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Osteoarthritis of the fingers and wrist, whether primary or secondary, is the most common degenerative disease. Its incidence is increasing due to the aging of the population. Most of the patients can be treated conservatively with good effect, but when conservative treatment fails, surgical intervention is considered. Essentially, there are 2 types of operations for this disease-radical (bone excision, arthrodesis, arthroplasty with an implant), and non-radical (joint denervation). Denervation of the joints has obvious advantages such as non-compromising the joint anatomy, preservation of range of motion, avoiding of an implant and low rate of complications. Denervation can be offered to younger patients, whatever their functional demands. Preservation of the bony anatomy does not preclude any further, more radical surgical interventions. This article presents a comprehensive information about methods of denervation of particular joints within the hand and their effectiveness in osteoarthritis. The current literature provides convincing evidence that denervation is a reliable and reproducible surgical technique for painful osteoarthritic conditions of the hand. It should be considered in patients presenting with painful joints which are still mobile, regardless the initial aetiology [ABSTRACT FROM AUTHOR]

Chronic refractory complex regional pain syndrome (CRPS) is the severest form of this condition characterised by acute pain, other painful phenomena (hyperpathia, allodynia), severe functional impairment of the affected extremity and non-responsiveness to standard treatments. This paper presents a case of a 40-year-old man suffering from this form of CRPS, in whom all treatment options, including non-standard appeared ineffective. The patient suffered from intractable pain and a completely disabled extremity was considered by him a burden, additionally affecting his daily living. After a review of the literature and informing the patient about the potential benefits and the potential risk of failure of surgery, at the request of the patient an amputation of the upper extremity was performed at the level of 1/3 distal arm. The postoperative course was uneventful, but amputation did not result in cessation of the pain which persisted in the residual limb. The presented case shows that limb amputation for chronic refractory CRPS may not give expected beneficial effect. [ABSTRACT FROM AUTHOR]

The number and variety of different classifications that have been proposed for assessing the severity of Dupuytren's disease (DD) and for evaluating the results of surgery for DD indicate that there is no single perfect tool for assessing this disease. Despite the multiplicity of these scales, there is no consensus on the best method of grading the severity of this disease and on the most accurate outcome measure after treatment. This review article presents scales for assessing the severity and outcomes of surgery for DD based on the current literature. Several different classifications are presented, such as assessment of the degree of contracture, assessment of hand function, histologic evaluation, and so-called "complex scales". Each of these classifications has its advantages, but each also has weaknesses. This article provides a comprehensive and critical review of these instruments. Of all the scales and outcome measures reviewed in this article, these so-called "patient-oriented outcome measures" probably best reflect patients' perceptions of their outcomes after treatment. Therefore, these instruments seem to be more accurate and effective than other outcome measures in assessing the severity of DD and evaluating the results of treatment. However, the selection of the ideal outcome measure remains a task for future research. [ABSTRACT FROM AUTHOR]

Carbon fiber reinforced plastics (CFRPs) are widely used in aerospace structures due to their high stiffness, strength and good fatigue properties. They are however vulnerable to loads perpendicular to their plane and, while impacted, can suffer significant internal damage decreasing their overall strength. Detecting and sizing such damage is an important task of the non-destructive inspection (NDI) methods. This study was conducted to detect and quantify damage in a set of six impacted even rectangular CFRP specimens designed from a MiG-29 vertical stabilizer’s skin. The inspection was done using the ultrasonic (UT) method (based on mobile scanner – MAUS V) and the pulsed infrared thermographic (IRT) method. Each specimen’s inside and outside (impacted) surface was inspected separately with IRT, while the outside surface was then inspected with UT. UT provided the most precise measurements of the damage area, while the IRT inspection of the outside surface (which would be accessible on a real aircraft structure) provided underestimated values due to the damage’s depth and geometry.

Introduction: Hand fractures are the most common fractures of the upper extremity. Following the outbreak of war in Ukraine, approx. 1.5 million Ukrainians fled to Poland. Many of these individuals quickly integrated into Polish society and found employment, often in manual labor. The objective of this study was to analyze the spectrum of hand fractures recorded in the emergency department of a tertiary hospital and compare the incidence of hand fractures among Polish and Ukrainian patients before (2020) and after (2022) the outbreak of the war in Ukraine. Materials and methods: The study utilized records from the database of the Emergency Department SPSK 1 in Szczecin from 2020 and 2022, representing the year before and the year of Russia's invasion of Ukraine. Results: A total of 344 hand fractures were recorded in 2020 and 437 in 2022. In both periods, the most common injuries were finger and metacarpal fractures, accounting for 74% (2020) and 72% (2022) of all fractures. In 2020, 12 Ukrainians were registered, representing 3.5% of all patients that year, while in 2022, there were 44 Ukrainians, representing 10% of all patients (statistically significant, p = 0.0004). The number of work-related fractures was significantly higher among Ukrainians than among Poles, in both 2020 (6% vs. 58%) and 2022 (8% vs. 61%; statistically significant, p = 0.0001). Conclusion: The higher incidence of hand injuries among Ukrainians may be due to less attention to work safety compared to Poles and the fact that they often work outside their trained professions, which increases the risk of injury. [ABSTRACT FROM AUTHOR]

