Pub Date : 2019-02-28DOI: 10.31139/chnriop.2019.84.1.05
J. Poszepczyński, A. Kaźmierczyk, Krzysztof Andrzejewski, Łukasz Okulski, R. Grabowski, J. Lesman, Marcin Domażalski
{"title":"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","authors":"J. Poszepczyński, A. Kaźmierczyk, Krzysztof Andrzejewski, Łukasz Okulski, R. Grabowski, J. Lesman, Marcin Domażalski","doi":"10.31139/chnriop.2019.84.1.05","DOIUrl":"https://doi.org/10.31139/chnriop.2019.84.1.05","url":null,"abstract":"","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48141699","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 : 2019-01-04DOI: 10.31139/chnriop.2018.83.6.40
G. Kandzierski, P. Jakubowski, Marcin Romanowicz, Radosław Kałakucki
Despite the discontinuation of non-surgical treatment of children with DDH, the development of the hip after a few years or a decade or so turned out to be correct in about 50% of the subjects. The authors present examples and analyze the reasons for effective stimulation of the acetabulum roof and proximal femoral roof growth zones in these children. They emphasize that after a closed reduction, the femoral head does not press against the edge of the roof, thus allowing it to grow. Similarly, the growth zones of the proximal femur after reduction have become active again, and the femoral head has a spherical shape fitted to the acetabulum. However, in a few-year-old children with a developmental dislocation of the hip, the femoral head shows deformations similar to those observed in tibial epiphysis in Blount’s disease.
{"title":"An attempt to explain the causes of hip development normalization in children with developmental dislocation, whose parents discontinued non-surgical treatment","authors":"G. Kandzierski, P. Jakubowski, Marcin Romanowicz, Radosław Kałakucki","doi":"10.31139/chnriop.2018.83.6.40","DOIUrl":"https://doi.org/10.31139/chnriop.2018.83.6.40","url":null,"abstract":"Despite the discontinuation of non-surgical treatment of children with DDH, the development of the hip after a few years or a decade or so turned out to be correct in about 50% of the subjects. The authors present examples and analyze the reasons for effective stimulation of the acetabulum roof and proximal femoral roof growth zones in these children. They emphasize that after a closed reduction, the femoral head does not press against the edge of the roof, thus allowing it to grow. Similarly, the growth zones of the proximal femur after reduction have become active again, and the femoral head has a spherical shape fitted to the acetabulum. However, in a few-year-old children with a developmental dislocation of the hip, the femoral head shows deformations similar to those observed in tibial epiphysis in Blount’s disease.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47672241","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 : 2019-01-04DOI: 10.31139/chnriop.2018.83.6.42
B. Jasiewicz, M. Tęsiorowski, T. Potaczek, W. Kącki
Introduction. Among various modern systems of limb lengthening, lengthening with an intramedullary nail seems to be most modern and comfortable for the patient. The aim of this study was to evaluate the femur lengthening with a self-distracting intramedullary skeletal kinetic distractor (ISKD). Material and methods. This is a retrospective study, conducted in one hospital and involved 10 patients with a mean age of 15.9 years. All patients underwent femur lengthening with an ISKD nail. The mean follow-up period was 38.7 months. We evaluated: gained length; treatment duration; healing index; problems, obstacles and complications during treatment; and the final result. At the last visit, we assessed the condition of the knee joint and daily performance. Results. Mean femur lengthening was 5.7 cm. Mean treatment duration was 7.8 months and mean distraction index was 1.4 months/cm. The main problems and obstacles were related to the initial nail distraction, occurring in 5 patients: ineffective distraction occurred in 4 of the patients and distraction was too rapid in 1 patient. Delayed union was observed in 1 patient. The most common problems reported by the patients were: limping, different thigh circumference, slight difficulties with squatting, and occasional knee pain during great effort accompanied by the feeling of instability. Conclusions. Intramedullary nail lengthening seems an effective method of limb equalization in teenagers and young adults, although patients should be warned that distraction with an intramedullary nail would not result in achieving perfect limb function.
