Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8264
M. Turgut, H. S. semis, Kamil Yamak, Fener Çelebi
BACKGROUND This 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. MATERIAL AND METHODS Patients 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. RESULTS A 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. CONCLUSION In 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.
{"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}
Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8375
J. Peters, H. Köhler, A. Gutcke, C. Schulze
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.
{"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}
Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8265
Marcin Maszke, Piotr Buchcic, M. Marciniak, Radosław Lebiedziński, Łukasz Lipiński, A. Grzegorzewski
BACKGROUND The 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. MATERIAL AND METHODS 15 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. RESULTS Every 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. CONCLUSIONS 1. 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.
{"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}
Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8267
Wojciech Koniec, W. Marczynski
BACKGROUND Ineffectively 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. MATERIAL AND METHODS We 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. RESULTS Bone 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). CONCLUSIONS 1. 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.
{"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}
Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8268
Bartosz Bagrowski, Joanna Krasny, M. Jóźwiak
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).
{"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}
Pub Date : 2022-04-30DOI: 10.5604/01.3001.0015.8374
M. Kwiatkowski, T. Guszczyn, A. Sobolewski, M. Sar, A. Hermanowicz
BACKGROUND Subtalar implant migration as a complication following subtalar arthroeresis has been described in the scientific literature. However, clinical studies do not allow for unequivocally determining the underlying causes. The aim of the study is to determine the risk of migration of two geometric types of subtalar implants. Biomechanical tests were carried out on a synthetic bone model with a soft tissue substitute, which allowed for reduction of variability of results caused by biological differences. MATERIAL AND METHODS A foot model mirroring natural anatomy was made from synthetic bone and a silicone soft tissue substitute with the same hardness as that of the soft tissues of the foot. Two types of 11 mm Ti6Al4V titanium alloy implants were studied, namely, a rectangular subtalar screw and a cylindrical subtalar screw, a type commonly used in flatfoot reconstruction surgery in children. The screws were placed in the sinus tarsi and subjected to cyclic loading (up to 1,000,000 cycles at a frequency of 5 Hz, with a maximum load of 500 N). Comparative pull-out force tests were performed immediately following implantation and after the dynamic loading test. Wyniki. Following the dynamic loading test, all 12 samples were qualified for the pull-out force test. Cylindrical screws demonstrated higher pull-out force values both for the samples tested immediately following implantation and for those that underwent dynamic loading. Implants of the same shape did not show statistically significant differences in the Mann-Whitney U test (p >0.05). Wniosek. The synthetic research model produces reproducible results in the assessment of risk of implant migration. Long-term loading does not significantly affect the risk of implant migration.