Introduction: The assistance of anaesthesiologist is considered an inseparable part of most surgical procedures, with the exception of a small proportion of minor procedures performed under local anaesthesia. In hand surgery, a vast majority of procedures, even those lasting several hours, can be carried out under regional (brachial plexus block) or local (infiltration) anaesthesia. These can be delivered by the surgeons themselves, allowing the surgeries to be carried out without the assistance of anesthesiologists. Aim: The aim of this study was to analyze the efficacy and safety of presurgical anesthesia as delivered by surgeons without the assistance of anesthesiologists in the course of hand surgery procedures performed within the institution headed by the author of this article. Material and methods: The analysis was based on the records of anesthesia protocols filled out by the surgeons who delivered the anesthesia and who operated on the patients. The variables considered included the efficacy of anesthesia and the anesthesia-related adverse effects and complications. Results: Over a period of 13 years (2010--2022), a total of 24,703 surgeries were delivered; of these, 22,228 (91%) surgeries were carried out without anesthesiologists, with anesthesia being delivered by the surgeon him/herself. The efficacy of these procedures (local anasthesia and brachial plexus blocks combined) was 99%. A total of 631 (2.8%) anesthesia-related adverse reactions were recorded, most of them being transient, requiring immediate interventions and not leading to any serious sequelae. In only 17 cases (0.07%), adverse effects resulted in cancellation and rescheduling of the elective surgery. Conclusions: Pre-surgical anesthesia as delivered prior to hand surgery procedures by the surgeons without the assistance of anesthesiologists is effective and safe while being associated with numerous benefits for patients, surgeons and the health care system's budget. [ABSTRACT FROM AUTHOR]

Introduction: The results of some studies show that predictors of less favourable outcomes of surgery for carpal tunnel syndrome might include the presence of comorbidities, such as diabetes and thyroid gland diseases. The role of these factors has not been clearly determined, but in most trials the patients burdened with comorbidities conducive to CTS are excluded from the analysis. Aim: The aim of this study was to investigate the effect of concomitant diseases on the clinical profile and outcomes of surgery for carpal tunnel syndrome. Material and methods: The study group consisted of 1117 patients -- 909 women (81%) and 208 men (19%) -- at a mean age of 63 years. A total of 972 patients (87%) declared having at least one comorbidity, whereas 145 patients (13%) declared no comorbidities. The measurements were performed preoperatively and at 6 months postoperatively; they included pain intensity, total grip and key-pinch strength, digital sensibility and hand function with Levine's questionnaire. Results: At baseline, the patients with comorbidities had significantly worse digital sensiblility, weaker total grip strength and greater functional impairment of the hand, but only grip strength reached the minimal important difference (3.5 kg). Carpal tunnel release resulted in significant improvement in the tested variables for all patients, although the outcomes at 6 months were less favourable for those with comorbidities with regard to digital sensiblility, total grip and pinch strength and function of the hand. All these differences were statistically significant, but only grip strength reached the minimal important difference (2.9 kg). Conclusion: The results of this study show that comorbidities in patients suffering from CTS had a statistically and clinically significant negative effect only on the total grip strength pre- and postoperatively, and no significant effect on the outcome of surgery, which was satisfactory in all patients. [ABSTRACT FROM AUTHOR]

