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The work presents the results of the treatment of 6 patients with periendoprosthetic hip infection with the use of the spacer in the Orthopaetic-Traumatic Ward between 01. 09. 2010 and 31. 12. 2013. Each case of infection was treated in two stages. In the first stage, the primary endoprothesis and inflammatory site were removed, and SPACER was implanted. In the second stage, after subsidence of clinical and laboratory symptoms of infection, the surgery was performed involving exchange of the SPACER to a revisory endoprothesis . All the patients were administered Vancomicine intravenously from the day of surgery until the results of bacterial culture were obtained. Then the antibiotic was given intravenously according to the antibiogram for 10 days; in case of negative culture, the therapy with Vancmicinewas continued for 10 days. This was followed by the administration of an oral antibiotic according to antibiogram for 6 weeks, and in case of negative culture, Biseptol 2 x 960 mg was given also for 6 weeks. The second stage of the procedure was carried out between the third and sixth month after the first surgery. In 5 patients inflammatory condition subsided, and a functional result was assessed by the patients as good. In one case inflammation did not heal and the patient remains with "hanging hip"; the result of the treatment was assessed as bad.

The aim of this study was to evaluate the clinical and radiological results of treatment and quality of life, and impact of surgical approach in patients after arthroplasty using anatomical stem ABG II in the Department of Orthopaedics and Trauma Regional Hospital. St. Luke in Tarnów of years 2008-2011. The material consisted of 68 patients operated using a Proxima stem (surgical approaches; anterolateral--34 cases, posterior lateral---34 cases similarly). The average age was 62.2 years. Patients stayed in the hospital an average of 8 days. Term follow-up was determined after 6 weeks, 3 months and then once a year. Postoperative results were evaluated using the scale: Harris and WOMAC NRS. X-rays were evaluated for setting and migration of the prosthesis components. In assessing patients with HHS to scale achieved 73.5% of very good and good. Compared to the pre-operative assessment resulted in a significant improvement in mobility of the hip after arthroplasty. According to the standardized WOMAC extended the average score of treatment was 77.0 points. During the study showed significant reduction in pain intensity after surgery. Average NRS score before surgery was 6.4 points and 1.4 points after surgery. In the material appropriate settings were 51 and 17 axial axis of the prosthesis. No effect on clinical outcomes set in the HHS and WOMAC scales. There was no effect on the results of surgical treatment.

BACKGROUND. The aim of the study was to evaluate clinical outcomes and broadly defined quality of life in patients with hip osteoarthritis after short stem hip arthroplasty. MATERIAL AND METHODS. The study enrolled patients operated on at the Trauma and Orthopedics Department of St. Luke's Regional Hospital in Tarnów in the years 2008-2010. The experimental group consisted of 67 patients aged 22 to 77 years (average age 54.0 years) who received Proxima short stem implants (DePuy, J&J, USA). The control group consisted of 68 patients, operated on at the same department and in the same period, who were implanted with the ABG II prosthesis with a classic anatomical stem (average age 62.2 years). The average duration of hospital stay was 8 days. Follow-up examinations were scheduled at 6 weeks, 3 months and subsequently once a year. Post-operative outcomes were evaluated with the Harris Hip Score (HHS), WOMAC index and NRS. RESULTS. Analysis of HHS scores in the experimental group showed that 89.6% of the patients demonstrated excellent and good outcomes. The hip range of motion improved significantly after arthroplasty compared to preoperative values. The mean standardized extended WOMAC score was 85.5. Pain intensity in the experimental group decreased significantly after surgery. The mean preoperative NRS score was 6.6 vs. 1.0 after surgery. The outcomes in the control group were also excellent and good, but far worse than those in the experimental group as regards both clinical status and quality of life. A comparison of HHS scores showed statistically significant differences between the groups (p=0.018). The mean WOMAC score in the control group was 77.0, which is a statistically significant difference compared to the figure in the experimental group (p=0.001). Both groups had lower NRS scores after surgery, but the values were significantly worse in the control group (p=0.001). CONCLUSIONS. The outcomes of Proxima short stem arthroplasty in patients with hip osteoarthritis were better than the outcomes of patients who were implanted with the classic anatomical ABG stem. Pain reduction and an increased hip range of motion had the strongest impact on improving patients' quality of life after short stem prosthesis hip arthroplasty.

