska (19111998), Associate Professor of Medical Sciences, towards the development of rehabilitation in Poland in the years 19481978. Her organizational, educational and scientific activity in the early years of the development of rehabilitation medicine in our country contributed significantly to the establishment of the Polish school of rehabilitation. The 30 years of her activity allow Janina Sikorska-Tomaszewska to be counted among the pantheon of founders of rehabilitation in Poland.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"24 3","pages":"209-217"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9081287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Assessment of Factors That Influence Outcome Following Fixation of Periprosthetic Distal Femur Fractures Associated with Total Knee Arthroplasty.","authors":"Keji Fakoya,&nbsp;Ramy Sedarous,&nbsp;Mina Seifo,&nbsp;Tosan Okoro","doi":"10.5604/01.3001.0015.9058","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9058","url":null,"abstract":"<p><strong>Background: </strong>Periprosthetic distal femur fractures following total knee arthroplasty (PDFFTKA) are increasingly common [1], mainly in elderly patients with significant co-morbidities [2]. Surgical management usually requires balancing prompt fixation for early mobilization with the need to consider the least physiologically demanding option [3].The aim of this study was to assess predictors of clinical and radiological outcome in patients with PDFFTKA treated with open reduction and internal fixation (ORIF).</p><p><strong>Materials and methods: </strong>A retrospective cohort study of patients managed for PDFFTKA over the last 21 years in the Trauma &amp; Orthopaedics Department of the Royal Shrewsbury Hospital (RSH) was carried out. Radiological images, pre- and post-operatively, were assessed for fracture related parameters. Last known functional status was evaluated using the most recent outpatient review letters. After assessment of normality of data, evaluation of predictors of clinical and radiological outcome was made using correlation analyses.</p><p><strong>Results: </strong>There was no statistically significant correlation between age, primary TKA to fracture interval, and length of intact medial cortex vs clinical outcome for the parametric variables evaluated. For non-parametric variables assessed, there was a statistically significant correlation between clinical outcome and evidence of callus formation (Spearman rho value -0.476; p=0.022). In stratifying the patients with poor and good outcome, there was no difference noted in primary TKA to fracture interval, or length of intact medial cortex (mm) between both groups. In terms of the number of comminuted fragments and anterior flange to fracture distance (mm), there was also no difference noted between the poor and good functional groups.</p><p><strong>Conclusions: </strong>1. There was no observed correlation in pre-operative patient and fracture related variables with outcome in this population of patients with PDFFTKA. 2. Post-operative evidence of callus formation appears to be directly related to better clinical outcomes.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"24 3","pages":"193-199"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9081289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Pelvic Asymmetry on Trunk Symmetry Among Children.","authors":"Blanka Jędra,&nbsp;Jerzy Kiwerski,&nbsp;Anna Sikorska,&nbsp;Izabela Korabiewska","doi":"10.5604/01.3001.0015.9056","DOIUrl":"https://doi.org/10.5604/01.3001.0015.9056","url":null,"abstract":"<p><strong>Background: </strong>Pelvic asymmetry and accompanying postural defects tend to become more common with age. The school period, which is associated with spending more time in a sitting position and daily activities performed with the dominant limb, may contribute to this.</p><p><strong>Material and methods: </strong>We examined 22 children (12 girls, 10 boys) aged 7 years. The same group was re-examined two years later. Pelvic asymmetry was identified by assessing the position of the iliac spines. The indicator of trunk asymmetry was the trunk rotation angle (TRA) measured with a Bunnel scoliometer within the spinous processes on the upper thoracic vertebra, apex of thoracic kyphosis, thoracolumbar junction, lumbar spine, and (if present in patients) the greatest deformity (rib hump, hump in the lumbar region).</p><p><strong>Results: </strong>Pelvic asymmetry was detected in 14 children at the age of 7 years compared to 16 in the same group of patients aged 9 years. During these two years, the prevalence of trunk asymmetry in children with an oblique/rotated pelvis had increased. The progression of trunk asymmetry with an oblique position of the pelvis was most marked in the lumbar region. In children with symmetrical pelvis, the most marked increase in TRA was recorded in the thoracic segment.</p><p><strong>Conclusions: </strong>1. The development of pelvic girdle asymmetry is influenced by the increasing number of asymmetrically performed movements and asymmetric body positions assumed, which increase in number with age. 2. The most marked increase in asymmetry of the spine in subjects with an oblique/rotated pelvis was seen in the lumbar spine, which proves an association of the former with tilting of the pelvic girdle. 