The currently used flexor tendon repair techniques and methods of postoperative rehabilitation differ significantly from those used as recently as 10-15 years ago. The repair techniques have evolved from 2-strand sutures (the Kessler suture) in the direction of the much stronger 4-strand and 6-strand sutures (the Adelaide and Savage sutures), reducing the risk of failure of the repair and allowing for more extensive rehabilitation. Rehabilitation regimes have also changed so as to be more comfortable for patients compared to previous protocols and to facilitate the achievement of better functional outcomes of the treatment. This study presents the updated trends in the management of flexor tendon injuries within the digits, with regard to the operative technique and postoperative rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Introduction: Dupuytren’s disease is a common fibrotic disorder of the palmar aponeurosis characterized by the formation of nodules and cords, as well as development of progressive flexion deformities in the digits, leading to functional impairment. Surgical excision of the affected aponeurosis remains the most common treatment. Quite a few new information appeared about epidemiology, pathogenesis and particularly treatment of the disorder. Aim: The aim of this study is an updated review of scientific data in this topic. Results: Results of epidemiologic studies showed that Dupuytren’s disease is not so uncommon in Asian and African population as it was earlier believed. An important role of genetic factors on development of the disease in a proportion of patients was demonstrated, however, it did not translate neither to the treatment nor to the prognosis. The most changes concerned the management of Dupuytren’s disease. A positive effect of steroids injections into the nodules and cords for inhibition of the disease in early stages was shown. In the advanced stages, a standard technique of partial fasciectomy was partly replaced by mini-invasive methods such as needle fasciotomy and collagenase Clostirdium hystolyticum injections. Unexpected withdrawal of collagenase from the market in 2020 resulted in considerable limitation of the availability of this treatment. Conclusion: It seems that updated knowledge on Dupuytren’s disease may be interested and useful for surgeons involved in management of the disorder. [ABSTRACT FROM AUTHOR]

The fibrous flexor tendon sheath is a relatively thick structure surrounding both flexor tendons (superficial and profundus) along the finger and distal part of the metacarpus. It consists of circumferentially and obliquely passing bands, so-called 'pulleys'. The flexor tendon fibrous sheath with its pulley system plays an important role in the proper gliding of the tendons by maintaining them close to the bone of phalanges during full finger flexion, and its major defects manifest by impaired flexion of the finger because the tendon bowstringing. There is no commonly accepted opinion about the range of pulley release which is safe and would not cause bowstringing. The article presents current recommendations about the safe range of release of pulleys during repair of the flexor tendons which essentially allows longer incisions than was suggested previously. The priority is the undisturbed gliding of repaired tendon along the finger and avoiding catching the repair at edge of the pulley, which would result in a reduction of the finger's range of motion. [ABSTRACT FROM AUTHOR]

A case of severe streptococcal phlegmon of the right upper extremity with subsequent necrosis of both hands and feet in a young, homeless alcoholic man is reported. The disease developed after a minor injury to the hand, and it progressed rapidly, resulting in the involvement of the whole hand and sepsis over 2 days. After admission, antibiotic and anticoagulant therapy was immediately administered, followed by wide surgical incisions on the hand and forearm. Nonetheless, over the course of 3 days, ischemia of the affected hand developed, followed by ischemia of the contralateral hand and both feet the next day. The treatment employed was not effective, and the patient eventually died on the fifth day after admission. [ABSTRACT FROM AUTHOR]

Introduction: Anesthesiologist's assistance is considered an inseparable part of most surgical procedures, except for minor operations performed under local anesthesia. In hand surgery, most of the operations can be performed under regional (brachial plexus block) or local (infiltration) anesthesia. These procedures can be carried out by the surgeons themselves, which allows them to operate without the assistance of an anesthesiologist. The objective of this study was an analysis of the efficacy and safety of anesthesia to operations in hand surgery performed by surgeons, without the assistance of anesthesiologists. Materials and Methods: This analysis was based on records of anesthesia protocols completed by the surgeons who performed the procedure and who operated on the patients. The following variables were considered: efficacy of anesthesia, adverse effects associated with anesthesia and complications. Results: Over a 10-year period (2013-2022), a total of 16,583 procedures were performed, of which 5638 (34%) were carried out under anesthesia by surgeons, without the assistance of anesthesiologists. The efficacy of these procedures (local and brachial plexus blocks) was 98%. A total of 203 (3.6%) anesthesia-related events were noted, most of which were transient, requiring emergency intervention and without serious consequences. In only 12 cases (0.02%) adverse effects led to cancellation and postponement of the planned operation. Conclusion: Anesthesia for operations in hand surgery performed by surgeons themselves and without the assistance of anesthesiologists is effective and safe and is associated with numerous benefits for patients, surgeons, and the budget of the medical care system. [ABSTRACT FROM AUTHOR]

