Search

The purpose of this study was to assess whether the type and duration of screw fixation affects ankle joint functional scores and patient activity levels. We evaluated 55 patients who had undergone surgical treatment for ankle fracture with concomitant distal tibiofibular syndesmosis injury. The follow-up period ranged from 2 years to 4 years and 2 months (mean 36 months). Depending on the time of screw removal, patients were divided into 2 groups (the 8–15-week group-19 patients, and the 16–22-week group-36 patients). There were 17 patients with tricortical and 38 patients with quadricortical syndesmosis fixation. The following parameters were assessed: range of motion, rates of complications, level of pain in visual analogue scale (VAS), and function. In the quadricortical fixation group the range of plantar flexion p =.04 and adduction p =.043 were significantly lower in the operated than in the nonoperated limb. In the patients who had their syndesmotic screws removed after 16–22 weeks, the range of plantar flexion in the operated limb was significantly lower than that in the nonoperated limb. We observed no differences between the evaluated groups in terms of ankle joint mobility, VAS pain levels, functional outcomes, or complication rates. All the analyzed subgroups showed poorer ranges of some types of motion in the ankle and worse functional scale and VAS pain scores after treatment in comparison with those before the injury. We suggest removing the syndesmotic screws after 8–15 weeks, due to the possibility of earlier rehabilitation, faster return to work and physical activity and less burden on the health care system. Tricortical or quadricortical syndesmosis fixation is at the surgeon's discretion. [ABSTRACT FROM AUTHOR]

There is no gold standard in the treatment of hallux valgus deformity. The purpose of our study was to compare various aspects of radiographic assessment following scarf and chevron osteotomies and try to determine which technique helps achieve a more pronounced intermetatarsal angle (IMA) and hallux valgus angle (HVA) correction and produces lower rates of complications, including adjacent-joint arthritis. This study included patients who underwent hallux valgus correction with the scarf (n = 32) or chevron (n = 181) method with a follow-up period of over 3 years. We evaluated the following parameters: HVA, IMA, duration of hospital stay, complications, development of adjacent-joint arthritis. The scarf technique helped achieve a mean HVA and IMA correction of 18.3° and 3.6°, respectively, and the chevron technique helped achieve a mean correction of 13.1° and 3.7°, respectively. The achieved deformity correction in terms of both the HVA and IMA was statistically significant in both patient groups. The loss of correction assessed with the HVA was statistically significant only in the chevron group. Neither group showed a statistically significant loss of IMA correction. The duration of hospital stay, reoperation rates, and fixation instability rates were comparable in the 2 groups. Neither of the evaluated methods caused a significant increase in total arthritis scores in the evaluated joints. Our study showed good outcomes of hallux valgus deformity correction in both evaluated groups; however, scarf osteotomy yielded somewhat better radiographic outcomes in HVA correction and no loss of HVA correction at 3.5 years of follow-up. [ABSTRACT FROM AUTHOR]

After arthroplasty, arthrodesis of the ankle joint is the most common method to treat advanced ankle osteoarthritis. The goal of the study was to assess the subjective and objective outcomes in 2 different types of fixation for ankle joint arthrodesis. We retrospectively assessed 47 patients who had undergone ankle joint arthrodesis with fixation either via an Ilizarov apparatus (group 1) (n = 21) or cannulated screws (group 2) (n = 26). The outcomes were measured by: (1) the quantity of analgesics administered, (2) the American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot score, (3) general patient satisfaction, (4) the patients' decision to undergo the same procedure given another chance, and (5) the necessity of blood transfusion during hospitalization. Data was collected at the last postoperative follow-up visit. The AOFAS scores in group 1 and group 2 patients were 73.9 ± 13 and 72.7 ± 14.3, respectively. In group 1, 17 patients (81%) were very satisfied with the results, while in group 2, 19 patients (73%) were very satisfied with the results (p =.043). Two group 1 patients (10%) and four group 2 patients (15.3%) reported that they were satisfied with the outcomes (p =.035). Two patients (10%) from group 1 and three patients (11%) from group 2 were fairly satisfied. Seventeen patients (81%) after arthrodesis with Ilizarov fixation and 21 patients (81%) after arthrodesis with internal fixation would choose the same procedure given the opportunity to choose again. In group 1 there were no patients who required blood transfusion; in group 2 one patient (4%) required blood transfusion; the difference was statistically significant (p =.039). Nineteen group 1 patients (90%) were administered an analgesic preoperatively, while postoperatively only 6 (29%) required analgesics. In group 2, 24 patients (92%) were administered analgesics preoperatively, with 8 (31%) of them still requiring analgesics postoperatively. Ankle arthrodesis patients from both group 1 and group 2 achieved good subjective and objective results of treatment. We noted slightly better results in the Ilizarov apparatus group. [ABSTRACT FROM AUTHOR]