{"title":"Femur lengthening with a telescopic ISKD nail – long-term clinical and radiological results","authors":"B. Jasiewicz, M. Tęsiorowski, T. Potaczek, W. Kącki","doi":"10.31139/chnriop.2018.83.6.42","DOIUrl":"https://doi.org/10.31139/chnriop.2018.83.6.42","url":null,"abstract":"Introduction. Among various modern systems of limb lengthening, lengthening with an intramedullary nail seems to be most modern and comfortable for the patient. The aim of this study was to evaluate the femur lengthening with a self-distracting intramedullary skeletal kinetic distractor (ISKD). Material and methods. This is a retrospective study, conducted in one hospital and involved 10 patients with a mean age of 15.9 years. All patients underwent femur lengthening with an ISKD nail. The mean follow-up period was 38.7 months. We evaluated: gained length; treatment duration; healing index; problems, obstacles and complications during treatment; and the final result. At the last visit, we assessed the condition of the knee joint and daily performance. Results. Mean femur lengthening was 5.7 cm. Mean treatment duration was 7.8 months and mean distraction index was 1.4 months/cm. The main problems and obstacles were related to the initial nail distraction, occurring in 5 patients: ineffective distraction occurred in 4 of the patients and distraction was too rapid in 1 patient. Delayed union was observed in 1 patient. The most common problems reported by the patients were: limping, different thigh circumference, slight difficulties with squatting, and occasional knee pain during great effort accompanied by the feeling of instability. Conclusions. Intramedullary nail lengthening seems an effective method of limb equalization in teenagers and young adults, although patients should be warned that distraction with an intramedullary nail would not result in achieving perfect limb function.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69597423","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 : 2019-01-04DOI: 10.31139/CHNRIOP.2018.83.6.44
I. Babiak, P. Pędzisz, J. Janowicz, P. Małdyk
According to current views, infection around the orthopedic implant and in chronic osteomyelitis is associated with the development of a bacterial biofilm, which is a barrier to systemic administered antibiotics. This results in the inability to cure the infection with systemic antimicrobial therapy because the doses guaranteeing activity in the biofilm will be toxic to the patient. The antibiotic concentration effective against bacteria in the biofilm can be achieved by local administration. The main advantage of local antibiotic carriers is the local release of drugs in high concentrations that exceed those achievable after systemic administration, but without systemic toxicity. The vehicle should provide a high local concentration of antibiotic above the minimal inhibitory con- centrations (MIC) for the most common pathogens an should be effective against sedentary forms of bacteria. It can not impair the regeneration of bone tissue and the biological integration of the implant with the bone. Carriers that are both a substitute for bone and have osteoconductive or osteoinductive properties protect the bone from re-infection and promote the reconstruction of cavernous defects. Local carriers of antibacterial drugs may be absorbable or non-absorbable and depending on physico-chemical properties include 6 classes of biomaterials. Local carriers of antibacterial substances are currently being and will probably remain the treatment of choice of infections of orthopedic implants and osteomyelitis.
{"title":"Antimicrobial biomaterials in the prevention and local treatment of infection in orthopedics","authors":"I. Babiak, P. Pędzisz, J. Janowicz, P. Małdyk","doi":"10.31139/CHNRIOP.2018.83.6.44","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2018.83.6.44","url":null,"abstract":"According to current views, infection around the orthopedic implant and in chronic osteomyelitis is associated with the development of a bacterial biofilm, which is a barrier to systemic administered antibiotics. This results in the inability to cure the infection with systemic antimicrobial therapy because the doses guaranteeing activity in the biofilm will be toxic to the patient. The antibiotic concentration effective against bacteria in the biofilm can be achieved by local administration. The main advantage of local antibiotic carriers is the local release of drugs in high concentrations that exceed those achievable after systemic administration, but without systemic toxicity. The vehicle should provide a high local concentration of antibiotic above the minimal inhibitory con- centrations (MIC) for the most common pathogens an should be effective against sedentary forms of bacteria. It can not impair the regeneration of bone tissue and the biological integration of the implant with the bone. Carriers that are both a substitute for bone and have osteoconductive or osteoinductive properties protect the bone from re-infection and promote the reconstruction of cavernous defects. Local carriers of antibacterial drugs may be absorbable or non-absorbable and depending on physico-chemical properties include 6 classes of biomaterials. Local carriers of antibacterial substances are currently being and will probably remain the treatment of choice of infections of orthopedic implants and osteomyelitis.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69597876","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 : 2019-01-04DOI: 10.31139/chnriop.2018.83.6.41
G. Kandzierski, Marcin Romanowicz, J. Kałakucki, T. Madej, V. Opoka-Winiarska
Assuming the mechanical significance of injuries in the etiopathogenesis of Osgood-Schlatter and Sever-Haglund diseases, it should be recognized that the areas susceptible to damage in growing apophyses are the growth zones and the newly formed bone. The SMI Doppler ultrasound (visualization of microvascular flows) helps to determine the precise location of the lesion, i.e. the area of the greater vascular microflow within the involved apophyses. The ultrasound examination revealed increased microflows within the growth zones of painful apophyses. On the “healthy” side, no microflows were observed. Relief of pain in the tibial tuberosities and the heel correlated with a marked reduction in the vasculature of the previously painful outgrowths. The authors suggest that as regards the imaging studies in Osgood-Schlatter and Sever-Haglund diseases, in the future, the most crucial method may be with Doppler ultrasound with microvascular visualization.