Most aircraft launchers exhibit a rapid acceleration of the launching aircraft, often exceeding ten times the acceleration due to gravity. However, only magnetic launchers offer flexible control over the propulsion force of the launcher cart, enabling precise control over the aircraft's acceleration and speed during its movement on the launcher. Consequently, extensive research is being conducted on magnetic launchers to ensure the repeatability of launch parameters, protect against aircraft overloads, and ensure operator safety. This article describes the process of modeling and analyzing the dynamical properties of a launch cart of an innovative prototype launcher, which employs a passive magnetic suspension with high-temperature superconductors, developed under the GABRIEL project. The developed mathematical model of the magnetic catapult cart was employed to conduct numerical studies of the longitudinal and lateral movement of the cart, as well as the configuration of the UAV–cart system during UAV takeoff under variable atmospheric conditions. An essential aspect of the research involved experimentally determining the magnetic levitation force generated by the superconductors as a function of the gap. The results obtained demonstrate that the analyzed catapult design enables safe UAV takeoff. External factors and potential vibrations resulting from uneven mass distribution in the UAV–cart system are effectively balanced by the magnetic forces arising from the Meissner effect and the flux pinning phenomenon. The primary advantage of the magnetic levitation catapult, in comparison to commercial catapults, lies in its ability to provide a reduced and consistent acceleration throughout the entire takeoff process. [ABSTRACT FROM AUTHOR]

The focus of this paper is to identify a method for defining the needs of logistical operational support based on the mean time to failure (MTTF) factor. The research was based on a helicopter intended for flight training. The MTTF indicator for selected equipment was determined based on failure data from previous flight operations. As the basic operational data for the developed method, the time from the beginning of the operation or the flight time from the last damage and the method of restoring airworthiness were selected. The MTTF and replacement index for the device were determined. The next step was to determine the index, based on selected probability distributions. The results were analyzed and presented in graphical form, and conclusions were drawn. Based on the MTTF index and replacement index, the logistics needs of selected devices were determined. The obtained results were compared with the actual exchanges of devices made in the year in question. The research proved that the MTTF reliability factor and the analysis of trends in value changes could be used to determine the needs for the logistical security of the operation process, particularly in relation to the equipment subject to accidental failures. This is important for maintaining high availability of an aircraft or other technical objects. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has impacted many medical specialties throughout the world, including hand surgery. Emergency hand surgery deals with a wide spectrum of injuries, including bone fractures, nerve, tendon and vessel cuts, complex injuries and amputations. These traumas occur independently to the phase of the pandemic. Aim: The objective of this study was presentation of changes in organization of activity of hand surgery department during the COVID-19 pandemic. Modifications of the activity were described in details. Material and methods: Over a period of the pandemic (from April 2020 to March 2022), a total of 4150 patients were treated, in this number 2327 (56%) with acute injuries and 1823 (44%) with common hand diseases. Forty-one (1%) patients were diagnosed COVID-19 positive, 19 (46%) with hand injuries and 32 (54%) with hand disorders. One case of work-related COVID-19 infection was registered in the 6-people clinic team in analysed period. Results: Results of this study show effectiveness of measures undertaken in the author’s institution to prevent the coronavirus infection and viral transmission in hand surgery staff. [ABSTRACT FROM AUTHOR]

Strangulation of the vermiform appendix into the femoral hernia sac (de Garengeot hernia) is very rare. This article presents a case of a 63-year-old woman with this kind of hernia which contained a strangulated tumour of the appendix. The patient presented to the hospital with a 3-day-long history of a palpable lump in the right groin. She had no other significant complaints, but USG imaging showed suspicion of the strangulated femoral hernia containing a bowel. The patient was operated on. As the tumour was not suitable to remove via groin incision, laparotomy was performed, followed by a release of the appendix with the tumour and their resection together with a fragment of the caecum. The postoperative course was uneventful, and histological examination showed appendiceal mucinous neoplasm with high-grade dysplasia. After oncological consultation, the patient underwent prophylactic right hemicolectomy. [ABSTRACT FROM AUTHOR]

Ganglion cysts are the most common benign soft tissue tumors of the hand and wrist. They are usually found on the wrist, more often on the dorsal side. Very rarely, these cysts can be located in the nerves, tendons, and bones (the intraneural, intratendinous, and bony ganglions, respectively). In this article, we report a case of a ganglion cyst localized in the extensor communis tendon of the index finger in a 54-year-old woman. The nature of the lesion was discovered intraoperatively; it was then resected. The postoperative course was uneventful and the patient recovered within 4 weeks. Histologic examination revealed that the cyst wall consisted of fibrous tissue with signs of degeneration and no epithelial lining. [ABSTRACT FROM AUTHOR]

This article is focused on the research concerning the calculation of the durability of electrical machines installed in the electrical system of M-28 and C-130 Hercules aircraft. The article presents a method of predicting the service life of aircraft commutator machines, which are the primary source of electrical energy. The result of the research was the determination of the durability of bearings and coils of electrical machines operated on aircraft based on a flight profile analysis. It is problematic to directly measure the wear of bearings and windings of an electric machine on the aircraft. Their usage can be determined from the relation between their wear and the ambient temperature. This research can be used in practice to plan maintenance work on the analyzed aircrafts. [ABSTRACT FROM AUTHOR]

