Chirurgia narzadow ruchu i ortopedia polska最新文献

{"title":"[Roentgenometric assessment of spine shape in patients with a flexion contracture of hip as a consequence of hip osteoarthrosis].","authors":"Mariusz Sniegowski,&nbsp;Dariusz Matewski,&nbsp;Jacek Kruczyński","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Current knowledge on influence of hip arthrosis on shape of the lumbar spine is insufficient. Also universal method of roentgenometric assessment of lumbar spine is not yet accepted. The aim of this study was the evaluation of influence of the degree of hip arthrosis on the shape of the spine in a sagittal plane measured by means of selected, roentgenometric parameters.</p><p><strong>Materials and methods: </strong>The study group consisted of 120 patients with hip osteoarthrosis, including 64 women and 56 men. Average age was 69.5 (range from 41 to 81 years). The analysis focused on the influence of age, flexion contracture and radiological degree of arthrosis on selected roentgenometric parameters of lumbar lordosis in the upright and supine positions: Fergusson angle (F), total lordosis angle (Th12-S1), lower lordosis angle (L3-L4/L5-S1), upper lordosis angle (L1-L2/L3-L4).</p><p><strong>Results: </strong>Correlation index between flexion contracture of the hip and total lordosis angle calculated in the upright and supine positions amounted to 0.627 (p < 0.0001) to 0.554 (p < 0.0001) respectively. For the Fergusson's angle correlation index ranged between 0.879 (p <0.001) to 0.758 (p <0.0001) respectively. Differences between average values of individual parameters in groups with varying degrees of arthrosis ranging at the significance level from p <0.0001 for total lordosis angle and Fergusson angle top < 0.04 for lower lordosis angle prove the interdependence between the degree of lumbar lordosis of the spine and hip joint osteoarthrosis.</p><p><strong>Conclusions: </strong>The Fergusson angle and total lordosis angle of Th12-S1 are the most sensitive roentgenometric parameters to the severity the hip arthrosis represented by it's flexion contracture.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"266-73"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40165449","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":"[Early results of revision hip arthroplasty using modular Restoration stem].","authors":"Patryk Nikratowicz,&nbsp;Waldemar Woźniak,&nbsp;Maciej Kluczyński,&nbsp;Małgorzata Wierusz-Kozłowska","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>There is an increasing number of hip joint arthroplasty procedures all over the world which are followed by revision surgery. The cases of severe bone loss and periprosthetic fractures revision of a stem can constitue a serious challenge even for an experienced orthopedic surgeon.</p><p><strong>Material: </strong>In the research material there are 18 patients 6-50 months after the stem of the hip prosthesis revision with Stryker Restoration modular stem.</p><p><strong>Methods: </strong>Clinical evaluation according to HHS protocol, the quality of life measured with SF-36 form, and physical activity evaluated using UCLA score. The methods are also AP and X-Ray of both hips and lateral X-ray of revised hip with osteolysis around stem, stem subsidence, and difference in leg length evaluation, as well as the comparison of hip offsets.</p><p><strong>Results: </strong>Mean HHS score was 78.6 pts, mean SF-36 based quality of life 50.5 pts, and the mean UCLA 4.72. Radiolucent zones around the stem were observed in several cases which were correlated with the stem subsidence.</p><p><strong>Conclusion: </strong>The clinical results in this study are similar to those from the literature, and slightly lower than of the patients after primary hip arthroplasty, particularly in function measuring subscales. The quality of life scores of our patients was significantly lower than reported by other authors in cases of hip revision arthroplasty. There was no case of aseptic loosening. Further observation of the patients considering osteolysis and its relation to stem subsidence is needed.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"286-90"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40166964","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":"[Congenital talipes equinovarus--family occurrence].","authors":"Ewa Kołecka,&nbsp;Kryspin Ryszard Niedzielski,&nbsp;Zbigniew Cukras,&nbsp;Małgorzata Piotrowicz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although congenital talipes equinovarus (CTEV) is one of the most frequently occurring congenital defects of locomotor organs, its ethiopathogenesis is still not fully known. Amongst the others, the inheritance patterns of that defect are not fully known, and that restricts genetic therapeutics and development of new treatment technologies. The aim of this study was analysis of family lineages of 205 children with CTEV (298 feet) treated at our centre in the years 1998-2008. The family occurrence of CTEV was found in 16 cases (8% of analysed group). 