http://www.ortopedia.com.plTable of contents Wolumin 14, 2012 Numer 1.en-usCopyright 2012 by the Ortopedia Traumatologia Rehabilitacjahttp://www.ortopedia.com.pl/rssIndexCopernicus Journal Management System RSS GENERATORwebmaster@www.ortopedia.com.pl (ADM)Wed, 29 Feb 2012 00:00:00 ESThttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976893The process of skeletal muscle regeneration comprises four phases: degeneration, inflammatory and immune response, regeneration and remodelling, which are regulated by a number of molecules secreted, by muscle cells and immune, epithelial, interstitial and other cells present in skeletal tissue. The molecules include cytokines, growth factors, erythropoietin, enzymes, and reactive oxygen and nitrogen species (RONS). Some of them are potent stimulators of the proliferation and growth of muscle cells while others may inhibit these processes. For several years, cytokines and growth factors have been used in regenerative medicine in the form of platelet concentrate or recombinant preparations. There have also been attempts to use muscle cells and muscle-derived stem cell (MDSC) cultures, which contain satellite glial cells, mesoanglioblasts and pericytes, as well as cultures of isolated satellite glial cells or myoblasts. The aim of the paper is to present current knowledge concerning the molecular and cellular mechanisms of regeneration and remodelling of skeletal muscles, the role of cytokines and growth factors in the proliferation of satellite glial cells and the possibilities of therapeutic use of stem cells of different origin for stimulating regeneration of damaged muscle fibres. Agnieszka Zembroń-Łacny , Jarosław Krzywański , Joanna Ostapiuk-Karolczuk , Anna Kasperska Review articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976893http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976906Caffey-Silverman syndrome, or infantile hyperostosis, is a rare condition of unclear etiology and pathogenesis affecting the skeletal system and the surrounding soft tissues. It is characterized by indurated swelling of soft tissues and cortical bone hyperostosis. The changes are usually multiple and affect such parts as the mandible, scapulae, ribs, clavicles, and forearm and shank bones. When long bones are affected, the lesions are typically limited to shafts, with the sparing of meta- and epiphyses. The prognosis is usually good and, in most patients, the changes resolve spontaneously after several months to over a year, leaving no permanent sequelae. Caffey-Silverman syndrome needs to be distinguished from osteitis, for which it is most often mistaken. We present a case of an early form of Caffey-Silverman syndrome. The course of disease in this form is usually severe, with multifocal lesions, and the typical self-limiting regression is not complete. In our patient, a systemic musculoskeletal condition was already suspected following the detection of skeletal defects in a prenatal US examination. Physical and radiological work-up in the first weeks of life revealed the typical signs of congenital Caffey-Silverman syndrome. Several years of follow-up showed gradual regression of the bone deformities with persistent lower-extremity bowing. Due to a positive family history for Caffey-Silverman syndrome, the patient’s pedigree was prepared. On the basis of the history data, existing radiographs and in- and outpatient medical records, Caffey-Silverman syndrome was confirmed in 10 family members. It was established that the cases of Caffey-Silverman syndrome in the patient’s family were characterized by diverse phenotypic expression and different times of onset. Aleksander Szwed , Maciej Kołban , Hanna Romanowska Romanowska , Elżbieta Baryła-Pankiewicz Case reporthttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976906http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976904Abstract Triquetral fractures are the second most common carpal fractures. Triquetral body fractures are the less common type of triquetral fractures but they can be missed on plain radiographs and a non-union can be associated with considerable morbidity and reduction in functional activities. We report a unique case of displaced isolated triquetral body fracture that was initially missed on plain radiographs and resulted in non-union. The fracture non-union was diagnosed on magnetic resonance imaging and was treated successfully with open reduction and internal fixation using compression screws, without bone grafting, and early mobilisation of the wrist allowing a return to premorbid activity levels. To our knowledge, this has not been previously described in the literature. We advocate early clinical suspicion of triquetral fractures in patients with persistent ulnar-sided wrist pain following trauma, and early evaluation using computed tomography or magnetic resonance imaging. Mamun Al Rashid Al Rashid, Sonia Rasoli, Wasim S Khan S Khan Case reporthttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976904http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976902Background: An evaluation of the