Chirurgia narzadow ruchu i ortopedia polska最新文献

This article describes a rare case of primary synovial chondromatosis of the hip associated with active tuberculosis of the hip. Twenty four years old patient underwent total hip replacement at our institution. No reactivation of the infection was detected in the four-years follow-up. Clinical and radiological evaluation of our material showed that joint space widening may be the first sign in synovial chondromatosis of the hip. Importantly, if the tuberculosis infection is suspected we have to take the material for bacteriological investigation, regardless of others, obvious diagnosis.

Total hip arthroplasty is commonly used way for treatment of degenerative changes of a hip joint. Continuous progress of medicine enables use of more and more modern implants, that are supposed to provide to patients comfortable and painless motility. Nevertheless, with increasing number of implanted endoprostheses, rising numer of loosened impants is observed. Proper laboratory dignostics and postoperative proceedings as well as systematic follow up with standard X-ray scans allow for early recognition of loosened prostheses and implementation of surgical procedure. In the article two-stage method for treatment of septic loosened primary total hip arthroplasties applied in CMKP Orthopedic Clinic in Otwock, Poland as well as results of treatment of selected cases are presented.

Oral bisphosphonates are currently known as medicines of a first choice in the treatment of osteoporosis and in preventing age-related fractures. However, despite their advantages, these medicines are not free of limitations. The most significant one is a complicated way of tablet administration, requiring from patients to remain upright position and to take a tablet before a meal. This may make the administration of other, chronic medicines, such as thyroid hormones, more difficult. Complications of the therapy include dyspepsia and gastrointestinal disorders. Approximately 48% of individuals taking bisphosphonates once a week resign from therapy within one year from the beginning of the treatment. There is a group of individuals who cannot take bisphosphonates orally at all. The alternative here is an intravenous injection. Therefore, there is a need for modifications of the existing therapeutic standards for osteoporosis. It is also necessary to emphasise the significance of intravenous medicines in the treatment of this disease.

Rheumatoid arthritis (RA) is a chronic disease with many somatic, psychological and social consequences. Somatic consequences are connected mainly with increasing levels of negative emotions such as depression, anxiety and a tendency to react with anger to many daily life situations. Additionally, loss of hope has been reported as another effect of rheumatoid arthritis. The goal of the study was to describe anxiety levels and its determinants in RA patients. The study was carried out on 31 RA patients, 22 (71%) of whom were females and 9 (29%) of whom were males. The respondents were assessed with a set of questionnaires such as Spielberger's State-Trait Anxiety Inventory (STAI), Multidimensional Health Locus of Control Scale (MHLC), The Coping Inventory for Stressful Situations (CISS) and Eysenck's Personality Questionnaire - Revised (EPQ-R). We have found the relationship between anxiety as (1) a state and external locus of control - powerful others (tau-b = 0.23, p = 0.09), task - oriented style of coping (tau-b = -0.34, p = 0.01), emotion-oriented style of coping (tau-b = 0.33, p = 0.02) and neuroticism levels (tau-b = 0.29, p = 0.03) and (2) anxiety as a trait and external locus of control - powerful others (tau-b = 0.40, p = 0.01), task - oriented style of coping (tau-b = 0.36, p = 0.01), emotion-oriented style of coping (tau-b = 0.33, p = 0.02) and neuroticism levels (tau-b = 0.47, p = 0,01).

Introduction: Modem indications for use of cemented or uncemented implants in revision hip arthroplasty are comparable. The use of bone cement provides predictable short term results, but the lack of osteointegration deteriorates its long term durability. Uncemented implants undergo osteointegration, but reduced contact with host bone may cause early loosening. Modular porous tantalum implants are highly osteointegrative, and the availability of bone stock augments increases the versatility of this system.

Material and methods: The study group consisted of 20 patients (21 hips) who underwent a revision hip arthroplasty using Trabecular Metal acetabular revision system. The follow-up period was between 7 and 31 months (average 20 months). All patients were evaluated with HHS and conventional radiography.

