Section: Kończyna górna i obręcz barkowa

June 21, 2022

Results of the treatment of distal radius fractures with a proprietary implant, the DRONes nail plate – preliminary report

Introduction. Distal radius fractures are one of the most common bone injuries. Modern treatment methods are needed not only to reduce the time needed to heal, but also allow the wrist the full range of motion as soon as possible. The solution should provide stable bone fixation with the least possible damage to soft tissues, which will allow quick recovery of extremity […]
June 21, 2022

Reversed shoulder arthroplasty in treatment of proximal humeral fractures – early results in Department of Orthopaedics, Traumatology and Oncology, Regional Hospital in Torun, Poland

Introduction. Proximal humeral fractures (PHF) are a frequent finding, and still growing part of it needs to be treated operatively. Extending life expectancy, increasing percentage of osteoporotic fractures and progressive patients’ demand force surgeons to seek the best solutions of treating complex fractures. Just some teen years ago older patients who suffered a severe PHF were doomed to shoulder dysfunction. Today we […]
June 21, 2022

Analysis of concerns among patients operated for carpal tunnel syndrome

Introduction. Carpal tunnel release (CTR) is among the most commonly performed procedures within a hand, in a day surgery setting. Studies suggest that patient concerns and emotional state may influence CTR outcomes. Aim. To determine the frequency of preoperative concerns among patients operated for carpal tunnel syndrome (CTS) and their correlation with negative emotions, socio-demographic and clinical variables. Materials and methods. A […]
June 21, 2022

Non-microsurgical replantation (composite graft with palmar pocketing) – a case report of successful reintegration of distal finger amputation

Microvascular replantation in not always feasible for distal finger amputations. Our work presents a case of 23-year-old woman who suffered an amputation of index finger at the level of nail base. She was disqualified from microvascular replantation, however, the cooperation with Replantation Service resulted in an uncommon method of treatment, which resulted in excellent functional and aesthetic outcome. Composite grafting for fingertip […]
June 21, 2022

Management of hipovascular non-union of ulna with implant destabilization in patient treated due to both forearm bone shafts fracture – a case report

A clinical case report of a 26-year-old patient with an open fracture of both forearm shafts without known comorbidities, who, during treatment, developed a non-union of the ulna with destabilization of the implants. After another fracture stabilization procedure, debridgement of the fracture ends and filling the bone gap with frozen allogenic bone grafts, union was obtained. In this paper, the authors consider […]
June 21, 2022

Operative treatment of pediatric diaphyseal both-bone forearm fractures with flexible intramedullary fixation

Forearm fractures constitute the largest group of injuries in children’s musculoskeletal system. When treating these injuries, we strive to achieve a complete union, not forgetting to restore the correct axis and limb length, which later determines proper functioning of the upper limb. As far as treatment is concerned, the operative method of choice selected more and more is the elastic (flexible) intramedullary […]
June 21, 2022

Ultra mini-invasive sonographically guided carpal tunnel release: a preliminary report

Ultra mini-invasive sonographically guided carpal tunnel release allows division only the deepest fibrous layer of the retinaculum, leaving intact the more superficial palmar layer. It uses a special retrograde hook-knife. The operation can be safely performed in a dressing room (not in the operative theatre) which significantly reduces costs and waste, comparing to standard technique of carpal tunnel decompression. Twelve patients, 10 […]
June 21, 2022

Evaluating outcomes of surgical treatment of patients with degenerative changes in the carpometacarpal joint of the thumb using percutaneous stabilization with Herbert screws and Reg-Joint implants – a pilot study

Based on a review of the current literature, different approaches are observed to treat degenerative changes within the carpometacarpal joint (CMC) of the thumb. The primary purpose of treating this type of condition is to relieve pain and also to obtain (restore) the best possible function of the thumb. Meeting these conditions ensures a minimum operative approach and the shortest possible immobilization […]
June 21, 2022

