Ortopedia, traumatologia, rehabilitacja最新文献

The incidence of anterior cruciate ligament (ACL) injuries in children and adolescents has been growing recently. This problem is a challenge for the treating orthopedic surgeon, especially when the patient is in the prepubertal period with a high growth potential. Since reconstructive procedures require interventions close to active growth plates, they are associated with the risk of postoperative limb length discrepancies and limb deformities. Postponing ACL reconstruction until the end of growth is not a solution, as persistent knee instability increases the risk of secondary intra-articular damage. The key to success is not only knowledge of the anatomy and biomechanics of the pediatric knee but also the ability to predict the remaining growth potential and familiarity with a wide range of reconstructive surgical procedures available for patients at different ages.

Based on an analysis of source materials from the private collection of the Zembaty family, the Medical Library of the Marian Weiss Rehabilitation Center in Konstancin, articles from daily press, and a few publications, we present the professional career, and academic and organizational activities of the late Professor Andrzej Zembaty (1935-2022), Doctor Habilitatus in Physical Culture Studies. While working at the Capital City Rehabilitation Center in Konstancin (Stołeczne Centrum Rehabilitacji), he served as an assistant to and close collaborator of Professor Marian Weiss. Affiliated with the Warsaw University of Physical Education for many years, he was known as a scholar, demanding teacher, author of well-known textbooks, and organizer of physiotherapy education. His vision of the professional development and role of physiotherapists in healthcare was realized only after the enaction of the Physiotherapist Profession Act. He undoubtedly ranks among the pioneers and founders of Polish physiotherapy.

Background: Besides arch-supportive insoles, sensorimotor insoles are used for the treatment of flatfoot in children. The aim of this study was to compare the effect of both types of insoles on the arch-supporting muscles and clinical aspects in children with flexible flatfoot.

Material and methods: 52 children with flexible flatfoot (mean age of 8.22.7 years) were enrolled. Supportive, sensorimotor, and placebo insoles were compared. Muscle activity was detected by surface electromyography during the midstance phase. Valgus index, foot and ankle disability index (FADI) and pain were assessed at enrolment and after 6 and 12 months. Mixed-design ANOVA was used for statistical evaluation.

Results: Supportive and sensorimotor insoles caused significantly lower activity in the tibialis anterior in comparison to placebo insoles regarding the parameter Mean. No significant differences could be detected between both types of therapeutic insoles. Supportive insoles showed a significant decrease regarding the parameter Amplitude of the peroneus longus. Placebo insoles produced an increase in the valgus index, while both therapeutic insoles did not induce any changes. The sensorimotor insoles induced an increase in FADI, while the supportive and placebo insoles had no significant effect on this parameter.

Conclusions: 1. Supportive and sensorimotor insoles potentially influence muscle activity in the lower leg. 2. Both could influence the longitudinal arch in flat feet. 3. While placebo insoles caused a deterioration of the valgus index, both kinds of therapeutic insoles could possibly prevent the progression of the flatfoot. 4. Clinical studies including more clinical aspects and long-term observations are necessary.

Background: Posterior stabilization surgery is considered the gold standard for restoring spine stability in patients with traumatic thoracolumbar fractures. However, whether long-segment (LS) stabilization or short-segment (SS) stabilization is an optimal approach for achieving more effective restoration of spinal stability remains unclear.

Material and methods: Patients who underwent posterior stabilization surgery for traumatic thoracolumbar fractures were included in the study. Radiological parameters were measured using pre- and post-surgical thoracolumbar computed tomography (CT) scans and compared between patients who received LS and SS stabilization.

Results: Ninety-eight consecutive patients (mean age 4414, 50% male) who underwent posterior stabilization surgery for traumatic thoracolumbar fractures were included. LS stabilization was performed in 52 patients, while SS stabilization was performed in 46 patients. Among spinal stability parameters measured on pre-surgical thoracolumbar CT scans, the anterior vertebral height (AVH) was significantly lower in the LS stabilization group compared to the SS stabilization group (14.44.0 mm vs. 16.44.0 mm, p=0.017), indicating a more severe compression fracture in the LS stabilization group. However, all parameters improved on post-surgical thoracolumbar CT scans, and there were no significant differences between LS stabilization and SS stabilization groups in terms of the restoration of spinal stability parameters. The type of stabilization (LS vs. SS stabilization) did not show an association with post-surgical measurements of spinal stability parameters (B=0.27, 95% CI -1.87 to 2.42, p=0.800 for superior inferior end plate angle (SIEA), B=0.20, 95% CI -1.33 to 1.74, p=0.796 for AVH, and B=0.39, 95% CI -1.72 to 2.50, p=0.714 for Cobb angle).

Conclusions: Both LS and SS stabilization approaches yield similar results in terms of restoring spine stability parameters in patients with traumatic thoracolumbar fractures. The choice of surgical approach should be individualized based on the patient's overall status and the surgeon's experience.

Background: Starting from the 1950s, shoulder arthroplasty has been developing, one consequence of which has been the concept of reverse shoulder arthroplasty (RSA). Initially, it was supposed to be used only in patients with irreversible rotator cuff damage, but it quickly gained more and more indications for use. The aim of the present study was to assess biomechanical, objective indications for RSA in patients with shoulder osteoarthritis (OA) based on an inertial measurement system with electromyography.

Material and methods: 20 patients were qualified to this prospective study, 10 each in a control and experimental group. The study was conducted between August 2020 and October 2021. The experimental group consisted of 9 women and 1 man aged 55 to 85 years old, with osteoarthritis of the shoulder associated with rotator cuff damage. The study utilised the myoMotion inertial sensor system (Noraxon, USA) synchronized with the surface electromyography system Myotrace 400 (Noraxon, USA).

Results: Movement phase diagrams were used to assess the movement patterns. To examine the movement pattern in the shoulder, three motor tests can be proposed: flexion-extension, flexion in the scapular plane and abduction-adduction. The observation of trends for the operated limb showed the highest absolute improvement in the group with the greatest impairment of the movement pattern in the initial test. However, on final evaluation, these results were still twice as low as those obtained in the group with the least impairment.

Conclusions: 1. Early qualification of patients with shoulder OA for RSA could mean a greater likelihood of functional and quality-of-life improvement. 2. Movement patterns after RSA may improve, but will probably not return to physiological values.