Introduction: The technique of reduction and fixation of distal radial fractures consisting in the introduction of K-wires between bone fragments ("intrafocal technique") was firstly described by French orthopedic surgeon dr. Adalbert Kapandji in 1967. This method allows a reduction of the fracture using the K-wire as a "lever", which elevates displaced bone fragments and places it on site. The objective of this article is the presentation of the Kapandji technique and the results of the treatment of distal radial fractures operated on at the authors' institution. Materials and methods: A total of 187 patients, 151 women 6 months after surgery, according to standard protocol. Results: The mean wrist total arch of motion (dorsal + palmar flexion) was 93°, grip strength of 17.2 kG and the quickDASH score 21 points. All these variables reflect the overall good function of the affected hand. Meaningful secondary displacements were noted in only 5 patients (2.6%). In general, the results obtained by the patients were satisfactory. The results of our study show that using the Kapandji technique for the treatment of distal radial fractures resulted in satisfactory clinical outcomes and relatively rare complications. [ABSTRACT FROM AUTHOR]

Vascular-derived tumours localized in the upper extremity are relatively commonly encountered, particularly in children. They are divided into 2 groups: vascular-derived neoplasms and vascular malformations. These 2 groups differ in several aspects, although their clinical presentation may be similar. Haemangiomas constitute the greatest group of benign vascular current information on the classification, aetiology, diagnostic, symptomatology, methods, and outcomes of treatment of vascular-derived tumours localized in the upper extremity. It may be useful in diagnosing and managing these conditions. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper limb. Mechanical compression and local ischemia of the median nerve result in paresthesia, pain, and sensory and motoric disturbances. There are some aspects of the disease that suggest the potential role of genetic predispositions. This article presents a review of the literature about the significance of genetic factors in the etiology of CTS. It discusses the effect of selected gene mutations on constitutional and anthropometric features which may predispose to CTS. These genes are involved in the organization of an extracellular matrix architecture, as well as in bone, cartilage, and tendons development pathways. Therefore they may be potentially responsible for the observed relationship between anthropometric/constitutional factors and CTS. The findings from the studies provide reliable information on the association between genetic risk factors and the development of CTS. [ABSTRACT FROM AUTHOR]

The paper presents an analysis of false triggers of fire protection systems installed on aircraft. They not only cause task interruption but also have a direct impact on flight safety, forcing the crew to land in a risky area. Simulation models of electronic actuators were developed to determine the conditions under which false alarms occur. Testing of the simulation models was carried out in the computational package Matlab-Simulink and Circum-Maker for different electrical disturbance generation conditions. The simulation of overvoltage, voltage drops and voltage decays in the on-board electrical network supplying the fire protection system, occurring during the start-up of aircraft engines and during the switching on and off of on-board high-power devices, was studied. The conducted studies have practical applications since the simulation results are an important element for planning experimental tests of the SSP-FK-BI executive blocks under electrical disturbance conditions. Based on the simulation and experimental studies, the conditions causing false tripping of the fire protection system and the parameters for selected disturbance factors have been determined. [ABSTRACT FROM AUTHOR]

Excessive hand injuries are not uncommon in hand surgeon’s practice. They are usually caused by various devices such as circular saws, grinders, millers, presses, conveyers, and agricultural machines. This article reports a case of mutilating injury to the entire upper extremity as a result of crush and burn of IV degree. The right upper extremity of a farmer who attempted to unblock the mechanism of a straw-press was pulled inside the machine. Despite resistance against the pulling force, the extremity was drawn inside the machine up to the elbow, where the cog-wheels started to glide on the exposed bones of the forearm and arm. The farmer first attempted to cut off the extremity with the pocket knife, following by firing the straw inside the press to draw somebody’s attention to his dramatic situation. Eventually, a person who passed by on the road nearby noticed the smoke flying out of the machine, came to the victim, and called for help. Despite the excessive injury of the entire upper limb and bleeding, the condition of the patient on admission was good. The extremity from the level of mid-arm was crushed, whittled, and burned, and the only option was the amputation at the proximal arm level. The post-operative course was uneventful. [ABSTRACT FROM AUTHOR]

