X-linked hypophosphatemia is a rare disorder of bone metabolism caused by inactivating mutations in the PHEX. Conservative therapies such as treatment with phosphate salts or FGF23-inhibiting antibodies can improve symptoms, the latter being superior to the healing of rickets. Recent studies show a high burden of disease of children and adults with XLH. Orthopedic surgeons should be aware that lower […]
Primary bone sarcomas are not frequent entities, but constitute important issue especially in pediatric population. Advances in chemotherapy and diagnostic modalities allowed limb saving resections of malignant bone tumors became leading surgical option. To be successful the treatment of primary bone tumors should be conducted in dedicated centers by experienced team of specialists. Nevertheless, the rules of such treatment should […]
Bone metastases are a great challenge in the practice of an orthopedic surgeon. Due to the development of oncological treatment, the approach to patients with bone metastases is changing. Previously, these patients were treated palliatively, mainly to decrease the pain intensity. However, with appropriate systemic, surgical and orthopedic treatment, patients with bone metastases often live for many years. Therefore, proper […]
Every year, the number of total hip replacement treatments increases and along with it, so does the number of local and systemic complications, including periprosthetic fractures. These fractures usually occur among elderly people with deteriorated bone quality and other general and neurological disorders. Treatment of periprosthetic femoral fractures imposes a difficult and complex medical problem, which requires adequate experience and a rational […]
The aim of this study is to clinically assess the results of a total hip arthroplasty surgery among patients with idiopathic hip degenerative lesions. These patients were treated using endoprosthesis with the standard Corail stem and the short Fitmore stem. The scope of this assessment includes surgeries carried out in the Provincial Hospital Complex in Kalisz in the Department of Orthopedics and […]
Treatment of calcaneal fractures remains a challenge for the orthopedic surgeon and is still controversial. There is no consensus on whether surgery is a better option that non-operative treatment. The indications for non-operative treatment are non-displaced extra-articular fractures and intra-articular fractures with fragment displacement of less than 2 mm on CT image (Sanders type 1) This type of treatment should be considered […]
For 40 years we have been observing clear changes in the interest of pediatric orthopedists. Some malformations and diseases have almost disappeared in pediatric orthopedic departments, such as developmental hip dislocation, multiple congenital clubfoot surgeries, torticollis, varus of the shin, Blounts disease,Volkmann syndrome, shin mower amputations and others described in this article. The reason for this phenomenon is usually the emergence of new […]
Anterior cruciate ligament injuries are one of the most frequent knee joint injuries, leading to instability which limits return to sport activity, and is one of osteoarthritis risk factors. Treatment issues are present since 1895, when Mayo Robertson performed first documented open ACL repair. Positive short-term results of open suturing led to rising popularity of this method, which in 70’s and 80’s […]
Introduction. The most challenging injury in orthopedic surgery is pelvic trauma. There are different concepts of treatment strategies, specially in final treatment of pelvic ring and acetabular fractures. Objectives. Analysis of recent studies and evaluation of treatment methods. Materials and Methods. Analysis of 22 recent studies. Five papers met our inclusion criteria, that equated 745 patients. Results. Patients hemodynamically unstable need […]
Microsurgery became an essential part of various specialties. Hand replantation, vascular free flap reconstruction, and cerebral bypasses are impossible to conduct without mastering microsurgical skills. Currently, the gold standard of microsurgical training is the course with living models during which participants perform basic microsurgical procedures under the supervision of an experienced tutor. However, due to high cost of training and ethical issues new […]
The enhanced recovery after surgery protocol (ERAS) – is generally modern comprehensive perioperative care to improve the treatment results. It is more widely used in surgery, including orthopedics. Implementation of the ERAS protocol has been shown to accelerate post-operative recovery, shorten hospital stays, increase patient satisfaction, and improve clinical outcome. This article describes the main elements of the ERAS protocol with the […]
The treatment of massive acetabular deficiency is a challenging problem even for the most experienced orthopaedic surgeons and the acetabular custommade implants are a relatively promising treatment option for severe bone defects. The aim of this study is to summarize and evaluate outcomes of using acetabular custom-made implants. This review material consists of the results of the selective literary research into custom-made […]
Introduction. The usually occurring pain associated with osteoarthritis causes a significant reduction in mobility. This article presents the need to personalize the rehabilitation of patients after hip arthroplasty taking into account age and weight. Material and Methods. The study included 158 patients who were patients of the orthopedic clinic of the SPSK4 Polyclinic in Lublin. All respondents were subjected to partial or […]
Introduction. We are currently experiencing revival of High Tibial Osteotomy (HTO) procedure. After having been forgotten in the 70s, when knee-joint arthroplasty gained popularity, it became more popular again at the beginning of this century and the procedure methodology has been refined. This procedure is widely performed to treat medial knee arthrosis. The main goals of HTO are pain relief, correction of […]