correctness in of feet structure is decisive significance with regard to the prevention and correction of their deformation. The aim of this work was an attempt to verify which of the indexes used in ascertaining longitudinal arch, transverse arch and foot proportions have the greater diagnostic force and therefore are the most accurate in premise. Material and methods: Cross-sectional studies included 130 randomly selected students. The tested men were aged 20-28. A plantographic method non-marking technique was used to evaluate the feet. The indexes evaluating the longitudinal arch of the foot, the transverse arch of the foot and foot proportions were obtained from the plantograms. Verification of relevance choice of plantographic indexes to feet evaluation was made by factors analysis. Results: The index of depth of the longitudinal arch of the foot (Wgwp) achieved the maximum load factor values. The Wejsflog index (Wwp) has achieved highest values of the factor loads than heel angle. The length and width index (Wd-sz) has achieved highest values of the factor loads than the foot corpulence index (Ts). Conclusions: 1. The most valid index in use for the evaluation of the longitudinal arch of the feet is the index of depth of the longitudinal arch of the foot (Wgwp). For evaluation of the transverse arch the most useful is the Wwp Wejsflog index, while to evaluate the proportions of feet the most accurate is the length and width index (Wd-sz). Ewa Puszczałowska-Lizis Original articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976902http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976901Background The Gibson and Piggott procedure for hallux valgus is based on sound surgical principles addressing the basic pathologies of this disorder. However, this procedure has not been studied extensively in the literature in comparison to the Mitchell and Chevron osteotomies. Material and methods We report a prospective study conducted on 50 adult feet with hallux valgus. The Gibson and Piggot osteotomy was done on all the feet. Results We obtained 76% excellent and 18% good results with this procedure. Conclusion The results bear out the fact that this procedure is a useful procedure for the management of this disorder. Arshad Bashir Rangrez, Tahir Ahmed Dar , Abdul Rashid Badoo , Sharief Ahmed Wani , Shabir Ahmed Dhar Dhar , Imran Mumtaz , Muzzaffar Ahmed Original articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976901http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976900With spreading of joint replacements rises the number of complications of that surgery. Although quite rare (<1%) the periprosthetic infection (PPI) are of the most serious complications of endoprothesoplasty. Infections frustrate results of even best technically performed joint replacement, cause great damage and loss of bone and periprosthetic tissues which handicap restoration surgery. The best solution for PPI patients seems to be two-staged revision arthroplasty. In the first stage excision of implants and radical debridement of infected tissues is performed and then antibiotic-loaded spacer is implanted. After few months the second stage is performed: removal of spacer and implantation of revision endoprosthesis. The aim of the study was to evaluate efficiency of periprosthetic infection treatment with two-stage revision arthroplasty. Between January 2007 and March 2010 forty one patients with diagnosed PPI were treated in Department of Orthopedic and Trauma Surgery of Silesian Medical University in Katowice. The complication followed in 12 cases (29%) after knee arthroplasty and in 29 cases (71%) after hip replacement. During first stage of the treatment 17 cases (41%) had no microorganism and 24 cases (59%) presented grown bacteria in taken intraoperatively smear. Cases with reinfection after revision endoprosthesoplasty (second stage of the treatment) had following results: no microorganism (1), MSSA (1), E.faecalis (1), A. baumanii concomitant with MSSA and MRSE (1). Afterward first stage of the treatment (spacer implantation) one case was not cured of the infection (2,5%). In 4 cases (10%) reinfection was presented after fixation of revision implants. Based on results of our analysis it may be presented a thesis that two-stage revision endoprothesoplasty is effective method of treatment of periprosthetic infections. Marcin Borowski , Damian Kusz , Piotr Wojciechowski, Łukasz Cieliński Original articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976900http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976898Introduction. The aim of this paper is to evalute perioperative blood loss associated with total cemented knee joint alloplasty, with special regard to specific factors that may influence this loss. Additionally, the significance of postoperative autotransfusion in these procedures is assessed. Materials and methods. The study group consisted of 85 patients (61 females and 24 males); in 32 cases a postoperative autotransfusion system was used (CBCII ConstaVac, Stryker). Factors analysed comprised pre- and postoperative