6 lineages, in which CTEV occurred in successive generations, were analysed in detail. Particularly interesting is the lineage of the family 1, in which the defect occurred in three successive generations. In case of that family, an autosomal dominant inheritance pattern is possible. Previously that pattern of CTEV inheritance was described only for isolated populations of Polynesians. In own material the family occurrence of CTEV was found to be less frequent than in bibliographic references. The defect occurred twice as often in boys, while the severe form was more frequently observed in girls, and that is consisted with data in the available bibliography. The analysis of presented lineages of families with CTEV did not allow unambiguous defining of the inheritance pattern for that defect. To confirm the autosomal dominant pattern of CTEV inheritance in the family in which the defect occurred in three successive generations, genetic tests would be necessary.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"252-5"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40166583","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":"Method of the nerve root selection in diagnostic and therapeutic process in patients with multilevel nerves entrapment in lumbar spine due to the degenerative process.","authors":"Łukasz Kubaszewski,&nbsp;Andrzej Nowakowski,&nbsp;Robert Gasik","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper presents a method for determining the proper diagnostic techniques and the respective therapy in patients affected with nerve root compression in the lumbar region of the spine based on developing an algorithm that attempts to assess the level of compression and determine the afflicted nerve root. The clinical picture of degenerative disease of the lumbar spine is characterized by symptoms related to the affected nerve root. The diagnosis and respective therapy benefits from the use of minimally invasive techniques, such as selective root blocks or use of the radiofrequency. For instance, with changes on many levels it is necessary to comply with the rules for the selection of the correct nerve roots so there can be referral for proper treatment. The method of selection is dependent on the correlation of the results of the clinical examination, as well as secondary diagnostic studies, of which the gold standard is the MRI. In clinical practice we rely on the results of magnetic resonance imaging to determine the nerve root level in the lumbar spine. This allows the classification of the roots in relation to the frequency of compression occurrence along its course. The morphologic changes resulting in a similar clinical picture may indirectly suggest a degree of exacerbated risk. In addition, we suggest a system of describing the MRI scans, which allows us to retrospectively obtain information on the locations of potential compression of nerve roots.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"301-4, 262-5"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40166962","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":"[Complications after intramedullary nailing of the tibia].","authors":"Krzysztof Pobłocki,&nbsp;Marcin Domaradzki,&nbsp;Jerzy Gawdzik,&nbsp;Paweł Prochacki,&nbsp;Rajmund Rajewski","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As demonstrated by the experience, treatment of fractures of the tibial intramedullary nail proved to be the most advantageous method of operating as: put the rod runs in the biomechanical axis of the limb, is inside of the bone, is a minimally invasive procedure (carried out with small cuts). Initially, the method of intramedullary nailing was used for the treatment of fractures of the shaft center of the tibia. However, the development of surgical techniques has meant that the method can also be used to treat fractures of the proximal and distal tibia. The most common complications of surgical treatment by this method, apart from infection include: changing the limb axis, rotation of the factions against each other, and degenerative changes in the knee depend on the introduction of nail art. The aim of this study is to analyze in order to treat patients with lower leg fractures using intramedullary nailing. It was carried out based on the collected medical records and clinical examination, which included 45 patients. It was found that the most common complication observed after treatment was varus tibial fragments (5 cases - 11% of respondents). Less commonly observed disorder in the form of the axis of rotation of the limb (1 case) and anteflexion -1 case. During the test showed that the axis of the limb abnormalities were associated with the initial surgery. There was no significant progression of the axis of the limb abnormalities in the period from the date of surgery to complete primary union. Complications in the form of secondary osteoarthritis of the knee reported in studies of other authors, did not occur in any of the analyzed in the work cases.