Aim. Stigmatization of those who seem to be superficially or innately different produces many negative consequences, such as hindered recovery process in people suffering from mental disorders. The tendency to stigmatize manifests itself in the majority of age groups, but the elderly seem to be ignored both in research concerning the phenomenon of stigmatization itself and research on methods of counteracting it. The aim of the study was to describe the experiences of contact between the elderly and people suffering from mental illness in order to recount both the symptoms of stigmatization and the readiness to meet such people. The additional goal of the study was to reflect on the methods of counteracting stigmatization. Method. A qualitative method based on the hermeneutic and phenomenological thought was used to analyze the data collected from four group interviews. Results. We distinguished three main themes: (1) "Beliefs about the causes of mental illness", (2) "Emotional attitude towards people suffering from mental illness" and (3) "Ways of interacting with people suffering from mental". Conclusions. Readiness to stigmatize (blaming, controlling, anxiety) and meet people affected by mental disorders as well as to acknowledge their autonomy was observed in our subjects. We propose methods of combating the stigma such as: acquainting recipients with existential and evolutionary thought, nurturing imagination and encouraging people to confront common stereotypes with stories of people they know. [ABSTRACT FROM AUTHOR]

Copyright of Przegląd Socjologii Jakościowej is the property of Redakcja Przegladu Socjologii Jakosciowej and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim. Evaluation of the effects of the lIizarov method on gait symmetry. Material and methods. 16 patients with limb length discrepancy and tibia deformation, treated with the llizarov technique in the 1st Clinic of Orthopaedics and Traumatology in Wroclaw between 1995-2005 participated in this study. They were divided into three groups based on the ethiology of the deformation. Gait analysis was performed by means of Pressure Distribution Measurement System (PDM-S) force-plate. Conclusions. 1. Correction and lengthening of the lower limb with the llizarov technique improved gait function assuming that it corresponds with the symmetry of weight bearing. 2. The ethiology of limb length discrepancy had a significant influence on gait function only when the second peak of the vertical ground-reaction- force vector was analysed. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy / Fizjoterapia is the property of Physiotherapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Developmental knee joint deformities are a common problem in pediatric orthopedics. Children with a valgus or varus deformity of the distal femur or the proximal tibia are commonly treated with hemiepiphysiodesis. Gait analysis in patients with lower limb deformities plays an important role in clinical practice. The purpose of our study was to assess gait parameters in patients who underwent hemiepiphysiodesis procedures of the distal femur or proximal tibia due to a knee deformity and to compare them with those in healthy controls. Methods: We prospectively evaluated 35 patients (14 females and 21 males) after hemiepiphysiodesis and compared the results with a healthy control group (26 participants). Gait was analyzed with a G-Sensor device (BTS Bioengineering Corp., Quincy, MA, USA). We assessed the following gait parameters: gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, cadence, velocity, and step length. We assessed these gait parameters in a group of patients before and after treatment with hemiepiphysiodesis. We compared the patients' results before and after treatment to those of a healthy control group. The level of significance was set at p < 0.05. Results: The mean follow-up period was 13 months. There was no difference in the results of gait assessments in patients prior to and after treatment. The median step length was 47.09% in the treated limb after treatment and 54.01% in the intact limb ( p = 0.018). There were no other differences in gait parameters in the treated limbs and the healthy, intact limbs in the patient group after treatment. There were no significant differences in the patients before and after treatment compared with those in the healthy control group in all gait parameters. Conclusions: Valgus or varus knee deformity correction with the use of hemiepiphysiodesis does not significantly improve preoperative gait parameters. The biomechanical outcomes of hemiepiphysiodesis in the treatment of valgus or varus knee deformity are good. We observed no differences in gait cycle duration, step length, support phase duration, swing phase duration, double support duration, single support duration, gait velocity, cadence, or step length between the experimental and healthy control groups.