Introduction. In a five-year follow-up comparative study we will present the outcomes after implantation of three cementless short femoral stems : MINIHIP (Corin), SMF (Smith&Nephew) and FURLONG EVOLUTION (jRi). Material and methods. We have analysed the data of 180 patients (88 females, 92 males), in three groups of 60 patients, each group using a different implant. Evaluation of the radiographic outcomes was […]
Introduction. Forearm fractures are the second most common injuries to the locomotor system in children, after injuries to the distal forearm. Usually, pediatric forearm fractures occur due to indirect violence. In the treatment of forearm fractures in children, we aim to achieve union, correct length and axis of both forearm bones. Forearm fractures can be treated non-operatively, with casting, as well as […]
Nowadays, pains in the lumbosacral region of the spine are one of the most common spinal illnesses in general. Non-specific back pain of this episode occurs in almost 85% of cases. Its etiopathogenesis is elaborate to determine, but the patient’s lifestyle is of great importance – the profession and physical effort during sports activities. Referring to current data from international literature, the […]
Developmental Dysplasia of the Hip (DDH) is the most common condition of the mouvement apparatus in children. If untreated, it leads to early degenerative changes of the joint with all the associated issues for the patient. Risk factors are important part of the diagnostic proces, however part of them seems to be less important that previously thought. In the article actual publications […]
Total knee arthroplasty is one of the most common orthopaedic procedures all over the world. Despite minimal invasive surgical techniques, the procedure is accompanied by the postoperative pain in various intensification. In this article we focus on the multimodal anlagesia, particulary taking local infiltration analgesia (LIA) in consideration. Review of current literature allows us to state that LIA decreases the level of […]
Benign joint hypermobility syndrome is a condition in which joint laxity causes clinical symptoms, mainly pain. The diagnostic process is based on physical examination. There is no specific treatment. Symptomatic treatment involves mainly physical therapy and psychotherapy. Considering the psychological impact of the symptoms BJHS patients need targeted multidisciplinary treatment. As the syndrome is chronic, and symptoms affect many sites, patients are often […]
The authors present their own experience with the use of dual-articulation prostheses in a group of patients with femoral neck fractures. The aim of the study was to assess the possible reduction of the risk of dislocation after hip arthroplasty in a group of patients particularly prone to dislocation, that is patients with traumatic femoral neck fracture . The material included 16 […]
Introduction. Inflammations of long bones are severe complications of fractures. The gradual development of industry and its automotive branch generates a higher number of injuries, including high-energy fractures, mostly open [1,2]. These injuries, which are primarily infected, despite the use of empirical antibiotic therapy, lead to osteomyelitis. Intramedullary nails coated with polymethyl methacrylate (PMMA) containing a targeted antibiotic help heal the inflammation and […]
Introduction. Total hip replacement is a common and succesful treatment of the osteoarthritis of the hip. Material and Methods. During the work on this article, an analysis of scientific articles on corticosis and hip arthroplasty has been made, with particular emphasis on studies investigating the influence of age and body weight on the obtained results of treatment. The second method of […]
Heterotopic ossification (HO) is the abnormal formation of mature bone in extraskeletal soft tissues, which may commonly occur after Total Hip Arthroplasty (THA). Despite the high incidence of HO and multiple clinical studies examining the phenomenon, the pathophysiology and etiology of HO remain unclear. In advanced cases, HO may significantly decrease results of surgery by impairing range of motion in joint and […]
This paper is a systematic review on the use thermography as a diagnostic tool in musculoskeletal disorders. Thermal imaging cameras record skin surface temperature. As many musculoskele-tal disorders impair cutaneous circulation, with thermography we can observe circulatory abnormalities in inflammation, ischemia or sympathetic system dysfunction. Based on literature data a number of uses for thermography in musculoskeletal medicine can be found. In orthopedics […]
The term frozen hip rarely appears in literature. The reason for this situation is the diffi culty of the diagnosis, the rarity of the disease, and non-specifi c course of illness. Classic X-ray may not show any signifi cant pathology. One of the most eff ective methods of diagnosis is arthrography . Because of the insidious nature of the disease, it may […]
Antithrombotic prophylaxis for microvascular anastomoses is an important problem in microvascular surgery, including replantation, reconstructions and free fl aps transfers. There is no consensus concerning effi cacy of particular antithrombotic drugs and, likewise, there is not one, commonly accepted guideline for postoperative management in microsurgery. Most commonly used medication includes acetylsalicylic acid, heparin and dextran. The paper presents mechanism of action of these […]
Most patients with cervical radiculopathy improve with non-operative treatment modalities. Surgical treatment is recommended when conservative methods fail. The most common technique is anterior cervical discectomy with fusion (ACDF). Many complications including pseudoarthrosis, recurrent laryngeal nerve injury, dysphagia and adjacent segment degeneration were described as being associated with ACDF. Posterior laminoforaminotomy is another method where neck pain is a frequent complication and has […]
Degenerative scoliosis of the lumbosacral region occurs in 6% of the population over 50 years of age. It is often accompanied by low back pain resulting from fibular (in the majority of patients) or frontal decompensation. Radicular pain is common, radiating to one (more often) or both (less often) lower limbs and is most often caused by lateral stenosis.