{"title":"Migration of Subtalar Implants in Paediatric Flatfoot Correction: A Pilot Study in Synthetic Bone Models.","authors":"M. Kwiatkowski, T. Guszczyn, A. Sobolewski, M. Sar, A. Hermanowicz","doi":"10.5604/01.3001.0015.8374","DOIUrl":"https://doi.org/10.5604/01.3001.0015.8374","url":null,"abstract":"BACKGROUND\u0000Subtalar implant migration as a complication following subtalar arthroeresis has been described in the scientific literature. However, clinical studies do not allow for unequivocally determining the underlying causes. The aim of the study is to determine the risk of migration of two geometric types of subtalar implants. Biomechanical tests were carried out on a synthetic bone model with a soft tissue substitute, which allowed for reduction of variability of results caused by biological differences.\u0000\u0000\u0000MATERIAL AND METHODS\u0000A foot model mirroring natural anatomy was made from synthetic bone and a silicone soft tissue substitute with the same hardness as that of the soft tissues of the foot. Two types of 11 mm Ti6Al4V titanium alloy implants were studied, namely, a rectangular subtalar screw and a cylindrical subtalar screw, a type commonly used in flatfoot reconstruction surgery in children. The screws were placed in the sinus tarsi and subjected to cyclic loading (up to 1,000,000 cycles at a frequency of 5 Hz, with a maximum load of 500 N). Comparative pull-out force tests were performed immediately following implantation and after the dynamic loading test. Wyniki. Following the dynamic loading test, all 12 samples were qualified for the pull-out force test. Cylindrical screws demonstrated higher pull-out force values both for the samples tested immediately following implantation and for those that underwent dynamic loading. Implants of the same shape did not show statistically significant differences in the Mann-Whitney U test (p >0.05). Wniosek. The synthetic research model produces reproducible results in the assessment of risk of implant migration. Long-term loading does not significantly affect the risk of implant migration.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"58 1","pages":"121-132"},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88489772","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}
Pub Date : 2022-02-28DOI: 10.5604/01.3001.0015.7806
Piotr Godek
BACKGROUND The PRP method is widely used to support healing and regeneration in musculoskeletal and aesthetic medicine. The current literature, however, brings contradictory reports as to its effectiveness, which, at least in part, should be attributed to the diversity of methods for producing the concentrate, including the use of various volumes of whole blood, single vs double centrifugation vs filtration, use of thrombin vs calcium chloride to activate the process, and, finally, the use of an anticoagulant. The aim of the study was to retrospectively evaluate the effectiveness of high-volume PRP therapy with the Angel® system (Arthrex) in our patients. MATERIAL AND METHODS A total of 400 therapies were performed on 299 patients. The most frequently represented indications were knee osteoarthritis (OA), n = 164, including mild (n = 30), moderate (n = 38), and advanced (n = 96) stage; lumbar degenerative disc disease (LDDD), n = 54; rotator cuff injuries (RCI), n = 52; lumbar spinal stenosis (LSS), n = 37; cervical degenerative disc disease (CDDD), n = 17; and shoulder OA, n = 12. Therapies for LDDD and LSS patients were additionally divided with respect to the route of administration (periradicular vs epidural). The assessment tool was the modified Macnab scale. Follow-up examinations were performed at two and six months after PRP administration. Indicators of treatment success were defined as the percentage of satisfactory results and the percentage ratio of satisfactory results to non-satisfactory results after 2 and 6 months of follow-up (S/NS2 and S/NS6). For the advanced stage of knee OA, the results were compared in three age groups (under 66, 67-73 and over 74). RESULTS For the entire treatment group, the mean S/NS2 ratio was 1.56; in the group of the most frequently represented indications, the highest satisfaction ratio was obtained in LDDD (2.84), and the lowest in the group of RCI (0.96). The mean value of the S/ NS6 ratio was 2.24, being the highest in mild knee OA (4.79) and CDDD (4.67), and the lowest in shoulder OA (0.72). In the age group over 74 years, the frequency of non-satisfactory results shows an increase in patients with advanced knee OA. CONCLUSIONS 1. High-volume PRP therapy can be used as a local regenerative and anti-inflammatory treatment, demonstrating the highest efficacy in early knee OA and CDDD. 2. High PRP therapy demonstrates a high safety profile. 3. The final effects of the therapy develop over a period of several months of follow-up and depend on the severity of the degenerative process and the patient's age.