Results: The mean HHS increased form40.45 (range 18.74-56.65) preoperatively to 78.8 (56.5-96) at the last follow-up. No mechanical failures, nor septic complications were noted.

We described a case of 64 year old overweight women, who was treated with revision tibio-talo-calcaneal artrodesis with the use of retrograde intramedullary nail. The procedure was performed after failed primary arthrodesis with the use of lateral approach and fibula osteotomy. Stabilization with intramedullary nail gave good clinical and functional result with a good bone healing.

Introduction: Spine pain is a serious clinical problem of physically active people and sportplayers . The pain may have different nature, related to different segments of the spine. Its intensity and frequency may impair the functionality of man. Most back pain is connected with the lumbo-sacral and cervical part of a spine. MAIN AIM: The hypothesis was: 1) That there were not any weak links of biokinematics chain. 2) Pain feeling in young players in the lumbar spine (LBP). The aim of this study was to determine in which direction and location the most weak links would occur in biokinematics chain and whether it was correlated with gender. In addition, it was examined whether a correlation between the weak links' presence in the lumbar spine and the occurrence of LBP existed and if it was connected with gender of the player.

Materials and methods: This study involved 40 players from Walcz School Sports Championships, including the twenty kayakers (8 women and 12 men), 13 canoeists and 7 rowers. The average age of players was 16.00 +/- 0.99, mean of training years was 4.92 +/- 2.20. Low threshold Performance Matrix tests were used for assessing the presence of weak links. Through analysis and identification of performed movement the weakest links in the biokinetics chain were found. Numeric scale was used for the evaluation of lumbar pain (LBP). The results were statistically analyzed.

Results: The main characteristics of statistical and graphical presentations were performed for the received values of weak links. The hypothesis of variances equality was verified, and all the hypotheses mentioned above were also verified using ANOVA analysis of variations and Tukey test for low threshold of weak links.

Conclusion: 1) The presence of weak links of biokinematics chain was found in all players especially in the lumbar spine, the presence is not associated with gender. Most weak links in the lumbar part occurred in the direction of rotation. 2) There is a correlation of the weak links of the lumbar spine and LBP, but it is not connected with gender. 3) The relationship between pain suffering in the lumbar spine (LBP) and the number of weak links of biokinematics chain was defined.

Introduction: The increase of the number of the multiple traumatic injuries is related to social factors, such as: the development of industry, the change of life style and the conditions of work, the manner and the speed of relocation and the biological factors related with the elongation of life time. According to the World Health Organization data the injuries are one of the main health problems in the world.

Aim: The clinical analysis of multitrauma patients treated due to the septic complications of the fractures.

Material and methods: The material consists of 34 multitrauma patients treated in The Osteomyelitis and Septic Complications Unit in Prof. A. Gruca Orthopedic and Trauma Hospital in Otwock, Poland between 2005 and 2010. The cause of trauma, the timing of arrival to our unit, the number of the days of treatment, the number and the specificity of bone and internal injuries, the bacteriology of bone infections and operative techniques and pharmacologic treatment were analyzed.

Results: The causes of the injuries were: road accident (79%), fall from the height (8.8%), others (12.2%). The first stay in our unit was 21 months after the injury on average (1-129 months), the number of stays in the unit was 2,8 on average (1-6), the length of stay was 25.7 days on average (4-108 days). In analyzed group of 34 patients, we found: 12 opened fractures of single bone, 11 opened fractures of more than one bone, 22 closed fractures of single bone, 12 closed fracture of more than one bone. Central nervous system (55.9%), abdominal organs (35.3%) and thorax (29.4%) were the most common internal organs ocuppied with the injury. Osteomyelitis was the most frequently diagnosed in femur (50%) and tibia (41.2%). The main reasons of bone infection were: Methycylin-Sensitive Staphylococcus Aureus (35,3%), Methycylin-Resistant Staphylococcus Aureus (17,3%), Pseudomonas aeruginosa (23,5%), Escherichia coli, Acinetobacter baumani, Enterococcus faecalis. The following treatment was undertaken: the debridement of septic bone, usually together with the removal of the hardware stabilization (73,5%), the removal of the damaged or improperly fixed stabilization (44%), the conversion of the internal fixation into the external fixation(62%). All the patients were taken intravenous antibiotics according to The Hospital Commission for Preventing of Infections, i.e. 2nd generation cephalosporin and gentamycin. Culture directed antibiotics were started after receiving the bacteriology results. The outcomes. The control of infection in 14 patients (41.3%), 18 patients (52.9%) still remain under the treatment, bad outcome (persistent infection, amputation of a extremity) we had in 2 patients.