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"274-7"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40165451","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":"Three point crutch gait from the perspective of biomechanics and kinesiology. State of knowledge and idea behind the research.","authors":"Lechosław B Dworak,&nbsp;Michał Murawa,&nbsp;Marek Owsian,&nbsp;Jacek Maczyński,&nbsp;Jarosław Kabaciński,&nbsp;Agata Rzepnicka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The study characterizes the idea behind the research project which consists in biomechanical and kinesiological analysis of three point crutch gait. The structure of the study is in part similar to an earlier publication of the authors [1], which discussed swing through gait. By defining the three point crutch gait and describing its general kinematic structure as well as synthetically analyzing the state of knowledge, the authors formulated the purpose of the study, the adopted research model - including the description of the modern and integrated measurement systems that were used and which consisted of: 2 AMTI force plates integrated into a measurement walkway, a set of 6 optoelectronic cameras of the BTS System as well as a multichannel kinesiological electromyography performed with the use of the NORAXON System. All phases of the research were characterized, presenting the adopted research protocol in its entirety.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"305-12, 278-85"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40166960","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":"[Obturator dislocation--a rare complication of the total hip prosthesis. Case study].","authors":"Krzysztof Niciejewski,&nbsp;Witold Banachowski,&nbsp;Adam Kowalczyk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article presents the case of a 55-year-old patient with an injury of the right leg, which was due to a falling lightly at her buttocks during squatting. Patient was transferred to hospital with complaints of severe pain and limited motion in her right hip. In view of the patient's clinical status and following radiological diagnostic work-up, she was diagnosed with femoral neck fractures, the decision was made to perform a primary total hip arthroplasty (THA) using an lateral approach in the lateral decubitus position. A good clinical and radiological outcome was achieved. Patient after 12 days without complications was released home. After 4 days being home she was transferred to hospital again with complaints of severe pain and limited motion in her operated hip. On admission, her right lower leg was lying in an extremely rotated and abducted position. However, the extremity was neurologically intact with good pedal pulses. Physical examination and an initial anteroposterior radiograph showed obturator dislocation of the hip prosthesis. The decision was made to perform an open reduction. The operative problem in this particular case was removing the head of the prosthesis from the obturator foramen without making any jatrogenic harm.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"295-7"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40165456","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":"[Kayakers' length of training period lumbar segment mobility and weak links occurrence in biokinematics chain].","authors":"Małgorzata Wójcik,&nbsp;Idzi Siatkowski,&nbsp;Tadeusz Rynkiewicz,&nbsp;Mateusz Rynkiewicz,&nbsp;Piotr Zurek","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Strength shaping in canoeists can cause limitation of spine movement and pain symptoms. Because of the problem's importance the following study has been undertaken: in order to: 1) determine the relationship between the range of lumbar spine mobility and training experience in kayaking; 2) estimate of the relationship between the occurrence of weak links and symptoms of pain and range of motion in the lumbar spine.</p><p><strong>Material and methods: </strong>25 Wałcz SMS players were examined, including 8 female kayakers, 8 canoeists and 9 canadians. Age (M +/- SD) 15.60 +/- 1.04 years; training period 5.64 +/- 1.78 years. Low threshold Performance Matrix. tests were used. to assess the presence of a weak connection The participants determined the sensation of pain in the lumbar spine (LBP) on a numeric scale. Mobility in the lumbar spine was rated by electrogoniametrics method. The results were statistically analyzed using analysis of variance ANOVA, Tukey's t tests and linear regression analysis.