背景PRP方法在肌肉骨骼和美容医学中广泛用于支持愈合和再生。然而，目前的文献对其有效性提出了相互矛盾的报告，这至少在一定程度上应归因于生产浓缩物的方法的多样性，包括使用不同体积的全血，单离心与双离心与过滤，使用凝血酶与氯化钙来激活该过程，最后，使用抗凝血剂。该研究的目的是回顾性评估Angel®系统(Arthrex)大容量PRP治疗在我们患者中的有效性。材料与方法299例患者共接受400种治疗。最常见的适应症是膝关节骨性关节炎(OA)， n = 164，包括轻度(n = 30)、中度(n = 38)和晚期(n = 96);腰椎退行性椎间盘病变(LDDD)， n = 54;肩袖损伤(RCI)， n = 52;腰椎管狭窄症(LSS)， n = 37;颈椎退行性椎间盘病变(CDDD)， n = 17;肩关节OA, n = 12。LDDD和LSS患者的治疗方法根据给药途径(神经根周围vs硬膜外)进行了额外的划分。评估工具为改良Macnab量表。在PRP给药后2个月和6个月进行随访检查。治疗成功指标定义为随访2个月和6个月后满意结果的百分比和满意结果与不满意结果的百分比之比(S/NS2和S/NS6)。对于晚期膝关节OA，比较三个年龄组(66岁以下、67-73岁和74岁以上)的结果。结果整个治疗组的S/NS2平均值为1.56;在表现最频繁的适应症组中，LDDD的满意度最高(2.84)，RCI最低(0.96)。S/ NS6比值平均值为2.24，其中轻度膝关节OA最高(4.79)，CDDD最高(4.67)，肩关节OA最低(0.72)。在74岁以上的年龄组中，不满意结果的频率在晚期膝关节关节炎患者中有所增加。大剂量PRP治疗可作为局部再生和抗炎治疗，在早期膝关节OA和CDDD中显示出最高的疗效。2. 高PRP治疗具有较高的安全性。3.治疗的最终效果需要几个月的随访，取决于退行性过程的严重程度和患者的年龄。
{"title":"High Volume PRP Therapy.","authors":"Piotr Godek","doi":"10.5604/01.3001.0015.7806","DOIUrl":"https://doi.org/10.5604/01.3001.0015.7806","url":null,"abstract":"BACKGROUND\u0000The PRP method is widely used to support healing and regeneration in musculoskeletal and aesthetic medicine. The current literature, however, brings contradictory reports as to its effectiveness, which, at least in part, should be attributed to the diversity of methods for producing the concentrate, including the use of various volumes of whole blood, single vs double centrifugation vs filtration, use of thrombin vs calcium chloride to activate the process, and, finally, the use of an anticoagulant. The aim of the study was to retrospectively evaluate the effectiveness of high-volume PRP therapy with the Angel® system (Arthrex) in our patients.\u0000\u0000\u0000MATERIAL AND METHODS\u0000A total of 400 therapies were performed on 299 patients. The most frequently represented indications were knee osteoarthritis (OA), n = 164, including mild (n = 30), moderate (n = 38), and advanced (n = 96) stage; lumbar degenerative disc disease (LDDD), n = 54; rotator cuff injuries (RCI), n = 52; lumbar spinal stenosis (LSS), n = 37; cervical degenerative disc disease (CDDD), n = 17; and shoulder OA, n = 12. Therapies for LDDD and LSS patients were additionally divided with respect to the route of administration (periradicular vs epidural). The assessment tool was the modified Macnab scale. Follow-up examinations were performed at two and six months after PRP administration. Indicators of treatment success were defined as the percentage of satisfactory results and the percentage ratio of satisfactory results to non-satisfactory results after 2 and 6 months of follow-up (S/NS2 and S/NS6). For the advanced stage of knee OA, the results were compared in three age groups (under 66, 67-73 and over 74).\u0000\u0000\u0000RESULTS\u0000For the entire treatment group, the mean S/NS2 ratio was 1.56; in the group of the most frequently represented indications, the highest satisfaction ratio was obtained in LDDD (2.84), and the lowest in the group of RCI (0.96). The mean value of the S/ NS6 ratio was 2.24, being the highest in mild knee OA (4.79) and CDDD (4.67), and the lowest in shoulder OA (0.72). In the age group over 74 years, the frequency of non-satisfactory results shows an increase in patients with advanced knee OA.\u0000\u0000\u0000CONCLUSIONS\u00001. High-volume PRP therapy can be used as a local regenerative and anti-inflammatory treatment, demonstrating the highest efficacy in early knee OA and CDDD. 2. High PRP therapy demonstrates a high safety profile. 3. The final effects of the therapy develop over a period of several months of follow-up and depend on the severity of the degenerative process and the patient's age.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"170 1","pages":"43-60"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77494165","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}
Pub Date : 2022-02-28DOI: 10.5604/01.3001.0015.7800
Serhii O. Bezruchenko, Oleksii Dolhopolov, M. Yarova, R. Luchko, V. Mazevych
