Polish Orthopedics & Traumatology

BACKGROUND: Male breast cancer (MBC) represents a rare cause of vertebral body compression fractures along with severe pain restricting the patient's daily functioning. Limited number of cases, lack of awareness among patients and physicians leading to delayed management, further increase the average age and disease progression at presentation, resulting in a poor prognosis. Additionally, studies on MBC treatment protocols and the use of female algorithms are unavailable. The implementation of vertebroplasty or kyphoplasty often results in unsatisfactory outcome due to recurrent pain and loss of vertebral height...

BACKGROUND: Radial head fractures are one of the more common fractures of the body, and the most common fractures around the elbow. CASE REPORT: While these can present in isolation, concomitant injuries to the ulna, elbow joint and surrounding ligaments, interosseous membrane, proximal radioulnar joint, and distal radioulnar joint can also occur. It is imperative that the treating surgeon rules out any concomitant injuries when evaluating a patient with a radial head fracture as the treatment options vary greatly depending on the structures which are damaged...

BACKGROUND: Chordoma is a rare tumor originating from the remnants of the notochord. The tumor is known as locally aggressive with a strong tendency for recurrence rather than metastasis. CASE REPORT: We reported on a case of a 47-year-old Caucasian male with a history of sacral chordoma with metastasis to the cicatrix. CONCLUSIONS: Skin involvement in chordoma is uncommon but, according to literature, possible. Nevertheless, to our knowledge, there were no reports on incisional chordoma...

BACKGROUND: Dysplasia epiphysealis hemimelica, also known as Trevor-Fairbanks disease, is a rare developmental disorder The objective of this article is to present own observations and experience in treating patients with dysplasia epiphysealis hemimelica. MATERIAL AND METHODS: Six children with dysplasia epiphysealis hemimelica were treated in years 1990-2007. The mean age of observation was 8.5 years (from 3 to 19 years). Analysis of medical and radiological documentation of patients was performed to collect data on symptoms, disease location, management and outcomes...

Systemic and chronic diseases frequently affect function of many organs and systems, not only those from which they derive. The hand is a very complicated structure in the human body and its normal activity is related to undisturbed function of many factors. Therefore, the hand is frequently exposed to harmful effects of systemic diseases. The article reports on disorders and functional disturbances of the hand that, more frequently than in an average population, accompany selected systemic diseases: rheumatoid arthritis, gout, and scleroderma...

BACKGROUND: Many various surveys are used to assess quality of life of patients with hip osteoarthritis, but none of them evaluates quality of life dependent on a single joint in bilateral disease. Aim. Development and preliminary validation of hip-specific quality of life survey (HSS) of patients with hip osteoarthritis. MATERIAL AND METHODS: A group of experts developed the final version of HSS questionnaire in 4 stages. Statistical analysis was conducted on 181 preoperative and postoperative HSS questionnaires completed by patients undergoing hip replacement surgery due to hip osteoarthritis...

The usual causes of injury to sciatic nerve during total hip replacement are intraoperative direct nerve injury, significant leg lengthening, improper retractor placement, cement extravasation, cement-related thermal damage, patient positioning, manipulation and postoperative hematoma. We present a case of early sciatic nerve injury with entrapment of sciatic nerve around the prosthetic femoral neck following repeated manipulation of dislocated total hip replacement. This case emphasises the importance of soft tissue in dealing with orthopedic problem...

Algodystrophy occurs in children significantly less frequently than in adults. Symptomatology, course, responsiveness to treatment and prognosis of the pediatric disease is also different from the "adult" form. This paper presents substantial peculiarities of pediatric algodystrophy: it occurs after relatively minor trauma, involves lower limb more frequently than upper limb and presents with pain, paleness and coldness of the skin in the affected part, as well as with serious functional impairment. Diagnosis of the condition is based on clinical grounds and no imaging is necessary to confirm the diagnosis...

BACKGROUND: Ceramic-on-ceramic articulation presents advancement in the development modern of hip prostheses. It is particularly important for young patients, in whom complications related with polyethylene damages and metalosis pose a serious clinical problem due to the long period of implant functioning. The aim of this study was to assess the effect of total cementless hip replacement using an implant with a ceramic insert embedded in a metal cup and large prosthetic head constituting a ceramic-on-ceramic system in patients with hip osteoarthritis...

BACKGROUND: Anterior knee pain (AKP) is a frequent serious clinical problem after anterior cruciate ligament (ACL) reconstruction, regardless of the graft material used. The author conducted prospective studies of the correlation between AKP and disturbed geometry of patello-femoral joint observed in magnetic resonance imaging (MRI), in patients with injured ACL reconstructed with the use of hamstrings. MATERIAL AND METHODS: The study included 60 patients (34 males and 26 females), at the mean age of 31, who underwent ACL reconstruction with flexors...