Conclusions: Multiple traumatic injury and its immunologic consequences predispose to systemic infections including bone infections. Posttraumatic osteomyelitis is the indi

Background: An observation of patients suffering from carpal tunnel syndrome shows distinct overweight, short stature and relatively thick hands in majority of them. Objective of this study was evaluation of the relationship of anthropometric and anatomical factors related to the hand with incidence of the syndrome.

Patients and methods: The anthropometric measurements of body weight and height, as well as anatomical of wrist girth, hand length and volume were performed in 105 patients, 84 women (80%) and 21 men (20%), aged a mean of 59 years, with idiopathic carpal tunnel syndrome. The same examinations were made in a control group consisting of 105 healthy individuals, age and gender matched.

Results: Statistically significant differences (t-Student or U Mann-Whitney test, p < 0,05) were noted in all considered variables: patients with carpal tunnel syndrome were heavier (of a mean of 6%), shorter (of 1,5%) and had of a mean of 9% greater body mass index. They had also statistically significantly greater hand volume (of 13%), hand length (of 2%) and wrist girth (of 5%). Although all variables were statistically significantly greater in a study group, the clinically meaningful were considered only differences of hand volume, wrist girth, body weight and body mass index.

Conclusion: Individuals with overweight and with thicker than average hands and wrists are more predisposed to carpal tunnel syndrome.

Aim: Two hypothesis were lunched: 1) three month segmental stabilization training (TSS) has the influence on reducing the number of weak connections in biokinematics chain in hockey players; 2) three month training has influence on reducing the pain perception in low back of a spine (LBP) in players. This work has been undertaken to estimate the usefulness of the low Performance Matrix threshold tests.Furthermore, the correlationbetween segmental stabilization training and the number of weak connections in biokinematics chain in hockey players has been tested.

Materials and methods: 12 players-hockey champions of Poland and vice-champions of Europe took part in the conducted research. An average age of a group is 30 +/- 5.03 years, an average training period 20.83 +/- 5.65 months. The low Performance Matrix threshold tests were used for weak connection assessment. Through analysis and identification of a performed motion the weakest connections of biokinematics chain have been found. The test were undertaken at the beginning of the research and it was repeated after 3 month. The players were advised to continue the segmental stabilization training for 3 months. Assessment of Low Back Pain (LBP) was undertaken by using the numerical scale. LBP was tested at the beginning of the project and after 3 months. The results were tested by using statistic analysis.

Results: For obtained weak links based statistical characteristics were gained before and after the TSS training. Two hypothesis have been tested: the first is about variance equality, the second has been settled to confirm that weak links before TSS training have the bigger values than weak links after TSS training. Next the correlation between weak connections before TSS training and after TSS training was determined. Variance analysis was done for regression.

Conclusions: 1) Three month segmental stabilization training (TSS) has the influence on reducing the number weak connections in biokinematics chain in hockey players. 2) Three month training has influence on reducing the pain perception in lower back of a spine (LBP) in players. 3) Performance Matrix low threshold tests have occurred to be a diagnostic tool due to which the quality of motor control can be assessed successfully in hockey players. 4) The correlation between segmental stabilization training and reducing of motor system's weak connection was found for hockey players.