Biomedical subjects
Publications and source records attributed to D Palczewski.
The authors present a case of 75-year old female, who has suffered from venous insufficiency crural ulcerations and lost hope for any relief for 50 years. Hospitalisation for a femur fracture has been a turning point. The patient learnt that modern medicine can treat disease that she suffered from for most of her life.
The Department of Orthopedics and Traumatology in Siedlce was responsible for specialized care of 662,000 people of the Siedleckie region in 1997. In the period from 01.01.97 to 31.12.97, 280 osteoporotic fractures of proximal femur, vertebral bodies and distal radius were treated in patients over 50 years of age. High impact trauma cases were excluded as well as those involving different than osteoporotic pathology of bone. The majority (217) of the fractures referred to the proximal femur (trochanter--125, neck--92). In these cases, operational methods (183) were used: Ender intramedullary nailing (108), hemialloplastics (56), hip screws (19). There were 39 patients hospitalized with the distal radius fracture, 29 of them were operated. The fractures of the vertebral bodies (24) were stabilized with Jewett brace (21). The results of osteoporotic fracture treatment in the Department support validity of principles of early operational treatment and intensive pre- and postoperative rehabilitation.
The authors analyzed 307 cases of osteoporotic fractures of proximal femur, distal radius and vertebral bodies treated in the Department of Orthopedics and Traumatology in Siedlce in 1997. The majority (243) of the fractures referred to the proximal femur. They were treated operatively (202) by Ender intramedullary nailing, hemialloplastics or fixation with hip screws. There were 40 patients hospitalized with the distal radius fracture, 29 of them were operated. The fractures of the vertebral bodies (24) were stabilized with Jewett brace or plaster jacket. When analyzing costs of hospital treatment of osteoporotic fractures, the authors considered the number of patients, the period of hospital stay and the number and type of surgeries. Higher costs of the therapy of osteoporotic fractures in comparison with the treatment of other cases in the orthopedic-traumatic ward were proven.
The authors present the results of treatment of cervical spine injuries with cervical dislocation with out neurological impairment afflicting 22 patients between 17-92 (average 42) years old. The patients were treated with a skeletal traction for 6 weeks and a Minerwa plaster jacket for next 6 weeks. Than a cervical collar was worn for 6-9 months. The results of treatment were good in 10 patients.
A series of 34 patients (21 males, 13 females aged 16 to 85 years) served to assess Partridge fracture stabilization method. The method was employed always with some other mode of fixation. Twenty-eight patients had primary long bone shaft fracture, in 6 cases refracture occurred in the course of treatment with different method or resulted from intraoperative complication. In authors' opinion Partridge method is best combined with intramedullar fixation, extends indications for the latter and is recommended in atypical surgical situations. Good clinical results were achieved and no bony union disturbances were observed.
The authors have showed a short nosography about carpal tunnel syndrome. History of research and treatment, pathogenesis, basic subjective and objective symptoms enabling diagnosis have been presented. Electromyography is a very important investigation to make a proper diagnosis. In differentiation between other diseases radicular syndromes of upper limb are very important, as they give similar symptoms and often are reasons of incorrect diagnosis and inappropriate treatment.
Analysis of some diagnostic mistakes in carpal tunnel syndrome has been discussed in relation to similar symptoms.
A case of 45 years old male with infected pseudoarthrosis of the tibia, 4 cm shortening of the limb involved, complicated with ipsilateral distal femur fracture is reported. Ilizarov apparatus was used to address whole pathology. At 8 months follow-up good clinical and radiological result is achieved--the fracture and pseudoarthrosis united, the leg is lengthened by 4 cm.
Early results of treatment for tibial condyles fractures in 39 patients are presented. Mean follow-up was 12 months (range 6-14 months), mean patient age was 54 years (range 37-74). Tibial plateau depression smaller than 5 mm was managed conservatively (15 cases). In 23 patients surgery was performed within 7 days from injury. It consisted of subchondral osteotomy and application of frozen cancellous bone graft. The extremity was immobilized in plaster of paris cast for 8 weeks. Bad results in 2 cases were attributed to previous degenerative changes. The authors claim good functional results after reconstructive surgery with the use of frozen cancellous bone grafts.
Pre and post-operative rehabilitation protocol used in 76 patients with femoral neck fracture treated with Austin-Moore hip plasty is presented. The age of patients ranged from 68 to 91 years (mean 79 years). They were operated on average 5 days after admission (range 1-16 days). The authors emphasize role of rehabilitation leading to regaining of ambulating skills by the operated patient. It also decreases the number of pulmonary and psychoorganic complications, shortens hospital stay. Cardiac infarct and pulmonary vein embolism were causes of two fatalities in postoperative period. Mean hospital stay was 22 days.
Two cases of long bone shaft fracture at the border of previously implanted AO bone plate treated with Zespol fixator are presented. Good fixation was achieved with AO plate left in place and Zespol platform screws introduced in place of removed AO screws. These two methods can be combined in exceptional cases.
Early results of vertebral body fracture reduced with Watson-Jones method in 31 cases have been presented. After the reduction the height and shape of the vertebrae has improved. Delayed treatment rendered the worst results. The mean degree of reduction in material analyzed was 61%.
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