hemoglobin levels, drain blood loss, heterologous blood transfusion volume and reasons for the transfusion, including co-morbidities. Results. Allogeneic blood transfusion was necessary in 54.72% of the patients who did not have autotransfusion and in 34.38% of the patients who received autotransfusion. The mean volume of blood collected in the drains was 882 ml, while the mean volume of reinfused blood amounted to 524.2 ml. Hypertensive patients experienced greater postoperative blood loss. The average drop in hemoglobin levels was 3.6 g/dl and was smaller by 0.6 g/dl in patients who received autotransfusion. The lowest preoperative hemoglobin values occurred in patients who required heterologous blood transfusion despite autotransfusion. Heterologous blood transfusion was performed at a hemoglobin level of 8.4 g/dl; in patients with a concomitant ischemic heart disease the cut-off value was 9.6 g/dl. Conclusions. 1. The average drop in hemoglobin levels associated with knee alloplasty was 3.5 g/dl. The volume of recovered blood used for post-operative autotransfusion was approx. 500 ml. 2. A low preoperative hemoglobin level is the most significant risk factor for heterologous blood transfusion. 3. Co-mordibities need to be taken into consideration when determining the amount of blood required. Mirosław Kulej , Szymon Dragan , Katarzyna Płocieniak , Artur Krawczyk , Szymon Łukasz Dragan Dragan , Piotr Baryła-Urban Original articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976898http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976896Background. Rheumatoid arthritis (RA) most frequently affects smaller joints in the hands and feet. Among the most common deformations resulting from the progression of the disease are ulnar deviation, Boutonniere deformity, swan neck deformity, contractures and limited range of movement in the hand and wrist joints, muscular atrophy of long and short muscles. The topic of this article is the influence of using Kinesiology Taping method on the functioning of the hand of the patient suffering from rheumatoid arthritis. Material and methods. The research involved 20 patients suffering from rheumatoid arthritis (16 women, 4 men), treated in the Hospital in Kup. Average age of patients was 62.2. Research subjects, apart from pharmacological treatment in the hospital ward, received standard physiotherapy. In case of 10 patients additional K-Active Tape applications were used to correct ulnar positioning of the hand and improve hand functioning. Prior to physiotherapy, all patients were given a hand functioning test and a dynamometer measurement was made. The tests were repeated after the 2-week rehabilitation process has been completed. The results were subjected to statistical analysis with the use of the Wilcoxon test and the U Mann-Whitney test. The assessment of the correlation between analysed parameters was made with the use of linear correlation test. Result. In the group where Kinesiology Tape applications were used, hand muscle strength increased significantly (p<0.05) in comparison with the group treated with standard physiotherapy. Hand muscle strength increase correlated with the tempo of carrying out the hand functioning test (r>0.8). Conclusion. Results suggest Kinesiology Taping method useful for physiotherapy of rheumatoid hand. Jacek Łuniewski , Jan Szczegielniak , Zbigniew Śliwiński , Dariusz Banik , Katarzyna Bogacz Original articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976896http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976894A very low coefficient of friction in joints makes it difficult to define clearly the mechanism of cartilage lubrication. The present paper describes the two currently predominant and mutually complementary views aiming to elucidate this mechanism. The first mechanism, referred to as hydrostatic lubrication, involves interstitial fluid pressurization from the cartilage and its importance for the formation of a layer separating the weight-bearing surfaces. The second mechanism, called boundary lubrication, assumes the existence of a substance that binds to the cartilage surface, permanently separating the friction elements. It has not been clearly determined which substances occurring in the synovial fluid function as boundary lubricants. The authors briefly describe the physicochemical properties of lubricin, surface-active phospholipids and hyaluronic acid, including their role in boundary lubrication. Stanisław Moskalewski , Ewa Jankowska-Steifer Review articlehttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976894http://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976907Osteoid osteoma has been traditionally treated by curettage and en bloc resection. These methods are now being replaced by low-invasive techniques. We present the description of a percutaneous thermoablation of a femoral neck osteoid osteoma performed under CT guidance in a 22-year-old female patient. Tomasz Lorenc , Radosław Górski , Piotr Palczewski , Marek Gołębiowski Case reporthttp://www.ortopedia.com.pl/abstracted.php?level=5&ICID=976907