{"title":"Remarks on the etiopathogenesis and diagnosis in Osgood-Schlatter and Sever-Haglund diseases based on the Doppler ultrasound of apophyses","authors":"G. Kandzierski, Marcin Romanowicz, J. Kałakucki, T. Madej, V. Opoka-Winiarska","doi":"10.31139/chnriop.2018.83.6.41","DOIUrl":"https://doi.org/10.31139/chnriop.2018.83.6.41","url":null,"abstract":"Assuming the mechanical significance of injuries in the etiopathogenesis of Osgood-Schlatter and Sever-Haglund diseases, it should be recognized that the areas susceptible to damage in growing apophyses are the growth zones and the newly formed bone. The SMI Doppler ultrasound (visualization of microvascular flows) helps to determine the precise location of the lesion, i.e. the area of the greater vascular microflow within the involved apophyses. The ultrasound examination revealed increased microflows within the growth zones of painful apophyses. On the “healthy” side, no microflows were observed. Relief of pain in the tibial tuberosities and the heel correlated with a marked reduction in the vasculature of the previously painful outgrowths. The authors suggest that as regards the imaging studies in Osgood-Schlatter and Sever-Haglund diseases, in the future, the most crucial method may be with Doppler ultrasound with microvascular visualization.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69597651","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 : 2019-01-04DOI: 10.31139/CHNRIOP.2018.83.6.43
Tomasz Pitera, G. Guzik, Piotr Biega, Marta Tarczyńska-Osiniak, K. Gawęda
Introduction. Resection arthroplasty of the knee is frequently used in patients with bone tumours. Rehabilitation plays an important role in optimizing the functioning of the patients. The aim of this study was to asses treatment and physical performance outcomes after modular prosthesis surgery and to demonstrate rehabilitation methods. Material and methods. A total of 36 resections of the tumours localized in the knee joint region, followed by modular prosthetic replacement, were performed at the Orthopaedic Oncology Department in Brzozów between 2014-2016. Females accounted for 47% of the group. The mean age of the patients were 60 years (range: 36-78 years). All the patients were rehabilitated according to the own protocol. The physical performance was assessed using the MSTS. The intensity of pain was measured with the use of the VAS (Visual Analogue Scale). Results. 24 MUTARS and 12 GMRS prostheses were implanted. The implants were fixed with bone cement in 7 (20%) cases and cementless in 29 (80%) cases. Six weeks following surgery, the mean functional status was 21,6 points (72%), the mean pain intensity assessed with the VAS was 4,2 points and 19 (53%) patients could walk without aid of crutches and unassisted by others. Conclusions. Modular prosthesis implantation provides good functional results. The rehabilitation procedure presented in our study positively affects the functional outcome. Postoperative complications were scarce.
{"title":"Resection arthroplasty of the knee – early treatment outcomes and rehabilitation efficiency","authors":"Tomasz Pitera, G. Guzik, Piotr Biega, Marta Tarczyńska-Osiniak, K. Gawęda","doi":"10.31139/CHNRIOP.2018.83.6.43","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2018.83.6.43","url":null,"abstract":"Introduction. Resection arthroplasty of the knee is frequently used in patients with bone tumours. Rehabilitation plays an important role in optimizing the functioning of the patients. The aim of this study was to asses treatment and physical performance outcomes after modular prosthesis surgery and to demonstrate rehabilitation methods. Material and methods. A total of 36 resections of the tumours localized in the knee joint region, followed by modular prosthetic replacement, were performed at the Orthopaedic Oncology Department in Brzozów between 2014-2016. Females accounted for 47% of the group. The mean age of the patients were 60 years (range: 36-78 years). All the patients were rehabilitated according to the own protocol. The physical performance was assessed using the MSTS. The intensity of pain was measured with the use of the VAS (Visual Analogue Scale). Results. 24 MUTARS and 12 GMRS prostheses were implanted. The implants were fixed with bone cement in 7 (20%) cases and cementless in 29 (80%) cases. Six weeks following surgery, the mean functional status was 21,6 points (72%), the mean pain intensity assessed with the VAS was 4,2 points and 19 (53%) patients could walk without aid of crutches and unassisted by others. Conclusions. Modular prosthesis implantation provides good functional results. The rehabilitation procedure presented in our study positively affects the functional outcome. Postoperative complications were scarce.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69598162","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 : 2019-01-04DOI: 10.31139/CHNRIOP.2018.83.6.46
Piotr Bargieł, Norbert Czapla, J. Petriczko, D. Kotrych, Wojciech Zacha, Szczepan Juszkiewicz, Dariusz Lusina, Piotr Prowanas
{"title":"Thermography in the diagnosis of musculo-skeletal disorders","authors":"Piotr Bargieł, Norbert Czapla, J. Petriczko, D. Kotrych, Wojciech Zacha, Szczepan Juszkiewicz, Dariusz Lusina, Piotr Prowanas","doi":"10.31139/CHNRIOP.2018.83.6.46","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2018.83.6.46","url":null,"abstract":"","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47274911","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 : 2019-01-04DOI: 10.31139/chnriop.2018.83.6.45