Developmental dysplasia of the hip in infants covers a wide range of different clinical severity, from complete dislocation, through subluxation to dysplasia, often of mild degree, which disappears on its own. The consequences of undiagnosed dysplasia may affect the motor skills of a child and an adult. A complete cure of the defect using simple nursing methods is possible only in infancy. […]
Flexible flatfoot is a common defect in children and adults. Up to about the age of 10, the longitudinal arch of the foot can be spontaneously reproduced and does not require treatment. After the age of 10 with the co-occurrence of pain, arthroereisis can be performed, i.e. limiting the excessive pronation by an implant located in the tarsal sinus region. This treatment […]
In their 2016 publication, the authors drew attention to the influence of generalized polyarticular laxity during the treatment and the final effect of the correction of lower limb axis disorder in children and adolescents . In addition to the influence of generalized polyarticular laxity on the outcome and time of treatment of patients, we also observe the flexion of the tibial shaft, […]
Juvenile idiopathic arthritis (JIA) is an arthritis in at least one joint lasting more than 6 weeks with onset before the 16th birthday, in case other known conditions are excluded. It is a heterogeneous disease with different onset symptoms: arthralgia, arthritis, enthesitis, fever, heel pain, back pain or other. Due to this conditions children with JIA are often first referred for orthopaedic […]
Introduction. Musculoskeletal disorders appear to be one of the most common work-related complaints among physicians. The aim of this study was to determine the prevalence of low back pain (LBP) among surgeons and its influence on postural stability and risk of injuries. Material and methods. The study group comprised of 21 surgeons (11 orthopedic surgeons, 10 other surgical specialties) at the […]
Introduction. A shoulder joint is the most often dislocated joint in a human body, with a great tendency to recurrences. How to prevent redislocations? It’s still an actual and clinically important problem. Aim. The aim of this study was to analyse the efficacy of primary treatments for first-time shoulder dislocations in the entire population of Poland with regard to age and gender. […]
Patellofemoral joint (PFJ) and it’s coexisting disorders are an essential clinical problem for orthopaedic surgeons. Literature is lacking of general population epidemiological studies that could confi rm an incidence rate of patellofemoral pain syndrome. Available studies are most often taken on a precise group of sport participants. In literature it is written that complaints coming from an anterior aspect of the knee […]
Along with the increase in life expectancy of society and striving to retain maximal body condition despite of degenerative changes, we observe continuously growing number of large joint replacements due to indications impairing organism’s condition [1,2]. The proportion of infective complications after these procedures amounts to 1-2% . There is many classifi cations simplifying the management and preliminary stating of pathogenesis in cases […]
A complex regional pain syndrome also known as Sudeck’s syndrome is a chronic neurological disorder characterized by pain, edema, vasomotor instability, and motor weakness . The Sudeck’s syndrome may occur as a result of a fracture or other mild form of injury. Additionally, it occurs quite often in hand surgery, which makes post-traumatic and post-operative care even more diffi cult. There is […]
Fracture of the radius is quite frequently observed within elbow joint. This pertains to nearly 20 per cent of acute traumas within elbow joint . Isolated fracture of the radial head occurs in only less than 2 per cent of fractures . Bilateral fracture of radial heads occurs most frequently as a component of severe, high-energy traumas of elbow joint but may […]
Bone cement implantation syndrome (BCIS) is a dangerous phenomenon occurring in patients undergoing cemented arthroplasty. Till today there is no widely agreed on definition. For this reason, the true incidence of complications is not known. BCIS is characterized by hypoxia, hypotension with or without changes in the level of consciousness, even complete loss of consciousness. BCIS may even cause cardiovascular collapse requiring […]
The importance of master transcription growth factors in generation of osteogenic cells from mesenchymal stem cells (MSC) is briefl y outlined. All stages of diff erentiation of MSC into osteoblasts are under the control of Wnt/β-catenin signaling. Enterance of undiff erentiated MSC into the osteogenic lineage is triggered by expression of Ihh and SOX-9 transcription factors. Thus MSC gains the […]
The aim of the study was to determine the epidemiology of open long bone shaft fractures treated surgically in the Department of Orthopaedics and Traumatology in Zielona Gora. We analyzed the distribution of open fractures based on gender, age, anatomical region, classifi cation according to Gustilo-Anderson and AO Muller, method of operating supplies and occurred complications. Collected date were covering […]
Background: Ankle arthritis is most commonly resulting from trauma. For some young patients joint preserving procedures are superior to arthrodesis or arthroplasty. Literature review and case reports: We present a review of current literature regarding treatment of ankle arthritis as a result of malunited ankle fracture, extra-articular deformation and diastasis of syndesmosis. The review is illustrated with clinical cases. Conclusion: […]
Osteoid osteoma (OO) is a benign bony lesion with a characteristic radiologic feature of x-ray focus (nidus). The most common symptom indicating diagnosis is strong nocturnal pain that eases with nonsteroidal anti-inflammatory drugs (NSAID). Computed tomography (CT) is a method of choice for diagnosing and localizing the tumor. Osteoid osteoma can regress spontaneously, thus conservative treatment is one of the […]
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