BACKGROUND The aim was to improve the diagnosis of acromioclavicular joint dislocation by studying the capabilities and characteristics of clinical and instrumental diagnostic methods. The idea is expressed that modern clinical and instrumental diagnostic methods comprise a large number of techniques, but no single algorithm for diagnosing injury to the AC joint has been developed. A gold standard for investigating and diagnosing acute AC joint dislocation does not currently exist. MATERIALS AND METHODS A retrospective study of the characteristics and capabilities of clinical and instrumental diagnostic methods was performed in 152 patients with traumatic shoulder pathology. The patients were divided into two groups: Group I of 102 patients (67%) with acromioclavicular joint dislocation type III-VI according to Rockwood classification and Group II of 50 patients (33%) with a partial tear of the rotator cuff. Clinical and instrumental examinations involved specific provocative tests; the radiological diagnostics comprised conventional radiographs with the Zanca, axillary and Alexander views, and CT, MRI, and ultrasound examinations. RESULTS The characterization of examination methods was based on the records of patients in Group I and II. The most sensitive clinical test to establish Rockwood type V of acromioclavicular joint dislocation was the Paxinos test (91%). The lowest sensitivity across the tests used was observed with the active compression test to diagnose type IV of dislocation (50%). As regards the X-ray examination, the axial view was 100% sensitive for detecting type IV and VI AC joint dislocation. The Zanca view is highly sensitive for patients with Rockwood type V and Alexander view for Rockwood type III and V dislocations. The accuracy of ultrasound work-up in Group I was 95%, with 96% sensitivity and 93% specificity, while MRI accuracy was 97%, with 96% sensitivity and 98% specificity, and CT accuracy was 81%, with 83% sensitivity and 75% specificity. CONCLUSIONS 1. Determination of the sensitivity and specificity of the X-ray examination revealed the absence of a 100% effective X-ray view for type III and V AC joint dislocation. 2. The accuracy and sensitivity of the ultrasound, MRI, and CT examinations are high. 3. There is currently no consensus on a protocol to view acute AC joint injuries. 4. Complete and timely early diagnosis of acromioclavicular dislocation allows for a diffe-rentiated approach to surgical treatment tactics, preventing possible complications and restoring the function of the injured shoulder joint to the fullest extent.
{"title":"Clinical Evaluation and Instrumental Diagnostics in Acute Acromioclavicular Joint Dislocation.","authors":"Serhii O. Bezruchenko, Oleksii Dolhopolov, M. Yarova, R. Luchko, V. Mazevych","doi":"10.5604/01.3001.0015.7800","DOIUrl":"https://doi.org/10.5604/01.3001.0015.7800","url":null,"abstract":"BACKGROUND\u0000The aim was to improve the diagnosis of acromioclavicular joint dislocation by studying the capabilities and characteristics of clinical and instrumental diagnostic methods. The idea is expressed that modern clinical and instrumental diagnostic methods comprise a large number of techniques, but no single algorithm for diagnosing injury to the AC joint has been developed. A gold standard for investigating and diagnosing acute AC joint dislocation does not currently exist.\u0000\u0000\u0000MATERIALS AND METHODS\u0000A retrospective study of the characteristics and capabilities of clinical and instrumental diagnostic methods was performed in 152 patients with traumatic shoulder pathology. The patients were divided into two groups: Group I of 102 patients (67%) with acromioclavicular joint dislocation type III-VI according to Rockwood classification and Group II of 50 patients (33%) with a partial tear of the rotator cuff. Clinical and instrumental examinations involved specific provocative tests; the radiological diagnostics comprised conventional radiographs with the Zanca, axillary and Alexander views, and CT, MRI, and ultrasound examinations.