T. Goryń, Bone Sarcoma, Poland Melanoma, A. Pieńkowski, A. Komor, P. Teterycz, S. Svensson, M. Zdzienicki, I. Ługowska, P. Rutkowski
Primary bone tumors are relatively rare but their diagnosis and treatment is difficult and connected with a high risk of complications. The most common primary bone sarcoma is the osteosarcoma, which in Poland it constitutes about 1% of all bone neoplasms and less than 1% of all malignancies. It is confirmed that the inappropriately performed diagnosis and treatment in soft sarcoma negatively influences patients survival but data about bone tumor are limited. The goal of this study is a retrospective evaluation of the influence of unplanned surgical excision of osteosarcoma on long treatment result. We have analyzed 299 patients with osteosarcoma treated in the years 1998-2016 at the Maria Skłodowska Curie Institute – Oncology Centre in Warsaw. The median observation period was 60 months. Patients were divided into groups: in first group patients were referred to our center with suspicion of osteosarcoma and the whole process of diagnosis and treatment was made there, in the second group biopsy was made outside referral center, and patients were sent to our center after histopathology result and in the third group patients were diagnosed and treated outside of a referral unit in an unplanned manner. The effects of treatment were significantly better if the biopsy and treatment were performed in the referral unit or biopsy was made in a local clinic and then patients were treated in referred center – the 5 year OS rate was 49%. Patients who were admitted to the referral center after biopsy and improper treatment in regional hospital (“whoops operations”) had a 5 year overall survival rate of 27%; p=0.011. During initial diagnostics, patients with suspicion of osteosarcoma on medical imaging, should be sent to referral center to obtain the correct diagnosis and treatment, which gives them the best chances for long survival and avoiding disability.
{"title":"The effects of unplanned surgical intervention on the long-term treatment outcomes of patients with osteosarcoma","authors":"T. Goryń, Bone Sarcoma, Poland Melanoma, A. Pieńkowski, A. Komor, P. Teterycz, S. Svensson, M. Zdzienicki, I. Ługowska, P. Rutkowski","doi":"10.31139/chnriop.2018.83.6.45","DOIUrl":"https://doi.org/10.31139/chnriop.2018.83.6.45","url":null,"abstract":"Primary bone tumors are relatively rare but their diagnosis and treatment is difficult and connected with a high risk of complications. The most common primary bone sarcoma is the osteosarcoma, which in Poland it constitutes about 1% of all bone neoplasms and less than 1% of all malignancies. It is confirmed that the inappropriately performed diagnosis and treatment in soft sarcoma negatively influences patients survival but data about bone tumor are limited. The goal of this study is a retrospective evaluation of the influence of unplanned surgical excision of osteosarcoma on long treatment result. We have analyzed 299 patients with osteosarcoma treated in the years 1998-2016 at the Maria Skłodowska Curie Institute – Oncology Centre in Warsaw. The median observation period was 60 months. Patients were divided into groups: in first group patients were referred to our center with suspicion of osteosarcoma and the whole process of diagnosis and treatment was made there, in the second group biopsy was made outside referral center, and patients were sent to our center after histopathology result and in the third group patients were diagnosed and treated outside of a referral unit in an unplanned manner. The effects of treatment were significantly better if the biopsy and treatment were performed in the referral unit or biopsy was made in a local clinic and then patients were treated in referred center – the 5 year OS rate was 49%. Patients who were admitted to the referral center after biopsy and improper treatment in regional hospital (“whoops operations”) had a 5 year overall survival rate of 27%; p=0.011. During initial diagnostics, patients with suspicion of osteosarcoma on medical imaging, should be sent to referral center to obtain the correct diagnosis and treatment, which gives them the best chances for long survival and avoiding disability.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69597986","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 : 2018-10-30DOI: 10.31139/CHNRIOP.2018.83.5.35
J. Poszepczyński
The study was aimed to assess the outcomes of the operative procedure applied in the patients with the femoral neck fracture, treated with the Targon FN system, manufactured by Aesculap, and identify relationships between the outcome of treatment of the femoral neck fracture, patient’s body mass, length of the period between the moment of injury and surgery, age of patient, prescribed medications. Study criteria were met by 19 patients aged between 25 and 87 and the average follow-up time was 20 months. Over the period between the surgery time and the study time, 3 patients died. The diagnosed complications included fracture below the implant (plate), aseptic necrosis of the femoral head, pseudarthrosis of the femoral neck and deep vein thrombosis. The joint functionality was assessed using the Harris Hip Score, where excellent and good results accounted for 70 per cent of all results. Given the low-invasiveness of the surgery, this is a recommendable method that allows for the preservation of the patient’s hip joint, early rehabilitation and bringing patient to the vertical position. Complications were primarily diagnosed in the patients who had a postponed surgery, i.e. over 4 days after the injury involving 31B3 fracture according to AO.