Operational treatment of trochanteric fractures of the femur, independently of the applied connecting implant, carries the risk of various types of complications. In this paper the incidence of mechanical complications in performed osteosynthesis of trochanteric fractures of the femur was analyzed as well as the risk factors influencing them and their extent were assessed. The results showed statistically significant influence of the type of implant, the type of fracture and the patients' age. It has been proven that the use of Gamma nail decreases the risk of mechanical complications almost twofold in comparison with the Ender's posts, disregarding the type of trochanteric fracture of the femur.

Management of infectious complications after primary total knee arthroplasty with a particular focus on the clinical usefulness of Spacer-K is presented in the following article. The choice of treatment depends on the timing of infection onset. The gold standard in the treatment of late infections is a two-stage exchange arthroplasty with usage of temporary antibiotic-loaded spacer prosthesis. The role of diagnostics and prompt treatment is emphasized. Applied management as well as treatment results have been analyzed.

This paper presents a group of patients which had femoral trochanter fracture. The study group was assessed in terms of age, sex, concomitant diseases and pre-traumatic motor efficiency. The author of the paper highlights the fact that the majority (42%) of patients is over 80 years of age, and frequently suffer from two or more concomitant diseases impeding the surgical procedure in the emergency mode. Moreover almost every second person had significant problems with movement before the fracture.

The paper presents a case of sub- and intertrochanteric fracture of the right femur in a patient with coexisting severe osteoarthritis of the ipsilateral hip. The patient underwent silmultaneous fracture treatment and total hip replacement. Applied management as well as treatment results have been analyzed.

The aim of the study is analysis of outcomes of surgical treatment in a group of 32 patients with fractures of the proximal humerus treated surgically in the orthopaedic and traumatic ward of St. Lucas Hospital in Tarnów during the years 2006-2009. Results were estimated by Constant-Murley criteria. Among the surgical methods the best results were observed in cases of healing with percutaneus Kirschners wires fixed appropriately with the closed method of two- and three-part fractures of the neck of the humerus. The worst results were observed in four-part humerus fractures when open surgical procedure were used irrespective of the kind of applied implant. In case of these fractures of proximal humerus, satisfactory results were obtained by using hemi-arthroplasty.

A higher mortality rate is observed in patients with femoral trochanter fractures than in patients with femoral cervix fractures. Moreover, a statistically higher incidence of chronic diseases has also been observed in this group. Multifactor analysis of annual mortality rate after fracture and connection of the femoral trochanter area in elderly patients was carried out by the author of this paper on the basis of the regressive model. The analysis has shown that the mortality rate is significantly influenced by unstable type of fracture, improper pre-traumatic activity and the presence of circulatory diseases. The observed mortality rate has not been related to the patients' age or to the type of the implant used for fracture connection.

Pleural mesothelioma is an extremely rare neoplasm. Its etiology is related to professional or environmental exposure to asbestos dust. In the present research, the analysis of frequency and causes of death due to asbestos-related cancers in the district polluted with asbestos in comparison with the district free of such pollution has been performed. The increase has been highlighted in the mortality rate because of pleural mesothelioma among inhabitants of the area polluted with asbestos wastes.

The work presents the results of the rehabilitation after osteosynthesis of femoral trochanter fractures with the Gamma nails. Femoral trochanter fractures usually affect the elderly and senile patients, which require the use of appropriate methods of operation as well as intense rehabilitation. Early and intense post-operational management, based on physiotherapy has advantageous effects on the process of mobilization of the patients. In the majority of them it allows to regain the pre-traumatic ability, mobility and activity.