Background: Intra-articular and comminuted fractures of the calcaneus constitute a significant orthopedic challenge. Calcaneal fracture management should primarily aim to achieve good clinical and biomechanical outcomes, pain reduction, and normal function following treatment., Research Question: How does Ilizarov treatment of calcaneal fractures affect gait parameters?, Methods: This retrospective study included 21patients (7 women, 14 men) who were treated for intra-articular calcaneal fractures with the Ilizarov method in the period 2021-2022. Nineteen healthy volunteers constituted the control group. Gait assessments were conducted with a BTS G-SENSOR device (BTS Bioengineering Corp., Quincy, MA, USA). The gait assessment evaluated the following parameters: assessment duration expressed in seconds (s), cadence expressed as the number of steps per minute (steps/min), gait velocity (m/s), stride length (m), stance phase (%), swing phase (%), double support phase (%), and single support phase (%).The study assessed pain intensity in the VAS scale, Böhler's angle and Gissane's angle., Results and Significance: We observed no significant differences between the experimental group and the healthy control group in terms of cadence, gait velocity, or stride length. Patients in experimental group showed significantly shortened stance and single support phases in the treated limb in comparison with those in the intact limb; the remaining gait parameters were similar in the treated and intact limb. We observed no significant differences between the treated limbs in the patient group and the nondominant limbs in the control group in terms of any gait parameters. In the follow-up, the average pain value on the VAS scale was 2.3. The median Böhler angle changed from 5.5° preoperatively to 28.5° postoperatively, p < 0.001. The median Gissane's angle was 119° before surgery and 143° after surgery, p < 0.001.The use of the Ilizarov method in the treatment of calcaneal fractures helps achieve sufficient normalization of most gait parameters, with their values similar to those observed in healthy volunteers. After treatment of calcaneal fractures using the Ilizarov method, radiological parameters improved. The biomechanical outcomes of calcaneal fracture treatment with the Ilizarov method are good., Competing Interests: Declaration of competing interest There was no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The goal of the orthopedic treatment of fractures is to achieve bone union as rapidly as possible in the largest possible number of patients and to minimize the number of complications. The purpose of this study was to assess if the use of Osteogenon would have a positive effect on radiological and clinical parameters in patients with lower leg bone fractures treated with the Ilizarov method. Methods: We evaluated 26 patients who had their lower leg bone fractures treated with the Ilizarov method and received Osteogenon at our clinic in the years 2021-2023. The control group comprised 25 patients with lower leg bone fractures treated with the Ilizarov method who did not receive Osteogenon. We assessed the following parameters: time to achieving bone union, bone union rate, time to resuming normal physical activity, time to achieving pain relief, the number of patients reporting pain relief, and the rate of complications. Results: The median time to achieve bone union after lower leg bone fracture treated with the Ilizarov method was shorter in the Osteogenon group (108.5 days) compared to the control group (134 days), p < 0.001. Bone union was achieved in all the patients in the Osteogenon group and in 96% of the patients in the control group; the difference was not statistically significant. The median time to resuming normal physical activity was shorter in the Osteogenon group (22.5 weeks) compared to the control group (27 weeks), p < 0.001. The median time to achieving pain relief was shorter in the Osteogenon group (21 weeks) compared to the control group (30 weeks), p < 0.001. The proportion of patients who reported pain relief was 88.46% in the group receiving Osteogenon and 76% in the control group; this difference was not statistically significant. The number of complications was lower in the Osteogenon group (8 patients; 30.77%) compared to the control group (15 patients; 60%), p = 0.035. Conclusions: The use of Osteogenon has a beneficial impact on the treatment of lower leg bone fractures with the Ilizarov method. Osteogenon shortens the time to achieve bone union. Moreover, the use of the ossein-hydroxyapatite complex helps reduce the number of complications and shortens the time to achieve pain relief and to resume normal activities.

Background: There is currently no established gold standard for the treatment of calcaneal fractures., Objectives: To conduct a clinical and radiological evaluation of patients following intra-articular calcaneal fractures treated with the Polish modification of the Ilizarov method., Material and Methods: This was a 2-center retrospective study. We evaluated 27 patients (2 women and 25 men) aged 28-73 years (mean age 50.5 years) after treatment of intra-articular calcaneal fractures with the Polish modification of the Ilizarov method. We assessed pain using a visual analogue scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) scores, patient satisfaction with treatment, use of analgesics, duration of Ilizarov treatment, length of hospital stay, duration of surgery, patient's declared willingness to choose the same treatment again, complications, degenerative changes, Böhler angle, inflection angle, and Gissane angle., Results: The mean follow-up period was 3 years and 2 months. Following treatment, the mean VAS pain score was 2.3. Prior to surgery, all patients were taking analgesics in comparison with only 2 patients (7.4%) at long-term follow-up. The treatment was rated as satisfactory by 11 patients, with 16 patients rating it as highly satisfactory. The mean post-treatment AOFAS score was 76.6 points. The Ilizarov fixator was removed after a mean period of 88 days. The mean duration of hospital stay was 7.4 days. The mean duration of the procedure was 44 min. All patients would choose the same treatment again. Complications were observed in 5 patients. The long-term follow-up visit revealed degenerative changes in the talocalcaneal joint in 8 patients. The median Böhler angle was 5.5° preoperatively and 28.5° postoperatively, p < 0.001. The median preoperative inflection angle of 160° decreased to 145°, p < 0.001. The median preoperative Gissane's angle of 119° increased significantly to a median postoperative value of 143°, p < 0.001., Conclusions: The patients achieved good clinical and radiological outcomes.

Background: Up to 75% of calcaneal fractures are intra-articular fractures, which may severely impair foot function and lead to disability. Methods: We retrospectively analyzed 21 patients with intra-articular calcaneal fractures who had been treated with the Ilizarov method in the period 2021-2022. The mean patient age was 47 years (range 25-67 years). We analyzed the following functional parameters: foot function with a revised foot function index (FFI-R) questionnaire and the level of physical activity, with the University of California Los Angeles (UCLA) activity scale, a visual analog scale (VAS), and a Grimby physical activity level scale; and ankle range of motion. Results: We observed a significant improvement in the UCLA activity scores and Grimby activity score at long-term follow-up. Functional outcomes based on the FFI-R questionnaires showed an improvement, from 292 points prior to surgery to 127 points at follow-up, p = 0.013. The post-treatment follow-up measurements revealed a median dorsiflexion at the treated ankle joint of 20 degrees, whereas that at the intact ankle was 40 degrees, p = 0.007. The plantar flexion showed asymmetry, with a median 15 degrees at the treated ankle and 30 degrees at the intact ankle, p = 0.007. The median range of inversion at the ankle joint was 5 degrees in the treated limb and 15 degrees in the intact limb, p = 0.039. Conclusions: Patients with calcaneal fractures treated with the Ilizarov method are recommended to have a longer and more intensive rehabilitation. The range of ankle motion in the treated limb was limited in comparison with that in the intact limb; however, this did not greatly affect the patients' return to their earlier, pre-injury level of physical activity.