Oxygen saturation measurement in dislocated supracondylar fractures in children

The goal of his study was to show that oxygen saturation measurement in the distal part of injured upper extremity is one of the best method to assess post-traumatic blood flow disturbances and the necessity for exploration of brachial artery in supracondylar fractures. 32 children, age 4-16, with Gartland’s displaced extension type III injuries and distal disruption of blood flow were treated […]
June 21, 2022

Biomechanical analysis of selected extratunnel and intratunnel preparation techniques of hamstring tendon graft in the arthroscopic reconstruction of the anterior cruciate ligament. Experimental and clinical tests

Introduction. Analysis of the tendency in the arthroscopic reconstruction of the anterior cruciate ligament indicates a gradual increase in the dominance of the selection of flexors as the primary material for its repair. Stable seams of flexor stumps are necessary to fix them in the bone canal under the appropriate tension. The aim of the study is to compare biomechanical parameters of […]
June 21, 2022

Simultaneous repair of scapholunate and distal radio-ulnar joints instabilities – case report

Simultaneous, serious injury to the scapholunate ligament and triangular fibrocartilage complex, causing symptomatic instability of the SL and DRUJ occurs rarely. In most cases the injury involves only one of these structures, and if both are affected, it usually does not result in symptomatic instability of both. The paper reports a case of simultaneous, symptomatic scapholunate and distal radio-ulnar joints instabilities, requiring […]
June 21, 2022

Flexor tendon repair in local infiltration anaesthesia and a bloodless field – case report

Local infiltration anaesthesia with a bloodless operation field allows for proceeding surgery within the hand with no need of use of the tourniquet. This effect is obtained through an injection of greater than standard volume of the anaesthetic solution composed of lignocaine and adrenaline. Adding adrenaline to the mixture induces spasm of small arteries within an infiltration area followed by bleeding inhibition […]
June 21, 2022

Leri Disease – case report of uncommon disease

Introduction. Leri disease (synonyms: melorheostosis, candle bone disease, melting wax syndrome) is a rare disease which affect bones, first described in 1922 by Leri and Joanny. The disease can be asymptomatic or manifested by severe pain of the limbs. A radiological feature is the increasing density of the bone structure resembling wax flowing from a candle. Case report. A 27-year-old Caucasian female […]
June 21, 2022

Surgical treatment outcomes of proximal humerus fractures including shoulder hemiarthroplasty in patients of the Orthopedics and Trauma Department in Siedlce

Proximal humerus fractures constitute 4-5% of all fractures occurring in adults. The aim of the study was to evaluate treatment outcomes for displaced proximal humerus fractures in patients eligible for surgical treatment who were hospitalized in the Orthopedics and Trauma Department of the Ministry of the Interior Hospital in Siedlce between 2016 and 2018. During this period, 153 patients with proximal humerus […]
June 21, 2022

The use of a self-designed external fixator for the treatment of distal radius fractures at the Orthopedics and Trauma Department of the John Paul II Mazowieckie Voivodship Hospital in Siedlce

Objective. The aim of the article is to describe the treatment of unstable distal radius fractures, consisting in the primary reposition of the fracture and stabilization with a self-designed external fixator modelled on the elements of the Ilizarov apparatus. The external device allows radical, efficient, cost-effective and patient-friendly stable fixation of a fracture. Materials and methods. 148 patients treated in 2014 for […]
June 21, 2022

Short term results of hemiarthroplasty of radiohumeral joint in treatment of radial head fractures

Radial head fractures are the most common elbow fractures [1,2]. They are most often associated with indirect trauma – fall on outstretched hand with elbow in extension and forearm in pronation [6,18]. Some of these fractures, more precisely the nondisplaced or minimally displaced ones, can be treated nonoperatively [19,20,22], but most require surgery. When treating patient with radial head fracture, surgeon should […]
June 21, 2022

Treatment of the 40-years old hypertrophic pseudarthrosis of the humeral shaft after breaking of the intramedullary nail – removal of the intramedullary fixation using Ender rod. Original modification of the method