3. Asymmetry is a dynamic process. When ignored, this postural defect progresses significantly and there may be compensatory changes in neighbouring systems.</p>","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"24 3","pages":"181-191"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9450622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Single-Blind Randomized Controlled Trial Investigating Changes in Electrical Muscle Activity, Pain, and Function after Shockwave Therapy in Chronic Non-Specific Low Back Pain: Pilot Study.","authors":"M. ElGendy, Mai H Mohamed, Hisham Barakat Hussein","doi":"10.5604/01.3001.0015.8266","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8266","url":null,"abstract":"BACKGROUND\u0000To investigate the effect of adding r-ESWT to a standard exercise program of chronic non-specific LBP on electrical muscle activity (EMG), pain and function.\u0000\u0000\u0000MATERIALS AND METHODS\u0000Our single-blind randomized controlled trial enrolled 30 patients with chronic non-specific LBP randomly allocated to an r-ESWT (n=15) group and a control group (n=15). All patients received a standard exercise program, while r-ESWT was additionally administered in the r-ESWT group. EMG activity, pain and function were assessed before and after 6 weeks of treatment.\u0000\u0000\u0000RESULTS\u0000After treatment, all outcome measures were significantly different (p < 0.05). The addition of r-ESWT produced a significant increase in EMG activity (of all muscles tested) and a reduction in pain intensity and functional disability scores (p < 0.05) compared to the control group.\u0000\u0000\u0000CONCLUSIONS\u00001. A standard intervention offered either alone or with r-ESWT increased EMG activities, reduced pain, and enhanced function in patients with chronic non-specific LBP. 2. Adding r-ESWT to the standard intervention program might produce better results.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"47 1","pages":"87-94"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90419060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Patients with Acromioclavicular Joint Separation Treated Using the Clavicular Hook Plate.","authors":"M. Turgut, H. S. semis, Kamil Yamak, Fener Çelebi","doi":"10.5604/01.3001.0015.8264","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8264","url":null,"abstract":"BACKGROUND\u0000This study aimed to evaluate the outcomes of patients who underwent surgical treatment using the clavicular hook plate for diagnosed Rockwood Type 3 - Type 4 - Type 5 acromioclavicular joint separation.\u0000\u0000\u0000MATERIAL AND METHODS\u0000Patients who were operated with the diagnosis of acute traumatic acromioclavicular joint separation between the years 2017-2021 were evaluated retrospectively. Patients' age, gender, mechanism of injury, time to surgery, follow-up duration, and complications were evaluated. Functional results were evalu-ated using pre-op and post-op VAS and the Constant-Murley Shoulder Score.\u0000\u0000\u0000RESULTS\u0000A total of thirty patients admitted with the diagnosis of acromioclavicular joint separation were included. All patients underwent surgical treatment using the clavicular hook plate. Twenty (66.6%) patients were male and 10 (33.6%) were female. Seventeen of the patients were admitted due to sports injuries, 6 due to traffic accidents, and 7 due to workplace accidents. The patients were followed up for an average of 26.1 weeks. The Rockwood Classification was used for classification of injuries. Accordingly, 12, 13, and 5 of the patients had Type 3, Type 4, and Type 5 injury, respectively. While the mean pre-op VAS score was 7.4 (5-9), it was 1.8 (1-4) in the post-op period. The mean pre-op Constant-Murley score was 31.5 (22-42), compared to 85.1 (72-100) in the post-op period. The differences between the pre-op and post-op VAS and Constant-Murley Shoulder Scores were statistically significant.\u0000\u0000\u0000CONCLUSION\u0000In this study, we achieved good functional results in the treatment of acromioclavicular joint separation by using a clavicular hook plate providing stable fixation and allowing early mobilization.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"23 1","pages":"73-78"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89827022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixing a Subtrochanteric Femoral Fracture with a Humerus Nail.","authors":"J. Peters, H. Köhler, A. Gutcke, C. Schulze","doi":"10.5604/01.3001.0015.8375","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8375","url":null,"abstract":"A 17-year-old paraplegic patient sustained a subtrochanteric femoral fracture due to inadequate trauma. The unusual anatomical conditions associated with his congenital paraplegia did not allow treatment with a standard intramedullary implant for the femur. Because his soft tissues were already compromised, alternative options like plate osteosynthesis were considered unfavourable as a salvage procedure. Therefore, we used an implant designed for the humerus. A satisfactory result of osteosynthesis was achieved despite varus deformity, shortening and rotational error.