Background : The biomechanical outcomes of intra-articular calcaneal fracture treatment have not been fully explored. The purpose of this study was to analyze pedobarographic assessments of balance and body weight distribution over the lower limbs in patients following calcaneal fracture treatment with the Ilizarov method and to compare the results with those of a control group. Materials and Methods : The data for our retrospective study came from cases of intra-articular calcaneal fractures treated with the Polish modification of the Ilizarov method in the period between 2021 and 2022. The experimental group (21 patients; 7 women, 14 men) included Sanders classification calcaneal fractures type 2 ( n = 3), type 3 ( n = 5), and type 4 ( n = 13). The control group comprised 21 sex-matched healthy volunteers, with no significant differences from the experimental group in terms of age or BMI. The examination included an assessment of balance and weight distribution over the lower limbs. The device used was a FreeMED MAXI pedobarographic platform (SensorMedica). Results : The mean displacement of the center of gravity in the experimental group was significantly higher at 1307.31 mm than in the control group (896.34 mm; p = 0.038). The mean area of the center of gravity was not significantly different between the groups. An analysis of weight distribution over the operated and uninjured limb in the experimental group and the non-dominant and dominant limb, respectively, in the control group revealed no significant differences. We observed no significant differences in the percentage of weight distribution over the lower limbs between the operated limb in the experimental group and the non-dominant limb in the control group, or between the uninjured limb in the experimental group and the dominant limb in the control group. Conclusions : The use of the Ilizarov method in calcaneal fracture treatment helps normalize the percentage weight distribution in the lower limbs, with the results comparable with those obtained in the healthy control group. The mean displacement of the center of gravity was worse in the experimental group than in controls; whereas the mean area of the center of gravity was comparable between the two groups. Treatment of calcaneal fractures with the Ilizarov method does not help achieve completely normal static parameters of lower-limb biomechanics. Patients treated for calcaneal fractures with the Ilizarov method require longer and more intense rehabilitation and follow-up.

(1) Background : The purpose of this study was to assess the effects of sex and age on the outcomes of hemiepiphysiodesis performed for genu valgum and varum deformity correction. (2) Methods : We analyzed patients who had undergone O-Plate hemiepiphysiodesis due to genu valgum or varum in the period of 2020-2023. The study group comprised 22 females and 20 males aged between 3 and 14 years at the time of surgery. Age-stratification yielded a subgroup of 3-10-year-olds (16 patients, 20 treated limbs) and a subgroup of 11-14-year-olds (26 patients, 28 treated limbs). We assessed the following parameters: hospital stay duration, deformity correction time, MAD correction, amount of angular correction, correction velocity, correction rate, complete deformity correction, deformity recurrence, surgery duration, and complications. (3) Results : The mean follow-up was 19 months. The mean surgery time in the subgroup of 3-10-year-olds (25.62 min) was significantly longer than that in the subgroup of 11-14-year-olds (22.81 min, p = 0.018). The mean deformity correction time in the male subgroup (11.33 months) was significantly shorter than that in the female subgroup (15.87 months, p = 0.013). A comparison of the subgroups stratified by age yielded a mean amount of angular correction of 10.5° in the younger children, which was significantly higher than that of 7.2° achieved in the older children; p = 0.027. The difference in mean correction velocity between 3-10-year-old children (4.03 mm/month) and that in 11-14-year-old children (1.39 mm/month) was statistically significant; p = 0.031. The mean rate of correction was 0.49°/month in females and 0.89°/month in males, with the latter rate significantly greater; p = 0.023. The difference in the mean rate of correction between the younger (1.08°/month) and the older subgroup (0.59°/month) was also significant; p = 0.018. A significant difference in terms of deformity recurrence rates was observed between the younger subgroup (66.67%) and older subgroup (only 10.53%); p = 0.005. (4) Conclusions : Patient sex had no significant effect on hemiepiphysiodesis outcomes; patient age has a considerable effect on hemiepiphysiodesis outcomes.

Background: Pes planovalgus, or flexible flatfoot, deformity is a common problem in pediatric orthopedic patients. There is no consensus on using the technique of arthroereisis in the treatment of symptomatic pes planovalgus. The aim of our study was to prospectively assess the functional outcomes following symptomatic pes planovalgus treatment with the use of the Spherus talar screw., Methods: Twenty-seven patients (11 females, 16 males), at a mean age of 10.5 years (7-14 years) were included in the prospective study. We assessed the level of physical activity (including sports) based on the University of California, Los Angeles (UCLA) activity scale, a 10-point level-of-activity VAS scale, and the Grimby physical activity scale. Pain was assessed based on a VAS pain scale; foot function was assessed with the revised Foot Function Index (FFI-R); and ankle joint mobility was measured., Results: The mean follow-up period was 18 months (14-26 months). There was a significant improvement in VAS-measured physical activity scores from 5.47 to 7 at follow-up, p = 0.048. There was a significant improvement in UCLA activity scale scores from 4.78 to 6.05 at follow-up, p = 0.045. Pain levels decreased from a mean VAS score of 4.73 prior to surgery to a mean score of 2.73 at follow-up, p = 0.047. The functional FFI-R scores showed a significant improvement from 140 points prior to surgery to 97.75 points at follow-up, p = 0.017. Comparison of the preoperative and follow-up values of the range of plantar flexion, adduction, and abduction in the operated limb also showed no significant changes in those individual parameters. The mean values of dorsiflexion, plantar flexion, adduction, and abduction at the ankle joint at follow-up, compared individually between the operated and non-operated foot showed no statistically significant differences., Conclusions: The use of a talar screw in the treatment of symptomatic pes planovalgus helps reduce pain and improve functional outcomes after treatment. Foot function assessments showed diminished pain, improved levels of physical and sport activity, and no effect on the range of motion after surgery in comparison with preoperative data. Arthroereisis with a talar screw is a valid surgical technique for the treatment of symptomatic pes planovalgus.