The work presents the results of a survey that was conducted amongst the inhabitants of the parish of Dabrowa Tarnowska concerning quack medical practices noted in the treatment of the musculo-sceletal system, as well as comments on the subject of the harm caused by the application of folk remedies. Within the group of those surveyed a startling 79% evaluated this form of treatment as satisfactory despite the appearance later of many medical complications.

The results of surgical treatment of acromioclavicular joint dislocation in 21 patients using closed reposition and stabilization with the use of 2 Kirschner arrowheads were presented in this study. Results of treatment were obtained on the basis of movable shoulder joint restriction, severity of pain, radiological images, as well as a subjective assessment of the operated limb function. Observation period ranged from 3 months to 3 years. It has been concluded, that closed reduction and fixation with Kirschner wires (arrowheads) is simple, barely invasive method of treatment for acromioclavicular dislocation and gives good final results, although a significant percentage of complications was observed.

Intertrochanteric fractures have always posed an interdisciplinary medical problem. Most frequently it happens between 7th and 8th decades of life. The majority of them are due to osteoporosis. Both for a medical doctor and surgeon they face quite a challenge when it comes to treating a patient with a fracture of the proximal epiphysis of the femur. Recently, the outcome of the fracture treatment has improved greatly due to introduction of modern methods of intramedullary and periosteal fusion. In this study we present a possible utilization of Gamma nails, its advantages and disadvantages compared with the stabilisation achieved using Ender rods. We analyzed the outcome of treatment of 198 patients treated for intertrochanteric fractures of the femur. We present advantages and disadvantages of both methods of stabilization. We stress the importance of the correct reduction of the bone even if requiring opening. We also point to difficulties that accompany both types of stabilization. The final results reveal a considerably better outcome in patients treated using Gamma nails, especially if fractures were instable.

The elaboration presents the operating indications in treatment of fractures of the nearer end of the femur using the Gamma nail. In comminuted fractures, the Kyle partition was used. The operating- techniques, difficulties and complications appeared after treatment with this method have been presented. Among 42 patients operated with the Gamma nail, 39 good and satisfactory results have been obtained. The stable intramedullary osteosynthesis ought to be recommended in fractures of the nearer end of femur having in mind characterised by the closed operating techniques, little loss of blood, stability of the junction and early mobilization of the patient.

Barton's fracture was first described and isolated as a disease entity in 1839. It is a quite rare fracture constituting, according to various authors 1.5-2.3% of the distal radius fractures. It is usually accompanied with subluxation or luxation in the radiocarpal joint. In the study we present treatment, dealing with operative difficulties and rehabilitation in a 52-year-old patient with an inveterate fracture of the Barton type of the distal radius with dislocation in the radiocarpal joint. He was previously treated by a local quack. The patient underwent an operative treatment; fragments were anatomically repositioned and a stable fixation was applied. As a result of treatment and intensive rehabilitation, we achieved synostosis and functionality of the wrist and left hand.

The elaboration presents cases of popliteal fossa tumors basing on the material presented by The Traumatic and Orthopedic Surgery Unit in Dabrowa Tarnowska. Special attention was given to numerous difficulties connected with the univocal diagnosis. It was based on accessible research methods and the need to extend diagnostic procedure to highly specialized procedures in justified cases.

An injury to the elbow constitutes 3.5% of all injuries of the movement system and of these 31% concern olecranon fractures. In the majority of cases they are intra-articular fractures, unstable because of the action of the triceps muscle of the arm. Most of the patients require operative treatment. In the years 1984-2001 in the Traumatic and Orthopedic Ward we treated 49 patients with olecranon fractures. In 30 patient we utilized Gruca screw and in 10 of them Weber girth. 3 fractures were fixed with a wire loop and the remaining 6 did not require operative but only conservative treatment. The results were estimated according to the Hofbauer's scale in 37 patients among whom 27 were treated making a fixation with a Gruca screw and 10 by using Weber girth. Altogether, we achieved good and satisfactory results in 33 cases and bad results in 4 cases. Based on these results there is no evident superiority of one method over the other. The study emphasizes the importance of the correct qualification to either therapeutic method.