Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · Jul 2007
Case ReportsIntramedullary nailing in treatment of complications of long bone union following fracture - case studies.
Open osteosynthesis of long bones fractures carries high risk of complications, the most common of which are plate breakage, slow union, delayed union and non-union. The paper analysis of 3 cases of bone union complications treated by locked intramedullary nailing. The aim was to show differences in the therapeutic management of different bones and non-unions following different types of osteosynthesis. ⋯ Locked intramedullary nailing permits stable bone fixation. Intramedullary canal reaming stimulates bone consolidation since it is the source of autologous bone graft. Similar to its use in the treatment of acute fractures, the method permits early, active and efficient patient rehabilitation.
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Ortop Traumatol Rehabil · Jul 2007
Use of reamed locked intramedullary nailing in the treatment of aseptic diaphyseal tibial non-union.
Tibial fractures have been associated with the highest rates of bone union disturbances for many years. Stabilization of the tibial shaft with a reamed intramedullary nail is now being increasingly recommended as a treatment of choice. The aim of this study was to evaluate the outcomes of treatment of tibial shaft non-union with reamed intramedullary nails locked distally and proximally. ⋯ The treatment of an aseptic non-union of the tibial shaft with an intramedullary nail is an effective procedure. This conclusion must be regarded as tentative in view of the small sample size.
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Ortop Traumatol Rehabil · Jul 2007
Treatment of femoral shaft union disturbances with intramedullary nailing. Treatment failure.
The paper contains an analysis of the treatment outcomes of intramedullary nailing for femoral shaft non-union. ⋯ Despite being an acknowledged method of treatment for delayed union of long-bone shafts, intramedullary nailing following reaming of the medullary cavity did not result in bone healing in all of our patients and additional procedures were often required. Therefore, the use of this procedure for femoral shaft pseudoarthroses should be decided on a case-by-case basis.
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Ortop Traumatol Rehabil · Jul 2007
ReviewCurrent understanding of osteoporosis according to the position of the World Health Organization (WHO) and International Osteoporosis Foundation.
The study documents a general change of position on osteoporosis (definition, diagnosis, aim of treatment). Taking into consideration a multifactorial nature of bone fragility in osteoporosis we do not diagnose "osteoporosis" but a total, individual 10-year fracture risk (AR-10) on the basis of independent and self-sufficient risk factors. These are: advanced age, prior fragility fracture, parental history of proximal femur fracture, low BMI, low bone mass, glicocortycosteroids treatment, rheumatoid arthritis, smoking, overuse of alcohol. ⋯ Spinal X-rays are performed in aim to diagnose vertebral fractures, which mean a multiple increase of risk of further fractures. The principles of low bone mass differential diagnosis and current possibility of pharmacological treatment are also described. Guidelines for fall avoidance in fracture prevention are described.