Background: There have been no reports on arthroereisis screw insertion into the talus in patients with flexible flatfoot. We aimed to conduct a clinical and radiological assessment in patients with symptomatic pes planovalgus deformity treated with a talar screw., Methods: This study involved a prospective assessment of 27 patients treated surgically for symptomatic flexible flatfoot deformity in the period 2021-2022. The following parameters were assessed in this study: Meary's angle, the Costa-Bartani angle, the calcaneal pitch angle, surgery duration, the length of hospital stay, patient satisfaction, patients' retrospective willingness to consent to the treatment they received, postoperative complications, and the use of analgesics., Results: The mean follow-up period was 14.76 months. Meary's angle decreased from 18.63° before surgery to 9.39° at follow-up ( p = 0.004). The Costa-Bartani angle decreased significantly from 154.66° before surgery to 144.58° after surgery ( p = 0.012). The calcaneal pitch angle changed from 16.21° before to 19.74°. Complications were reported in three patients (11.11%). The mean surgery duration was 32 min. The mean hospital stay was 2.2 days. Fourteen patients (51.85%) were highly satisfied with the treatment, and 12 patients (44.44%) were quite satisfied with treatment. Twenty-five (92.59%) of the evaluated patients would choose the same type of treatment again. Six patients (22.22%) needed to use analgesics prior to surgical treatment, whereas none of the patients needed to use them by the final follow-up., Conclusion: Spherus screw arthroereisis helps improve radiological parameters in patients with flexible flatfoot. We observed good clinical outcomes after treatment with a talar screw, with a majority of patients reporting moderate-to-high levels of satisfaction with treatment. Both short- and medium-term treatment outcomes of pes planovalgus treatment with the use of Spherus screw are good.

Direct vertebral rotation (DVR) is the most widespread method to correct axial vertebral rotation. Differential rod contouring (DRC) also includes derotation, but not to the same extent as DVR. DVR requires additional surgical effort with potential consequences, which are absent in DRC; moreover, the data concerning the clinical benefits of apical derotation are not convincing. In the present study, clinical and radiological outcomes were compared in patients who underwent surgery for adolescent idiopathic scoliosis (AIS), having DVR and DRC vs. DRC only. In total, 73 AIS patients with curves of 40-85°, consecutively operated on by one surgeon, participated in this study and were followed up over 2 years. Scores from the SRS-22 questionnaire were analysed, the angles of trunk rotation (ATR) were measured with an inclinometer and a radiographic assessment of coronal and sagittal spinal profiles was conducted. In 38 cases, only DRC was performed, and in 35 DRC was performed and followed by DVR; the groups did not differ from an epidemiological point of view. Total SRS-22 scores after 2 years were similar in both groups (4.23 (±0.33) in DRC vs. 4.06 (±0.33) in DRC/DVR, p = 0.1). In all components of SRS-22, the differences were minor, with p being way above 0.05. The mean ATR in the DRC/DVR group was slightly smaller (8 ± 4°) than that of the DRC group (10 ± 5°), p = 0.16. Radiographic analysis did not show significant differences. The coronal curve was corrected by 66 ± 12% for DRC and 63 ± 15% for DVR, p = 0.28. Thoracic kyphosis in the DRC/DVR group increased by 1°, whereas in the DRC group the average kyphosis increased by 5° with a p value of 0.07. The complication rates were similar in both groups. This investigation did not show any advantages of the combination of DRC and DVR in scoliosis correction over DRC only, both radiologically and clinically, yet it affected intraoperative parameters, extending the operation time with only a minor increase in blood loss.