Hypertrophic humeral pseudarthrosis is a frequent complication following a surgical treatment. The question arises about the least invasive treatment to be applied when the intramedullary nail stabilizing axially a humeral pseudarthrosis breaks. So far no explicit answer to this question has been found. We have operated a patient with a 40-years old hypertrophic pseudarthrosis using the Ender rod to remove a broken […]
June 21, 2022

Operative treatment of distal radius fractures: stabilization with Kirschner wires or plate fixation? Comparison of treatment methods based on own observations

Fractures of the distal radius are one of the most common fractures among adults. Despite, there still ongoing discussions on the choice of method of surgical treatment. Recently also emphasizes the increasing role of bone grafts in the reconstruction of the articular surface especially in compression fractures and osteoporotic fractures. The study conducted in our hospital evaluated 127 patients with the fracture […]
June 21, 2022

Antithrombotic prophylaxis and salvage procedures in microsurgery – a review

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 […]
June 21, 2022

Evaluation of the influence of the primary treatment on recurrences after the first-time traumatic shoulder dislocation

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. […]
June 21, 2022

Anterior subcutaneous transposition and simple decompression of the ulnar nerve at the elbow – the postoperative improvement in DASH score, VAS score and sonographic findings

Introduction. Although a lot of studies have described long- term outcomes after surgical treatment of cubital tunnel syndrome, and the usefulness of sonography in diagnosing of this disorder, few studies have evaluated patients self-reporting outcomes or sonographic findings after surgery. Aim. We assessed patients self-reporting instruments and sonographic findings in patients with the cubital tunnel syndrome before and after a surgery. […]
June 21, 2022

Treatment of fractures for lateral part of humeral condyle in children – a single-center experience

Introduction. Elbow fractures are among the most common injuries of the locomotor system in children, second only to forearm fractures. Diagnostic and treatment errors often lead to complications. The presence of ossification centres must be taken into consideration when analysing and interpreting x-ray images. The many classifications do not reflect the whole picture of the injury in question, which is characterised by […]
June 21, 2022

Trans-metacarpal hand replantation – case report

A 53-year old patient amputated his hand with a sheet metal guillotine while working in a workshop. After a preliminary assessment consisting of running diagnostics and wound dressing, he was transported and admitted to the Department of Orthopaedics and Traumatology of the Medical University of Gdańsk. The initial surgery took 8 hours. The microsurgical procedures consisted of anastomosis of the ulnar artery […]
June 21, 2022

Comminuted distal radius fracture managed by osteosynthesis with xenogenic bone graft – case report

Distal radius fractures are the most frequent fracture location among adults and make up to 17% of all cases. Most vulnerable are elderly women with poor bone quality. Over the years method of choise in supplementing bone defects was harvesting autogenic bone from iliac crest, although it in not always possible in patients suffering from osteoporosis. The presented case refers to female […]
June 21, 2022

The Hand among criteria of Marfan syndrome and other Marfan-like hereditary elastopathies

Introduction: The Marfan syndrome (MFS) is a genetically determined illness inherited in an autosomal dominant pattern [9,17]. Other elastopathies present in our study are: Ehlers-Danlos syndrome (EDS) – a genetically conditioned disorder of synthesis and metabolism of collagen and other proteins of the connective tissue, Loeys-Dietz syndrome (LDS) – autosomally dominant inherited mutation of the transforming growth factor gene TGFBR1 or TGFBR2, Takayasu […]
June 21, 2022

Bilateral fracture of radial heads with dislocation treated surgically

Fracture of the radius is quite frequently observed within elbow joint. This pertains to nearly 20 per cent of acute traumas within elbow joint [2]. Isolated fracture of the radial head occurs in only less than 2 per cent of fractures [3]. Bilateral fracture of radial heads occurs most frequently as a component of severe, high-energy traumas of elbow joint but may […]
June 21, 2022

Paralysis of three upper limb nerves due to a humerus supracondylar fracture – distant results of treatment. Case report