{"title":"Analysis of complications resulting from femoral neck fracture treatment using Targon FN system","authors":"J. Poszepczyński","doi":"10.31139/CHNRIOP.2018.83.5.35","DOIUrl":"https://doi.org/10.31139/CHNRIOP.2018.83.5.35","url":null,"abstract":"The study was aimed to assess the outcomes of the operative procedure applied in the patients with the femoral neck fracture, treated with the Targon FN system, manufactured by Aesculap, and identify relationships between the outcome of treatment of the femoral neck fracture, patient’s body mass, length of the period between the moment of injury and surgery, age of patient, prescribed medications. Study criteria were met by 19 patients aged between 25 and 87 and the average follow-up time was 20 months. Over the period between the surgery time and the study time, 3 patients died. The diagnosed complications included fracture below the implant (plate), aseptic necrosis of the femoral head, pseudarthrosis of the femoral neck and deep vein thrombosis. The joint functionality was assessed using the Harris Hip Score, where excellent and good results accounted for 70 per cent of all results. Given the low-invasiveness of the surgery, this is a recommendable method that allows for the preservation of the patient’s hip joint, early rehabilitation and bringing patient to the vertical position. Complications were primarily diagnosed in the patients who had a postponed surgery, i.e. over 4 days after the injury involving 31B3 fracture according to AO.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47832861","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 : 2018-10-30DOI: 10.31139/chnriop.2018.83.5.38
M. Kulig, I. Babiak, P. Pędzisz, R. Górski, S. Żarek, P. Małdyk
Chronic active tibia osteomyelitis accompanied by soft tissue defects with exposed bone, infected pseudoarthrosis or pathological fractures are a recon- structive challenge to the orthopedic surgeon. We present a case of a 68 year-old patient with chronic tibia osteomyelitis associated with a wound exposing tibia diaphysis. The successful local debridement and reaming of a tibia followed by local antibiotic delivery and cross-leg flap transfer from opposite tibia with stabilization of lower extremities with Ilizarov fixator was achieved in two stages. After 14 months the patient is free from infection and skin defect, able walk with full weight bearing. We consider securing of cross-leg flap with stabilization of lower extremities with Ilizarov fixator as relevant for successful reconstructive procedure for soft tissue defect over tibia in cases of osteomyelitis not suitable for local or microsurgical flap.
{"title":"Fasciocutaneous cross leg flap combined with stabilization of lower extremities with Ilizarov fixator as a effective salvage procedure for treatment of soft tissue defects with infection and exposure of tibia – case report","authors":"M. Kulig, I. Babiak, P. Pędzisz, R. Górski, S. Żarek, P. Małdyk","doi":"10.31139/chnriop.2018.83.5.38","DOIUrl":"https://doi.org/10.31139/chnriop.2018.83.5.38","url":null,"abstract":"Chronic active tibia osteomyelitis accompanied by soft tissue defects with exposed bone, infected pseudoarthrosis or pathological fractures are a recon- structive challenge to the orthopedic surgeon. We present a case of a 68 year-old patient with chronic tibia osteomyelitis associated with a wound exposing tibia diaphysis. The successful local debridement and reaming of a tibia followed by local antibiotic delivery and cross-leg flap transfer from opposite tibia with stabilization of lower extremities with Ilizarov fixator was achieved in two stages. After 14 months the patient is free from infection and skin defect, able walk with full weight bearing. We consider securing of cross-leg flap with stabilization of lower extremities with Ilizarov fixator as relevant for successful reconstructive procedure for soft tissue defect over tibia in cases of osteomyelitis not suitable for local or microsurgical flap.","PeriodicalId":89713,"journal":{"name":"Polish orthopedics and traumatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69597535","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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