Background: Bilateral osteoarthritis of the knee is an indication for a bilateral total knee replacement (TKR) procedure. The goal of our study was to assess the sizes of the implants used during the first and second stages of TKR procedures in order to compare their size and identify the prognostic factors for the second procedure., Methods: We evaluated 44 patients who underwent staged bilateral TKR procedures. We assess the following prognostic factors from the first and second surgery: duration of anesthesia, femoral component size, tibial component size, duration of hospital stay, tibial polyethylene insert size, and the number of complications., Results: All assessed prognostic factors did not differ statistically between the first and second TKR. A strong correlation was found between the size of femoral components and the size of tibial components used during the first and second total knee arthroplasty. The mean duration of the hospital stay associated with the first TKR surgery was 6.43 days, whereas the mean duration of the second hospital stay was 5.5 days ( p = 0.211). The mean sizes of the femoral components used during the first and second procedures were 5.43 and 5.2, respectively ( p = 0.54). The mean sizes of the tibial components used during the first and second TKR procedures were 5.36 and 5.25, respectively ( p = 0.382). The mean sizes of the tibial polyethylene inserts used during the first and second procedures were 9.45 and 9.34 ( p = 0.422), respectively. The mean duration of anesthesia during the first and second knee arthroplasty was 117.04 min and 118.06 min, respectively ( p = 0.457). The mean rates of recorded complications associated with the first and second TKR procedures were 0.13 and 0.06 per patient ( p = 0.371)., Conclusions: We observed no differences between the two stages of treatment in terms of all analyzed parameters. We observed a strong correlation between the size of femoral components used during the first and second total knee arthroplasty. We noted a strong correlation between the size of tibial components used during the first and second procedure. Slightly weaker prognostic factors include the number of complications, duration of anesthesia and tibial polyethylene insert size.

Background: Ankle joint injuries are an important orthopedic issue due to their high incidence and the variety of treatment methods available. This study assessed the effect of the COVID-19 pandemic on the epidemiology and treatment of ankle joint injuries. There is lack of papers which address this problem., Material and Methods: This study compared epidemiological data on ankle joint injuries in adults and children collected during the period of the COVID-19 pandemic (2020) and a corresponding prepandemic period (2019). Epidemiological data, demographic data, treatment methods, hospital stay duration, and injury-to-surgery time were analyzed., Results: The total number of patients hospitalized for ankle fractures in the evaluated pandemic period was lower by 34% than that in the corresponding prepandemic period in 2019. The pediatric patient subpopulation showed a 70% decline during the analyzed period of COVID-19 pandemic. The number of hospitalized females declined by 12%, and the number of hospitalized males dropped by 53%., Conclusions: 1. Our study showed the impact of the COVID-19 pandemic on the epidemiology and treatment of ankle joint injuries. 2. The COVID-19 pandemic effected a decrease in the number of patients with ankle joint injuries, particularly pediatric and male patients with these injuries. 3. National lockdown measures had a considerable effect on lowering the numbers of pediatric patients with ankle joint injuries treated conservatively. 4. Importantly, the tendency can be noted among orthopedic surgeons and emergency room doctors to more readily qualify orthopedic patients for a trial of conservative treatment. This only prolongs the duration of treatment and time to the ultimate therapeutic surgery.

Introduction: There is no consensus among orthopedic surgeons on the number of cortical layers (tricortical or quadricortical fixation) involved or the duration of syndesmotic fixation after a tibiofibular syndesmosis (TFSD)-injury treatment. The purpose of this study was to assess radiographic parameters following the treatment of TFSD injuries, with various time-windows of syndesmotic screw removal and numbers of cortical layers involved., Materials and Methods: Fifty-five patients, aged from 25 to 75 years, were included in the study. The follow-up period ranged from 2 years to 4 years and 2 months. The patients were subdivided into groups based on the duration of the syndesmotic fixation (8-15 weeks-19 patients or 16-22 weeks-36 patients) and the number of cortices involved (tricortical-17 patients or quadricortical fixation-38 patients)., Results: The quadricortical fixation group showed a significant development of ankle joint arthritis and subtalar joint arthritis at the final follow-up. The mean medial clear space was 2.84 mm in the tricortical fixation group and 3.5 mm in the quadricortical fixation group ( p = 0.005). Both groups, with different screw removal times showed significant development of posttraumatic arthritis. A comparison of the two groups (with different time-windows of the screw removal) revealed a significant difference only in terms of the postoperative tibiofibular (TF) overlap and the observed rates of talonavicular arthritis at the final follow-up., Discussion: We found that the duration of the screw fixation had no effect on most of the evaluated radiographic parameters. Only the postoperative TF overlap was lower in the 8-15-week fixation group, and the proportion of patients with talonavicular joint arthritis at the final follow-up was higher in the 16-22-week fixation group. In addition, the number of cortices involved in the screw fixation had no effect on the radiographic outcomes in our patients, apart from the differences in one parameter-the medial clear space-at the final follow-up., Conclusion: We achieved similar radiographic results irrespective of the duration of the screw fixation and the number of cortices involved. All study subgroups showed the development of adjacent-joint arthritis following treatment. Considering the results of our study, the economic and medical aspects of treatment, and the possibility of a faster recovery, the most optimal solution seems to be the use of a tricortical fixation, with the screws being removed after 8-15 weeks.

Background: the COVID-19 pandemic with the following lockdown strategies have affected virtually all aspects of everyday life. Health services all over the world faced the crisis on an unprecedented scale, hampering timely care delivery. The present study was designed to assess the impact of the COVID-19 outbreak on the incidence and treatment of traumatic brain injuries in Poland., Methods: the data on hospital admissions with traumatic brain injuries as the primary diagnosis were extracted from the National Health Fund of Poland. For the purpose of this study, the search was limited to four relevant diagnosis-related groups. The overall in-house mortality was calculated., Results: there were 115,200 hospitalizations due to traumatic brain injury identified in the database. Overall, in comparison with the average of six prior years, in 2020 the volume of patients with traumatic brain injury dropped by 24.68% while the in-house mortality rate was increased by 26.75%., Conclusions: the COVID-19 pandemic with the resulting lockdown caused a radical reduction in human mobility. It had a profound impact on the incidence of traumatic brain injury, which dropped significantly. At the same time, the mortality rate increased drastically.