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"3 1","pages":"133-137"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81491658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Monteggia Fracture Outcome Assessment - Preliminary Report.","authors":"Marcin Maszke, Piotr Buchcic, M. Marciniak, Radosław Lebiedziński, Łukasz Lipiński, A. Grzegorzewski","doi":"10.5604/01.3001.0015.8265","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8265","url":null,"abstract":"BACKGROUND\u0000The term Monteggia fracture refers to a class of injuries encompassing the fracture of the proximal end of the ulna with subluxation or dislocation of the radial head. These injuries account for 0.4-1% of all forearm fractures in children. Despite its low incidence, Monteggia fractures require particular attention, since as much as 30-50% of the cases may be unrecognized, which subsequently leads to complications. The purpose of this paper is to evaluate treatment outcomes of Monteggia fractures in children. Both conservative treatment and surgery were analyzed.\u0000\u0000\u0000MATERIAL AND METHODS\u000015 children (7 boys and 8 girls) between the ages of 4-16.3 years (mean age 8.3 years) with Monteggia fractures were hospitalized at our center in the years 2015-2020. Closed reduction and immobilization in a cast were performed in 12 patients, while three children underwent surgical treatment with internal fixation of the ulna. The radial head dislocation was reduced successfully in every patient.\u0000\u0000\u0000RESULTS\u0000Every child from the study group who received conservative treatment regained full elbow mobility as well as normal forearm supination and pronation. Only one of the patients who underwent the surgery demonstrated a 20° deficit in elbow flexion that did not affect limb function.\u0000\u0000\u0000CONCLUSIONS\u00001. Our experience shows that closed reduction together with immobilization in a cast is usually a sufficient treatment in Monteggia fractures. 2. However, the dislocated radial head should be properly reduced in all patients. 3. Correct diagnosis and treatment followed by appropriate rehabilitation result in full recovery and no mobility limitations in children and teenagers.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"9 1","pages":"79-86"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79117602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Dynamization of Trochanteric Fracture Osteosynthesis on Bone Union.","authors":"Wojciech Koniec, W. Marczynski","doi":"10.5604/01.3001.0015.8267","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8267","url":null,"abstract":"BACKGROUND\u0000Ineffectively treated trochanteric fractures lead to disability and thus constitute a significant social problem. The aim of the study was to analyze the effect of dynamization of the fixation of trochanteric fractures on bone union.\u0000\u0000\u0000MATERIAL AND METHODS\u0000We conducted a retrospective study involving 149 patients operated on for trochan-teric fractures in 2015-2017. The fractures were anastomosed with a DHS extramedullary device or a Gamma 3 intramedullary nail.\u0000\u0000\u0000RESULTS\u0000Bone union was achieved at an average of 11 weeks after the surgery (8-20 weeks). In the extra-me-dullary stabilization (DHS) group, union was achieved after 12 weeks (8 to 16 weeks) (N = 47). In in-tramedullary stabilization, union was achieved after 10 weeks (8 to 20 weeks) (N = 96). The intramedullary nails were locked statically or dynamically. The time to union in static stabilization was 12.3 weeks (8 to 20 weeks) (N = 31), while in dynamic stabilization it was 9.4 weeks (8 to 16 weeks) (N = 64).\u0000\u0000\u0000CONCLUSIONS\u00001. This study revealed a measurable biologically beneficial effect of dynamization of the fixation of trochanteric fractures on the time of bone union. 2. Conventional radiographs and CT imaging according to indications significantly facilitate the classification of fractures and selection of the method of stabilization with dynamization. 3. Due to the considerable comminution of the trochanteric massif, double dynamization (cervical-trochanteric and femoral-trochanteric) of fracture fragments is essential, ensuring reduction of fracture gaps and self-reduction of inter-fracture resorptive gaps, which is a prerequisite for optimal union. 4. Allowing early, full weight-bearing of the operated limb within the painless range is an important element of effective dynamization.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"46 1","pages":"95-106"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79677461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the Relationship Between Regulation Disorders of Sensory Processing (RDSP) and the Development of the Gait Function and Motor Learning Processes in Children and Adolescents with Cerebral Palsy.","authors":"Bartosz Bagrowski, Joanna Krasny, M. Jóźwiak","doi":"10.5604/01.3001.0015.8268","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8268","url":null,"abstract":"1. These results correlate with the outcomes of other studies on the relationship between sensory impairment and motor skills. 2. The study may contribute to the identification of more predictors of the effectiveness of rehabilitation of patients with CP, which can be used in the longer term to forecast the effects of therapy and the development of personalized medicine, as manifested in comprehensive therapeutic approaches (e.g. supplemented with sensory integration therapy).","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"28 1","pages":"107-119"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87179407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}