Introduction: Gouty tophi occur in approx. 50-60% of patients suffering from gout. Their occurrence is related to severity of disease and effectiveness of treatment. They develop more frequently in patients with long lasting and poorly controlled disease. Aim: The aim of the study was to evaluate the results of surgical treatment of gouty tophi of the upper and lower extremities. Materials and methods: The results of surgical treatment of gouty tophi in the extremities in 14 patients, 13 men and 1 woman, at a mean age of 51 years, are presented. Twelve patients had tophi localized in the upper extremities, whereas 3 had tophi in the lower limbs (1 patient had upper and lower extremity involved). The duration of disease to the operation was a mean of 8 years. Results: Seven patients received excision of a single tophus, and the remaining patients had 3-15 operations performed due to multiple tophi over a period from 3 months to 2 years. The treatment outcomes were assessed at a mean of 3 years (range 2-8) after the last operation in a form of phone interview. Conclusions: All patients declared satisfaction from the result of treatment. No case of complication or tumor recurrence was noted. The results confirm usefulness of surgical treatment in this form of gout. [ABSTRACT FROM AUTHOR]

Introduction: Metastases of malignant neoplasms to the hand are very rare and constitute approximately 0.01% of whole distant metastases. They usually indicate generalized neoplastic disease, although sometimes can be a first manifestation of dissemination. Cases reports: The study presents 4 cases of metastatic tumors to the hands in patients with diagnosis of renal (2) and lung cancer (1) and one of unknown point of origin. The lesions were localized in the fingers in two patients and in the wrist in the other two. The patient with wrist involvement received excisional biopsy of the lesion, followed by forearm amputation. Two patients with finger tumors had their affected fingers amputated. The patient with the cyst involving the wrist received local excision of the lesion. Operative wounds healed uneventfully in all patients, but 3 of them eventually died within one year from hand operation. [ABSTRACT FROM AUTHOR]

Bite wounds occur as a result of bite by an animal or a human. They are relatively frequent due to the growing number of pets living with people, as well as from inadequate human-animal interactions. The knowledge of most surgeons about the management of these injuries is relatively outdated, whereas the current literature points to important changes in this field. The article presents several aspects concerning epidemiology, classification, bacteriology, and characteristics of bite wounds to the hand. Based on the actual literature, detailed rules for the management of these injuries are described. This information may prove useful in the daily practice of surgeons and doctors at emergency departments who are frequently faced with bite wounds. [ABSTRACT FROM AUTHOR]

Introduction: Immune thrombocytopenia (IT) is an acquired immune-mediated disease characterized by a decrease in platelet count due to antiplatelet autoantibody-mediated increased platelet destruction. Platelets which are "labelled" by autoantibodies are recognized and destroyed first of all in the spleen, and, therefore, splenectomy is one of the treatment options, particularly in cases refractory to conservative treatment. The objective of this study was to determine long-term outcomes of splenectomy in the treatment of IT in adult patients. Materials and methods: Eleven patients, 7 men and 4 women with a mean age of 43 years and IT lasting 30 months on average underwent splenectomy. Indication to surgery was failed conservative steroid therapy in all patients. Outcomes of surgery were assessed in 9 patients on average 5 years following the surgery. Results: In all patients, good response to the treatment was obtained (remission). None of the patients continued therapy against the disease and all had platelet count at the follow-up higher than 100 G/L. No serious complications were observed. Conclusion: Splenectomy is an effective and relatively safe, second-line treatment of IT, in cases in which conservative therapy fails. [ABSTRACT FROM AUTHOR]

The results of functional treatment, without immobilization, in 7 patients with stable fractures of the metacarpal bones and phalanges is reported. Each patient was instructed to make a full flexion and extension of all fingers in 1 block (fingers kept close each other). No immobilization was used. The results were assessed at 1 month and 3 months from the beginning of therapy. All patients achieved consolidation of their fractures confirmed radiologically at 3 months. All patients achieved full finger movement and very good function of the hand. No change of treatment into operative was necessary. The results of this study demonstrate that the treatment of stable fractures of the metacarpal bones and phalanges according to the presented "functional" protocol is safe, well tolerated by the patients and gives good outcomes. [ABSTRACT FROM AUTHOR]

The diagnosis of complex regional pain syndrome (CRPS) is made on clinical grounds, based on the presence of several symptoms and signs that are relatively easy to find when recording the patient's history and in the clinical examination. It is not as easy, however, to quantify these features. Maintaining objectivity is desired in clinical practice, and is particularly important in research studies. Complex regional pain syndrome causes a functional impairment of the affected extremities and limits daily living activity in the patients. An objective measurement of these limitations is also desired. In this paper we present methods used in contemporary research on CRPS, attempting to objec-tivize features that are primarily subjective, such as pain and level of impairment. The methods of assessment of these variables are useful in studies on the impact of the disease on patient functioning in daily living. They are also important in a complex assessment of the results of treatment of the condition. [ABSTRACT FROM AUTHOR]