Background: The purpose of this study was an experimental assessment of changes in bone fragment position in patients with non-union of the tibia treated with a hexapod fixator., Hypothesis: We hypothesized that the use of hexapod fixators leads to differences between the planned and actual position of bone fragments., Methods: The study was conducted in physical models of the hexapod fixator-bone fragment system. Bone fragment displacement was measured using the Optotrak Certus Motion Capture System. We assessed differences between the planned and actual position of bone fragments., Results: Assessment of bone fragment compression demonstrated a difference between the target and actual correction ranging from 1.5% to 13.2% (depending on the force applied to bone fragments) for configuration 1, from17% to 21.3% for configuration 2, and from 13.2% to 17.9% for configuration 3. The achieved varus deformity correction constituted 93.7-98.4% of the target correction for configuration 2 and 98.3-98.9% of the target correction for configuration 3. Torsional deformity correction showed considerable discrepancies between the target and achieved correction, ranging from 65.6% to 83%., Discussion: The value of the applied compression force had no marked effect on the differences between the target and achieved correction or on the magnitude of unintended rotational and transverse displacement of bone fragments. The use of hexapod fixators helped achieve complete correction of the simulated varus deformity; however, complete correction of torsional deformities was not achieved. Deformity correction in physical models with the use of a hexapod fixator yielded instances of unintended rotational and transverse bone-fragment displacement. The use of hexapod fixators in physical models leads to differences between the planned and actual position of bone fragments., Level of Evidence: IV, case series., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Background: The evaluation of the efficacy of platelet-rich plasma (PRP) in clinical practice yields conflicting results and raises numerous controversies. This may be due to different concentrations of biologically active components in PRP obtained with the use of different methods of gravity separation., Aim: To compare the content, repeatability and correlations between biologically active components in PRP obtained with four different commercial systems., Methods: From a whole blood sample of each of 12 healthy male volunteers, 4 PRP samples were prepared using 4 different commercial kits [Arthrex Autologous Conditioned Plasma (ACP), Mini GPS III, Xerthra, Dr. PRP] in accordance with the instructions provided by the manufacturers. A comparative analysis of blood cell components - 13 selected inflammatory cytokines and 7 growth factors - in the obtained PRP samples was performed using the Kruskal-Wallis test by ranks. The repeatability of results in each method was evaluated by the estimation of the coefficient of variation. The Spearman correlation was used to estimate the relationship between blood cell content and cytokines., Results: Significantly higher concentrations of platelets (PLT), white blood cells (WBC) and red blood cells (RBC) were found in PRP obtained with the use of Mini GPS III than in PRP obtained using other systems. Significant differences in the content of growth factors and cytokines in PRP were found. A positive correlation of the amount of PLT, RBC and WBC with the concentration of most of the growth factors was found but in only three inflammatory cytokines. The obtained correlations between blood cell components and cytokines differed between the systems in terms of statistical significance, which may be due to insufficient sample size. The repeatability of the obtained PLT concentration also varied between protocols with the lowest in Xerthra and the highest in Arthrex ACP., Conclusion: Significant differences in the content of biologically active components and their repeatability were found in PRP obtained by various methods, providing new data for further research., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest. The founders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: The optimal duration of cast immobilization following distal radius fractures (DRFs) in elderly patients has not been established., Objectives: To assess the functional and radiological parameters following DRF treatment in elderly patients using 2 different periods of cast immobilization., Material and Methods: We assessed 50 patients (33 women and 17 men). The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. One subgroup (n = 26) included patients treated with a cast for 4 weeks, whereas the other subgroup (n = 24) included patients treated with a cast for 6 weeks. The following measures were assessed: union rate, radial inclination, volar tilt, radial height, Visual Analogue Scale (VAS) pain score, Mayo Wrist Score, and VAS activity score., Results: The mean volar tilt was 9.13° in the group treated with a cast for 4 weeks and 3.29° in the group treated with a cast for 6 weeks (p = 0.043). There were no differences between the groups in terms of any other functional or radiological parameters., Conclusion: The VAS pain score, Mayo Wrist Score and VAS activity score were similar between the 2 study groups. The greatest volar tilt angle was observed after 6 weeks of cast immobilization. The study groups showed no significant differences in terms of radial inclination, union rate, radial height, or bone union. A period of 4 weeks of cast treatment was sufficient for elderly patients with DRFs.

Background: The purpose of our study was to analyze kinematic parameters following pilon fracture treatment with the Ilizarov method. Methods: Our study assessed kinematic parameters of gait in 23 patients with pilon fractures treated with the Ilizarov method. Patients had completed their treatment 24−48 months prior to measurements. The range-of-motion values in the non-operated limb (NOL) and operated limb (OL) were compared. Kinematic parameters were measured using the Noraxon MyoMOTION System. Results: We observed no significant differences in hip flexion, hip abduction, or knee flection between the OLs and NOLs in patients after treatment with the Ilizarov method. We observed significant differences in the ranges of ankle dorsiflexion, inversion, and abduction (p < 0.001; p < 0.001; p < 0.003, respectively) between the OLs and the NOLs. Conclusion: Following pilon fracture treatment with the Ilizarov method, we observed no differences in terms of knee or hip joint mobility between the OL and the NOL, whereas the range of motion in the ankle joint of the OL was significantly limited. The treatment of pilon fractures with the Ilizarov method does not ensure the complete normalization of ankle joint kinematic parameters. Therefore, intense personalized rehabilitation of the ankle joint is recommended.