</p><p><strong>Results: </strong>In all examined players weak connection in the lumbar spine were found in the direction of flexion, rotation and lateral flexion, and there were no weak links in the direction of extension. Only 10 players did not suffer from LBP. The other declared the existence of these symptoms. It has been found that the length of training period in kayaking is associated with reduced mobility in the lumbar spine and the occurrence of weak links. As a result pain symptoms have often occurred. Gender and specialization have no influence on the frequency and Range of LBP symptoms in kayaking.</p><p><strong>Conclusions: </strong>1) Sports training in kayaking causes reduced mobility of the lumbar spine and may cause weak links in the chain of biokinenatics connections and symptoms of LBP. 2) Gender and sports specialization does not differentiate canoeists because of LBP symptoms. The reasons for their occurrence can be ascribed to the use of weight training.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"256-61"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40165453","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":"[Treatment of open femur fracture with critical bone loss of femoral shaft in politrauma patient--case report].","authors":"Paweł Skowronek,&nbsp;Julian Dutka,&nbsp;Michał Skowronek,&nbsp;Łukasz Dutka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>The authors describe the case of a 21 year old patient who suffered an politrauma injury in a traffic accident (motorcyclist).</p><p><strong>Objectives: </strong>Presentation of possiblities of treatment femur bone fracture with critical bone loss using intramedullary nail.</p><p><strong>Methods: </strong>Patients's Injury included: fractures of the femur, temporal bone, and ulna. The patient's Severity Score (ISS) was 24. The dominant trauma fracture was open, comminuted fracture of femur shaft (AO 32-C2, Anderson-Gustilo IIIa) with bone loss stated as critical (loss of femoral shaft over 10 cm, including the loss of more than 50% of the circumference was about 8 cm length, and the loss of the full circumference of more than two branches of the missing bone). Osteosynthesisnad bone length reconstruction of the femur was with use of intramedullary locking nail.</p><p><strong>Results: </strong>Full reconstruction was regenerated after 12 months. Although there was extensive injury no local and general complications appeared.</p><p><strong>Conclusion: </strong>Early definitive fracture stabilization and secondary dynamisation possible to obtain the bone regeneration at the defect site.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 5","pages":"291-4"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40166966","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":"[Symptoms of the compression of median nerve in patients after fractures of the distal radius treated operatively].","authors":"Andrzej Zyluk,&nbsp;Beata Waśków","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Unlabelled: </strong>As distal end of the radius is anatomically localised close to the carpal tunnel, fractures of this part of the bone is fairly commonly associated with symptoms typical for median nerve compression. The objective of the study was to assess frequency of the occurrence of these symptoms in patients after operative treatment of the fractures of the distal radius, and, additionally to evaluate the validity and specificity of the Levine questionnaire in the detection of symptoms of median nerve compression.</p><p><strong>Patients and methods: </strong>In 101 patients, at a mean of 9 weeks after surgery for fracture of the distal radius, the following variables were assessed: 1) pain intensity in visual analogue scale as well as 2) complaints and functional impairment of the hand typical for carpal tunnel syndrome with the Levine questionnaire.</p><p><strong>Results: </strong>Pain intensity in the affected hand averaged 2.8 points in 0-10 scale, the Levine symptom score amounted a mean of 2.1 (range 1.0-3.7) and the Levine function score amounted a mean of 2.1 (range 1.0-5.0). Nine patients had score at least 3 in both symptom and function sub-scales of the Levine form, suggesting carpal tunnel syndrome. However, at the assessment at a mean of 15 months thereafter, none of these patients were treated for carpal tunnel syndrome, although, five of them still suffered from similar symptoms. The results of this study show transient character of compressions symptoms on the median nerve In patients after fractures of the distal radius, and, moreover, suggest poor validity and specificity of the Levine questionnaire as the diagnostic tool in suspicion of carpal tunnel syndrome associated with other diseases and injuries of the hand.</p>","PeriodicalId":75702,"journal":{"name":"Chirurgia narzadow ruchu i ortopedia polska","volume":"76 4","pages":"189-92"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30378357","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}