Polish Orthopedics & Traumatology

Proper design and functioning of the hip joint ensure smooth motion over the full range in multiple planes. Any change in this arrangement may lead to joint damage, causing deformation, pain and loss of functionality. Hip replacement is a procedure intended to replace the damaged articular surfaces and replacing them with artificial components. However, as any surgical intervention, it carries the risk of serious complications. One of them are isolated stem fractures, consisting of breaking the implant inside the intramedullary canal without damaging the surrounding tissue...

BACKGROUND: Fractures of the femoral bone shaft during and after hip arthroplasty are a serious clinical problem. CASE REPORT: The paper presents the use of rapid computer modeling FEM 2D to optimize the stabilization of femoral shaft fracture in case of hip revision arthroplasty. CONCLUSIONS: Using the FEM modeling may be helpful for planning and assessment of orthopaedic treatment in similar cases.

Whiplash injuries, also known as neck sprains and strains, are currently some of the most common injuries of the cervical spine. Mechanism of injury is still controversial and current treatment methods do not provide satisfactory results. In this article we present QTF classification of related disorders, epidemiological data and treatment methods. We described basic principles of using a soft collar, goals and effects of collar use and potential complications ensuing from immobilization. Authors reviewed publications comparing the effects of collar use with other methods of treatment and physiotherapy following whiplash injury...

BACKGROUND: Fatigue (slow) fractures are a result of cyclic burden on the affected bones. At the same time, regeneration processes are disturbed or appropriate mechanical environment to promote healing is lacking. Fatigue fractures are classified into two types: stress fractures and deficiency fractures. The former occur as a result of excessive training in healthy individuals with normal bone structure, e.g. in sportsmen and soldiers. Deficiency-related fractures are most common in individuals with metabolic disorders that affect bone mineralization, such as osteomalacia or osteoporosis...

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated...

BACKGROUND: Distal femur fractures are relatively rare injuries that usually require surgical treatment. Angular-stable plates allowing for anatomical repositioning and stable fixation of splinters, particularly in articular fractures, are commonly used in such cases. The goal of the study was to analyze the outcomes of the surgical treatment of high-energy articular fractures of distal femur. MATERIAL AND METHODS: The study included 22 patients treated in years 2007-2013...

Fractures of calcaneus are the most common among all tarsal bone fractures. Such injuries are most often produced by large forces, while accompanying soft tissue trauma makes them complicated and difficult to treat. Due to complex structure of the foot and talocalcaneal joint all injuries to this area constitute an important orthopedic problem, as improper treatment or lack thereof leads to gait impairment, particularly with regard to moving on uneven surface. In this work we presented the problem of intraarticular calcaneal fractures with particular consideration paid to methods of its treatment...

This article presents advantages and disadvantages associated with percutaneous, noninvasive repair of Achilles tendon rupture. We presented most widely known procedures, such as Ma/Griffith, Web/Banister, McCleland/Maffulli, Carmont and Assal Achillon suture system, as well as several other less known surgical techniques. We performed a review of literature with regard to possible complications, including sural nerve damage, possibilities of broadening those techniques to include arthroscopic as well as ultrasound imaging, and proposed a scheme of patient management after surgery...

BACKGROUND: We reported on a case of a giant-cell tumor of the patella which occurred in a skeletally immature patient. This combination of unusual age of presentation and atypical location made our case clinically and radiologically unique. CASE REPORT: A 13-year-old girl presented with complains of knee pain and swelling. After radiological investigations and percutaneous needle biopsy a diagnosis of giant-cell tumor of the patella was made, for which the patient underwent patellectomy with en bloc resection of the lesion and the diagnosis was confirmed by histopathological examination...

BACKGROUND: Severe, multitissue hand injuries constitute a serious problem of the modern world. Despite investing significant funds in their management these injuries often exclude young people from professional life. It is often due to improper management conducted by untrained personnel lacking appropriate instruments. The goal of this work is to review the literature on the problem and attempt to organize this information. MATERIAL/METHODS: A review of available literature on mutilating hand trauma, amputations in the hand region, replantation and scales used for assessment of the severity of injury and hand function, both in Poland and internationally...