BACKGROUND: Therapeutic management of proximal humerus fractures is still controversial. There are several ways of proceeding in these cases, ranging from conservative treatment to shoulder joint arthroplasty. Open surgical reduction and stabilization with a locking compression plate is currently the most widely used method of treatment, especially in younger patients. The purpose of this study is to analyze the results of surgical treatment of fractures of the proximal humerus using locking compression plates...

BACKGROUND: Rotator cuff (RC) tear is one of the most common disorders affecting the shoulder. Acromioclavicular (AC) joint arthritis is an equally common pathology of the shoulder. The coexistence of both disorders is common, although RC tear is more frequently the cause of shoulder pain than AC joint arthritis. The purpose of this study was to compare the results of arthroscopic treatment of RC tear and simultaneous resection of symptomatic AC joint with arthritis. MATERIAL/METHODS: We retrospectively evaluated 40 patients who underwent arthroscopic RC repair between January 2008 and December 2009...

The incidence of carpal tunnel syndrome in pregnant women reported in the literature varies from 2 to 70%. Hormonal fluctuations, fluid accumulation with tendency to oedemas, nerve hypersensitivity and glucose level fluctuations are factors that predispose pregnant women to the development of symptoms. The syndrome is rarely a matter of concern, as the symptoms are mild and no treatment is needed in majority of patients. The diagnosis is basically clinical and electrodiagnostic or sonographic testing provides no meaningful diagnostic aid...

BACKGROUND: The objective of this study is to compare the results of microbiological examinations of two types of materials: specimens collected intraoperationally upon removal of prostheses following septic loosening and cultures from sonicated implants. The study was the effect of collaboration between the Clinic of Orthopedics of A. Gruca Hospital in Otwock and the Department of Microbiology in Lublin. MATERIAL AND METHODS: The study population consisted of 24 patients aged 39 to 84 years, average of 68 years, undergoing surgeries at the Department of Bone and Joint Inflammation, Clinic of Orthopedics of A...

BACKGROUND: The amount and diversity of scientific publications requires a modern management system. By "management" we mean the process of gathering interesting information for the purpose of reading and archiving for quick access in future clinical practice and research activity. In the past, such system required physical existence of a library, either institutional or private. Nowadays in an era dominated by electronic information, it is natural to migrate entire systems to a digital form...

BACKGROUND: Calcaneal fracture is a most common bony injury of the hindfoot. In constitutes 60% of foot fractures and 1-2% of all fractures. According to current literature 75% of these fractures involve articular surfaces, which makes them especially difficult to treat. Intraarticular fractures often result in permanent disability impairing foot function and ambulation, sometimes due to inadequate treatment method. According to literature, in developed countries open reduction and internal plate fixation is standard treatment of intraarticular calcaneal fractures...

BACKGROUND: In this study we have compared the femoral component alignment in primary cemented THR performed by a single surgeon using the same implant by trochanteric osteotomy and posterior approach in 50 consecutive cases. MATERIAL AND METHODS: The femoral component was compared in sagital and coronal planes on plane X-rays. The femoral stem position was classified as neutral, varus or valgus in the sagital plane. In the coronal plane the femoral stem was graded as neutral, stem pointing anteriorly or stems pointing posteriorly...

BACKGROUND: This publication compares the results of physiotherapy after total hip replacement in two groups, each consisting of 50 subjects, differing in age by 10 years. MATERIAL AND METHODS: A group of 100 patients after total hip replacement was divided into two subgroups consisting of 50 subjects each, with mean age difference of 10 years. The first group included patients aged 47-60 years, the other 61-69 years. Patients were assessed at 6 weeks and reevaluated at 10 weeks after surgery during a 4-week in-hospital rehabilitation program...

This paper presents the technique used in anterior cruciate ligament(ACL) reconstruction using the ring finger flexor digitorum superficialis tendon (FDS IV). The biologic material used in autografts and allografts is subject of controversy. Due to this some authors suggest using synthetic materials. All the authors agree that the use of biological material harvested from the vicinity of the knee joint can cause further dysfunction of this joint(weakening) It would seem that use of a biological material harvested from another part of body would be the optimal solution for ACL reconstruction...

Anatomical variability of sacral bone as well as its diverse interpretations a surgical field prompted the authors to modify surgical technique in such manner to allow unequivocal identification of a starting point for introduction of transpedicular screws into the first sacral vertebra. The starting point is not located, as described in previous publications, inferiorly and laterally to the S1 articular process, but goes through a precisely defined place in the dorsal ridge of superior articular process following its partial resection...