\u0000\u0000\u0000RESULTS\u0000The characterization of examination methods was based on the records of patients in Group I and II. The most sensitive clinical test to establish Rockwood type V of acromioclavicular joint dislocation was the Paxinos test (91%). The lowest sensitivity across the tests used was observed with the active compression test to diagnose type IV of dislocation (50%). As regards the X-ray examination, the axial view was 100% sensitive for detecting type IV and VI AC joint dislocation. The Zanca view is highly sensitive for patients with Rockwood type V and Alexander view for Rockwood type III and V dislocations. The accuracy of ultrasound work-up in Group I was 95%, with 96% sensitivity and 93% specificity, while MRI accuracy was 97%, with 96% sensitivity and 98% specificity, and CT accuracy was 81%, with 83% sensitivity and 75% specificity.\u0000\u0000\u0000CONCLUSIONS\u00001. Determination of the sensitivity and specificity of the X-ray examination revealed the absence of a 100% effective X-ray view for type III and V AC joint dislocation. 2. The accuracy and sensitivity of the ultrasound, MRI, and CT examinations are high. 3. There is currently no consensus on a protocol to view acute AC joint injuries. 4. Complete and timely early diagnosis of acromioclavicular dislocation allows for a diffe-rentiated approach to surgical treatment tactics, preventing possible complications and restoring the function of the injured shoulder joint to the fullest extent.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"8 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86602439","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}
Pub Date : 2022-02-28DOI: 10.5604/01.3001.0015.7802
V. Sulyma, T. Kovalyshyn, Andrii Sribniak, Roman Bihun, V. Krasnovskyi, Yu.O. Filiak
BACKGROUND Clinically, functional instability (FI) of metacarpophalangeal joints (MCPJ) is not considered to represent a pathology. This excessive mobility can be detected by the application of external forces to a MCPJ at different angles. Our study aimed to measure the FI of 2nd to 5th MCPJ. MATERIALS AND METHODS A group of 36 healthy right-handed individuals were enrolled. The value of FI was measured in millimeters and verified by a CT scan. Statistical calculations was made in Statistica v.10.0. RESULTS The largest values of the right and left-hand finger posterior displacement (FI) in the second to fifth MCPJ were obtained in the neutral position 0° (p<0.05). Measurements of volar displacement of the proximal phalanx second to fifth MCPJs in both hands revealed higher values at position 0° (p<0.05). CONCLUSIONS 1. FI of the second to fifth MCPJs is determined by anatomical configuration and dynamic stabilizers. 2. Instability measurements show that posterior displacement of the proximal phalanges is greater by at least 1 mm in the 0° neutral position.
{"title":"Functional Instability of the Second to Fifth Metacarpophalangeal Joints.","authors":"V. Sulyma, T. Kovalyshyn, Andrii Sribniak, Roman Bihun, V. Krasnovskyi, Yu.O. Filiak","doi":"10.5604/01.3001.0015.7802","DOIUrl":"https://doi.org/10.5604/01.3001.0015.7802","url":null,"abstract":"BACKGROUND\u0000Clinically, functional instability (FI) of metacarpophalangeal joints (MCPJ) is not considered to represent a pathology. This excessive mobility can be detected by the application of external forces to a MCPJ at different angles. Our study aimed to measure the FI of 2nd to 5th MCPJ.\u0000\u0000\u0000MATERIALS AND METHODS\u0000A group of 36 healthy right-handed individuals were enrolled. The value of FI was measured in millimeters and verified by a CT scan. Statistical calculations was made in Statistica v.10.0.\u0000\u0000\u0000RESULTS\u0000The largest values of the right and left-hand finger posterior displacement (FI) in the second to fifth MCPJ were obtained in the neutral position 0° (p<0.05). Measurements of volar displacement of the proximal phalanx second to fifth MCPJs in both hands revealed higher values at position 0° (p<0.05).\u0000\u0000\u0000CONCLUSIONS\u00001. FI of the second to fifth MCPJs is determined by anatomical configuration and dynamic stabilizers. 2. Instability measurements show that posterior displacement of the proximal phalanges is greater by at least 1 mm in the 0° neutral position.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"6 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89315575","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}
Pub Date : 2022-02-28DOI: 10.5604/01.3001.0015.7801
Anna Kierońska, Elżbieta Oliwko, Magdalena Babuśka-Roczniak, B. Brodziak-Dopierała, W. Widuchowski, W. Roczniak