BACKGROUND: Traumatic femoral head fracture without dislocation with ipsilateral intertrochanteric fracture is an extremely rare injury and has not been reported in the literature. CASE REPORT: We reported a case of simultaneous ipsilateral femoral head and intertrochantric fracture without dislocation of the hip in a 74-year-old woman. The patient presented with a history of road traffic accident. Radiographs and computerised tomography scans revealed a right intertrochantric fracture and femoral head fracture without dislocation of the hip...

BACKGROUND: Reconstruction is the method of choice in the treatment of ACL rupture. Postoperative rehabilitation is a very important aspect of therapeutic management. One of priority elements is to regain proper strength and function of the quadriceps muscle in a short time. The aim of this study was to estimate the dynamics of the increase in strength and girth of quadriceps after ACL reconstruction. MATERIAL AND METHODS: The examined group consisted of 30 patients who had undergone arthroscopic assisted quadruple bundle dual channel ACL reconstruction surgery in years 2010-2011...

BACKGROUND: Carpal tunnel syndrome is traditionally treated with open release through a long palmar incision, which leaves some patients with pillar pain and scar tenderness. The Knifelight (Stryker, Kalamazoo, MI) is an exciting new instrument that allows minimally invasive release of the transcarpal ligament without subjecting the patient to the traditional problematic open palmar incision. However, no long-term data has been published in the literature so far. MATERIAL AND METHODS: A modified QuickDASH score questionnaire was used to assess long-term results and patient satisfaction 10 years following our department's original randomized control trial comparing open carpal tunnel release (43 patients) to carpal tunnel release using the Knifelight method (39 patients)...

In throwing sports shoulder is exposed to enormous and often repetitive overloads. Some sports (contact sports) are also connected with direct trauma. We are thus dealing with traumatic injuries, overload and degenerative damage. The article discusses the most frequent injuries of the shoulder characteristic for throwing sports. These are mainly disorders of arm rotation, internal impingement, lesion of the labrum (SLAP) and rotator cuff tears (PASTA).

The article discusses the biomechanical processes that occur during an overhead throw. This activity is highly specialized and requires full and proper function from the shoulder joint. It consists of active and passive stabilization and synchronous work of the accelerating and decelerating muscles. The process of the overhead throw can be divided into several phases that differ from each other in biomechanical parameters and involvement of specific muscles.

Additional suture anchor fixation to coracoclaviculer area with precountered distal clavicle locking plate allows an anatomic reduction with bone-bone contact and gives additional neutralisation effect with coracoclavicular suture anchor fixation against the trapezius muscle pulling effect .Event though the effeciency of this technique reported by other authors,still there is a few articles and cases reported.In the terms of proving the efficiency of the combination technique we would like to stress to contribute the published article by Haque et al...

Abstract Chronic algodystrophy is difficult to treat, because the disease in this stage is usually resistant to many therapies. It particularly concerns conditions with predominant severe, intractable pain and disability of the involved extremity. In these, the severest cases, searching for effective pain control therapy is extremely important. Intravenous ketamine infusions constitute a promising therapy, which appeared recently. Ketamine possesses properties of blocking central sensitization and development of neuropathic pain through its effect on NMDA receptor, a critical factor in this process...

We present a review of the current literature and the author's opinion regarding Septic arthritis in the pediatric age group. The etiopathogenesis, clinical features, the laboratory parameters for diagnosis and monitoring of treatment, radiological features, are discussed along-with the debatable issues pertaining to the choice of antibiotics, their duration, and the need and mode of surgical drainage and mobilization of the joint.

BACKGROUND: We present a case series of 3 patients who underwent a novel technique of tight rope fixation for Neer type II distal clavicle fracture. MATERIAL AND METHODS: 2-3 cm incision was made lateral to the fracture site moving inferomedially. Part of the distal end of clavicle was exposed close to fracture site and further dissection was carried out to reveal the coracoid process. Tight rope fixation of the distal ends of clavicle and coracoid was performed to achieve satisfactory fracture reduction on x-ray...

BACKGROUND: Galeazzi fractures are a rare injury to occur in adults, which are typically associated with high energy trauma. To our knowledge, the reported cases in the literature have only been associated with motor vehicle accidents, falls from a height, or athletic endeavors. The application of the force in the setting of a Galeazzi fracture has been disputed, but it is believed to occur with the wrist in hyperextension and pronation. CASE REPORT: We describe a 27-year-old male who presented with multiple gunshot wounds that included his right forearm...