We are presenting the case of an 8 year old patient who suffered from a left elbow joint trauma and was admitted to the clinic of Children’s Orthopedy and Rehabilitation in Lublin due to a left humeral supracondylar fracture in an extensor mechanism injury. Because of this injury, besides damage to the locomotor system, it lead to sensory and motor dysfunction of […]
June 21, 2022

The Rehabilition after the allogenic hand transplantation – case report

Thanks to the modern technology, today’s artificial limbs are nearly perfect. However, for a human being a hand is more than a simple pinching organ – its presence has a huge impact on one’s psyche. Even a malfunctioning hand that is only able to sense provides one with the impression of the integrity of one’s body. The aim of this paper […]
June 21, 2022

A double carpal tunnel – a case report of rare anatomic variation

The paper describes a rare anatomical variation of double carpal tunnel which appeared once among approximately 10,000 patients treated from carpal tunnel syndrome by an experienced hand surgeon. The tunnel was divided into two separate compartments by a thick sagittally oriented fibrous barrier. The radial compartment of carpal tunnel consisted of 1st palmar common digital nerve and flexor pollicis longus tendon while […]
June 21, 2022

Assessment of the eff ectiveness of rehabilitation in the conservative treatment of carpal tunnel syndrome

Rehabilitation therapy is more often used in the treatment of carpal tunnel syndrome (CTS). The aim of the study was to evaluate the effi cacy of rehabilitation in the treatment of carpal tunnel syndrome. The clinical material consisted of 40 hands in 28 patients, mainly women aged from 48 to 77 years (mean age 59.4 years). Medical history showed that patients suff […]
June 21, 2022

Eff ectiveness of bone infl ammation treatment in ulna using Bon Alive s53P4 bioactive glass – a case report

The case of 25-year-old patient, male, involved in a traffi c accident is presented. Galeazzi fracture with damage to the triangular complex, DRUJ instability and ACL rapture was diagnosed. The patient has been operated several times because of DRUJ instability. Clinical and radiological analysis suggested an infection around stabilizing implants – K wires. In bacteriological analysis S. aureus MSSA strain was confi […]
June 21, 2022

Regulation of osteoblastogenesis by transcriptional growth factors and a role of osteoblasts in osteoclastogenesis

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 […]
June 21, 2022

Joint sparing procedures in ankle arthritis – is it feasible?

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:  […]
June 21, 2022

Operative treatment of radial neck fractures in children – Metaizeau technique

Introduction:  The area of the elbow joint is exposed to frequent damage in children. Among them, the fracture of proximal radial bone may, depending on the type and the extent of bone fragments displacement, constitute a clinical problem, especially because of the possible consequences of open reduction. Metaizeau technique reduces the risk of their occurrence.  Objective:  The aim of the […]
June 21, 2022

Treatment of acute acromio-clavicular joint dislocation by hook plate – report of 25 cases

Acromioclavicular (AC) dislocation represents 8% of dislocations in the upper limb and 12% of dislocations in the shoulder girdle. Rockwood types III, IV and V require surgical treatment. The aim of this retrospective, two-center and multi-operator study was to assess the objective and subjective results from a sample of 25 patients treated for acute AC dislocation with a clavicular hook […]
June 21, 2022

Comparison analysis Mondelli’s scale and Levine’s questionnaire in the monitoring rehabilitation effect in the patients with tunnel carpal syndrome

Currently, simple and easy to use methods allowing to objectively evaluate the results of treatment of carpal tunnel syndrome (CTS) are searched for. The aim of the study was to analyze and compare the Mondelli’s scale and the Levine’s questionnaire for monitoring rehabilitation effects in patients with CTS. The clinical material consisted of 40 hands in 28 patients, mainly women aged […]
June 21, 2022

Results of conservative treatment of clavicle fracture

Introduction. Fractures of the clavicle account for 2-5% of fractures in adults and 10-15% of fractures in children, encountered during on call duties. The ongoing discussion on the strate-gy for treating clavicular fractures, operative or non-operative, led us to carry out this research. Material and methods. In the years 2014-2015, at our hospital during on-call duties, we had an admission of 39 […]