BACKGROUND Supracondylar humerus fractures are a serious problem in children. The complicated anatomy of the elbow joint necessitates careful assessment of the damage before individually adapting treatment methods. The aim of the study was to evaluate the effectiveness of comprehensive treatment of children in Group A in relation to children in Group B. Moreover, the impact of rehabilitation on the function of the affected elbow joint was examined. MATERIALS AND METHODS The study enrolled 40 children divided into two groups: Group A and Group B. In Group A, the dominant method of treatment was percutaneous K-wire stabilization. The results demonstrate that the use of this treatment method and the implementation of systematic rehabilitation made it possible to achieve very good results. In Group B, stabilization was performed in less than half of the children and rehabilitation was carried out at home. The initial and follow-up examinations were carried out in both groups according to a medical test card. In Group A, the initial examination was performed on the day the rehabilitation commenced, and the follow-up examination after the completion of a 10-day rehabilitation cycle. In Group B, the initial examination was carried out after immobilization was removed and a follow-up examination was performed after 3 weeks of home-based rehabilitation. RESULTS The treatment model used in Group A was more effective than the model used in Group B. CONCLUSIONS 1. Correct repositioning, the use of percutaneous K-wire stabilization and elbow rehabilitation performed at the earliest possible time give very good functional results. 2. The use of percutaneous stabilization shortens the hospitalization period, which is of great importance in the treatment of young patients.
{"title":"Tentative Assessment of Treatment of Supracondylar Humerus Fractures in Children.","authors":"Anna Kierońska, Elżbieta Oliwko, Magdalena Babuśka-Roczniak, B. Brodziak-Dopierała, W. Widuchowski, W. Roczniak","doi":"10.5604/01.3001.0015.7801","DOIUrl":"https://doi.org/10.5604/01.3001.0015.7801","url":null,"abstract":"BACKGROUND\u0000Supracondylar humerus fractures are a serious problem in children. The complicated anatomy of the elbow joint necessitates careful assessment of the damage before individually adapting treatment methods. The aim of the study was to evaluate the effectiveness of comprehensive treatment of children in Group A in relation to children in Group B. Moreover, the impact of rehabilitation on the function of the affected elbow joint was examined.\u0000\u0000\u0000MATERIALS AND METHODS\u0000The study enrolled 40 children divided into two groups: Group A and Group B. In Group A, the dominant method of treatment was percutaneous K-wire stabilization. The results demonstrate that the use of this treatment method and the implementation of systematic rehabilitation made it possible to achieve very good results. In Group B, stabilization was performed in less than half of the children and rehabilitation was carried out at home. The initial and follow-up examinations were carried out in both groups according to a medical test card. In Group A, the initial examination was performed on the day the rehabilitation commenced, and the follow-up examination after the completion of a 10-day rehabilitation cycle. In Group B, the initial examination was carried out after immobilization was removed and a follow-up examination was performed after 3 weeks of home-based rehabilitation.\u0000\u0000\u0000RESULTS\u0000The treatment model used in Group A was more effective than the model used in Group B.\u0000\u0000\u0000CONCLUSIONS\u00001. Correct repositioning, the use of percutaneous K-wire stabilization and elbow rehabilitation performed at the earliest possible time give very good functional results. 2. The use of percutaneous stabilization shortens the hospitalization period, which is of great importance in the treatment of young patients.","PeriodicalId":19622,"journal":{"name":"Ortopedia, traumatologia, rehabilitacja","volume":"78 1","pages":"13-22"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75000207","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}
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