Haemangiomas are fairly common tumours encountered in the upper extremity. They are composed of non-homogenous groups of lesions of arteriosus, venous or lymphatic origin. The results of surgical treatment of haemangiomas in the upper extremities of 19 patients, 11 women and 8 men, at a mean age of 46 years are presented. Eleven patients (58%) had lesions localized in the digits, 6 (32%)) in the wrist or metacarpus and 2 (10%)) in the forearm or arm. The duration of the disease until operation was 6 years on average. The most common motivation to undergo surgery was cosmetic concern. The follow-up assessment was performed in a form of a phone interview for all patients, at a mean of 4 years after the operation. No serious postoperative complications were observed. Four patients were not satisfied with the appearance of the postoperative scar, 1 reported sensory disturbances in the operated finger and another had reduced grip strength of the operated hand. One case (5%) of a recurrence of the lesion was noted, at 1 year after the operation. [ABSTRACT FROM AUTHOR]

Glomus tumours are rare, benign lesions of vascular origin. In the hand, they frequently localize in the distal phalanges and under the nail plate. Most tumours are symptomatic with characteristic features such as spontaneous pain at the end of the digit exacerbated at exposure to the cold, and trigger point tenderness. This study presents results of the operative treatment of 18 patients, 12 women and 6 men, at a mean age of 38 years with glomus tumours in the hand. Most of them (n = 16) were localized in the distal phalanges, 8 of which were subungual. The follow-up assessment was performed in the form of a phone interview at a mean of 4.2 years following surgery. All patients declared pain relief almost immediately after the tumour's resection. Problems reported by the patients at the follow-up were inaesthetic scars, occasional pain in the operated digit at weather changes, and mild tenderness at the operation site. Three cases of recurrence were noted. These results show that operative treatment of glomus tumours is effective, provides fast relief of troublesome symptoms and is associated with a moderate risk of recurrence. [ABSTRACT FROM AUTHOR]

Anal and rectal injuries are rather uncommon in surgical practice. They are mainly caused at traffic accidents, sexual assaults, harmful voluntary, and eccentric sexual activities, or medical measures. Spectrum of these injuries is wide -- from minor wounds of anodermy or rectal mucosa, until rectal tears penetrated the peritoneal cavity. A case of an accidental, intraperitoneal injury of the rectum caused by a wooden broomstick is presented. The range of trauma was diagnosed based on computed tomography imaging of the abdomen and treatment consisted in the resection of the damaged fragment of the rectum followed by end colostomy. The post-operative course was uneventful. The authors emphasize the necessity of a careful evaluation of these injuries, because any delay in the treatment may result in serious, even fatal complications. [ABSTRACT FROM AUTHOR]

Introduction: Schwannoma is a nerve tumor originating from Schwann-cells of the nerve sheath. It is found in all body regions, the most frequent in the head, neck and in the extremities. Aim: The objective of this study was analysis of outcomes of surgery for these lesions in the authors' institution. Materials and methods: Results of the treatment of 12 patients, 7 women and 5 men, aged a mean of 40 years with shwannomas localized in the upper limb are presented. The follow-up assessment was performed in a form of telephone interview at a mean of 4.2 years post-operatively. Results: The tumors were located in the hand in 5 patients, in the forearm in other 5 and in the wrist in 2. In 3 patients the tumors originated form the median, in 2 from the ulnar and in 2 from the radial nerves; in 5 cases it grew from small nerve branches. All lesions of the median, ulnar and radial nerves were encapsulated without damage of the nerve fascicles, while in the hand they were resected in total. At a mean of 4.2 years of follow-up, two recurrences (17%) occurred, both following resection of the tumor located in the hand. Complications were noted in 5 patients: two felt parasthesiae in the operated finger, two were disappointed due to unaesthetic scar and one patient following tumor resection from posterior interosseous nerve had incomplete finger extension. Conclusion: Outcomes of surgery for these rare tumors are generally good, but functional deficits should be considered in cases of lesions involving motoric nerves. [ABSTRACT FROM AUTHOR]