We aimed to investigate changes in postural stability on a stable surface after the application of dynamic tape for patients with inversion ankle sprains. This study enrolled 30 patients (age 25.5 ± 8.0 years) with grade I and II ankle sprains, which occurred 7−21 days before enrolment. Postural stability (balance, coordination, feedback) was assessed before and after the application of dynamic tape using a stabilographic platform. Three 32-s exercises were performed on the stabilographic platform, one with eyes open, one with eyes closed and one with visual feedback. After the application of dynamic tape, an improvement was observed in terms of the mean radius of sway (4.2 ± 1.3 mm vs. 3.4 ± 0.9 mm; p = 0.012) and coordination (48.8 ± 19.2% vs. 59.3 ± 5.8%; p = 0.021). Selected balance parameters did not improve significantly in the tests with open and closed eyes. Asymmetric load improved for all tests, but significant differences were only observed with eyes closed (34.9 ± 24.4 vs. 41.7 ± 30.5; p < 0.01). We concluded that the use of dynamic tape after an ankle sprain significantly improved balance and coordination on a stable surface. The benefits were shown in terms of a significant improvement in the asymmetric load of the injured limb in comparison to the healthy limb during the test with closed eyes and a considerable improvement in the asymmetric load that was evaluated with visual feedback on a stable surface.

(1) Background: The pandemic of COVID-19 and subsequent lockdown strategies had a profound impact on many aspects of everyday life. During this time the world faced the unprecedented crisis of healthcare disrupting timely care delivery. This study was designed to evaluate the impact of the pandemic on the acute treatment of stroke in Poland. (2) Methods: The national data on hospitalizations with stroke as a primary diagnosis were obtained from the National Health Fund of Poland. Poisson regression was used to determine the significance of the change in hospital admissions. The differences between proportions were analyzed using the "N-1" Chi-squared test. (3) Results: During the COVID-19 period, the number of hospitalizations dropped by 8.28% with a monthly nadir of 22.02 in April. On a monthly scale during 2020, the greatest decrease was 22.02%. The thrombolysis ratio was also affected, with the highest monthly drop of 15.51% in November. The overall number of in-hospital deaths did not change. (4) Conclusions: The pandemic caused a serious disruption of the acute care of stroke. There is no evidence that the quality of care was seriously compromised.

Percutaneous iliosacral screw fixation is a widely accepted method of stabilizing the posterior pelvic ring. Recently developed tools such as 3D-navigated fluoroscopy and computed navigation seem to prevent a surgeon from conducting screw misplacement. The study aimed to comparatively assess the introduction of sacroiliac screw placement using 2D and 3D fluoroscopy in terms of accuracy and radiation exposure. Iliosacral screws were introduced in 37 patients using 2D (group N1) and in 36 patients using 3D fluoroscopy (group N2) techniques. Overall, 61 and 56 screws were introduced in groups N1 and N2, respectively. Screw placement accuracy was assessed using postoperative computed tomography and Smith's scale. Intraoperative radiation exposure was also assessed. No differences were noted between groups in terms of screw positioning accuracy and radiation dose. Both 2D and 3D fluoroscopy provide good visualization for safely placing percutaneous iliosacral joint screws. Using 3D fluoroscopy-based navigation in comparison with 2D fluoroscopy is not advantageous.

Introduction: Retrospective study to assess correlation between the sagittal alignment of the cervical spine and the long-term outcomes of long cervical fusion due to cervical spondylotic myelopathy (CSM), with the emphasis on T1 slope minus cervical lordosis (T1S-CL)., Summary of Background Data: Growing evidence shows that the sagittal profile can play a major role in the outcomes of treatment, but the role of its correction is yet to be established., Material and Methods: We conducted a retrospective analysis of 54 patients treated for CSM from 2006 to 2012. The neck pain-related disability was measured using NDI, the myelopathy was measured with the mJOA and Nurick scales. Six years after the surgery, standardised X-ray measurements were obtained, including C2-C7 lordosis (CL), C2-C7 sagittal vertical alignment (SVAC2-C7), T1 slope (T1S), and T1S minus CL (T1S-CL). The patients were divided based on the T1S-CL into two groups, using the threshold value of 16.5 degrees., Results: A statistically significant improvement was noted in the mean NDI, mJOA, and median Nurick scale during the initial two years in both groups. The better aligned group had a better outcome measured with NDI at all follow-ups. The mJOA was significantly better in the better aligned group, but only preoperatively; at all follow-ups, the difference was not significant. T1S-CL had the strongest correlation with the NDI at the final follow-up., Conclusions: T1S-CL is an effective prognostic factor of the long term outcome after long cervical fusion in CSM treatment.