Introduction: Benign tumours of the hand and upper limb are frequently seen by hand surgeons. The literature in this field is relatively rich, however there are several issues which are not referenced in the literature or are subject to divergent opinions. These concerns complaints caused by the tumours. The objective of this study was to investigate the distribution, symptomatology and histological analysis of benign tumours within the upper extremity. Materials and methods: The study group consisted of 346 patients – 234 women (68%) and 112 men (32%) at a mean age of 53 years who were operated on in the authors’ institution between 2015–2018. The criteria of inclusion were as follows: the presence of a tumour in the upper extremity which was not a ganglion cyst or malignant tumour, and available results of histopathological examination of the resected tumour. Results: Most lesions – 231 (67%) were localized in the digits, followed by the metacarpus – 46 (13.3%). The size of most of the tumours – 204 (59%) was 0.6–2 cm. The tumours were present for a mean duration of 2.6 years before surgical excision. For most patients, an unaesthetic appearance of the hand was the primary problem. Most of the tumours – 248 (72%), were symptomatic by means of pain at compression or caused mild dysfunction. In the study group, most tumours were giant-cell tumours of the tendon sheath – 96 (27.7%), lipomas – 44 (12.7%) and rheumatoid nodules – 30 (8.7%). [ABSTRACT FROM AUTHOR]

Rheumatoid nodules are common extra-articular manifestations of rheumatoid arthritis (RA). It is estimated that 35–40% of patients diagnosed with RA have got nodules localised in various body regions. Rheumatoid nodules constitute a fairly common problem in the hand surgeon’s practice. This study presents the results of operative treatment of 30 patients with rheumatoid nodules in the upper limb – 21 women and 9 men with a mean age of 51 years. Only 6 of the 30 patients (20%) had RA diagnosed prior to surgery. All but 1 nodules were localised on the hands. The follow-up assessment was performed in a form of a phone interview on average 1.5 years following the surgery. All patients declared satisfaction with the results of the treatment, 5 (17%) had a slight pain in the postoperative scar, and 6 (20%) complained about the esthetic effect. Two cases (7%) of recurrence at the operation site were noted. The results of this study indicate a good effect of surgery and justify this approach to rheumatoid nodules in hands. [ABSTRACT FROM AUTHOR]

The key aspect affecting the safety of routing and the unmanned platform mission execution is the autonomy of control systems. To achieve the mission goal, control algorithms supported by advanced sensors have to estimate the obstacle location. Moreover, it is needed to identify potential obstacles, as well as algorithms for trajectory planning in two or three dimensions space. The use of these algorithms allows to create an intelligent object that performs tasks in difficult conditions in which communication between the platform and the operator is constricted. The article mainly focuses on unmanned aerial vehicle (UAV) control systems. [ABSTRACT FROM AUTHOR]

Introduction: Endoscopic measures have continued to be the primary procedures in the management of ulcer bleeding. Nevertheless, in cases of failed endoscopic hemostasis and re-bleedings, endovascular techniques have gradually gained increased acceptance as an alternative to surgery, allowing to avoid surgical intervention in some cases. Case report: A case of a 42-year-old patient presenting to the authors’ institution with massive bleeding from the duodenal ulcer, sprang from a pathologically enlarged gastroduodenal artery is reported. This vascular anomaly was a consequence of occlusion of the coeliac trunk (Dunbar syndrome), which was shown on an angio-CT scan. In spite of several endoscopic and endovascular measures, as well as three operations, the bleeding persistently recurred (a total of 6 episodes) and the patient eventually died. The article presents details of operative and endovascular treatments. Contemporary trends in management in cases of failed endoscopic interventions and re-bleedings form peptic ulcers are shown in the discussion. [ABSTRACT FROM AUTHOR]

Introduction: Carpal tunnel syndrome is the most common compressive neuropathy in the upper limb. Morbidity is approx. 4 times higher in women than in men. Clinical observations suggest that the sex and age of patients influence a preoperative reduction of grip and pinch strengths as well the range of improvement in these variables postoperatively. The objective of the study was to investigate this issue. Materials and methods: The study group consisted of 1,117 patients, 909 women (81%) and 208 men (19%) at a mean age of 63 years. Each patient had been tested for total grip strength, pinch strength and completed the functional part of the Levine questionnaire which evaluates the severity of dysfunction caused by the disease. Results: Preoperatively, men had almost a double-fold total grip and pinch strength compared to women, whereas women had greater, but clinically irrelevant, hand dysfunction. The total grip and pinch strengths were statistically and clinically significantly lower in patients >80 years old. Postoperative improvement of the power and function of the hand was similar in women and men. Patients in different age groups achieved similar improvement of the power and function of the hand postoperatively, except in the oldest group (>80 years old) in which the improvement was smallest. Conclusion: In the course of carpal tunnel syndrome, reduction of the power and function of the hand are similar in women and in men, as well as in different age ranges, except for the oldest patients in which dysfunction is the greatest. Surgery results in similar improvement of power and function of the hand in both sexes and in different age groups, except for the oldest patients, who show the least improvement. [ABSTRACT FROM AUTHOR]