Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · Nov 2008
Comparative StudyCost analysis and sociomedical aspects of the conservative and surgical treatment of hip osteoarthritis.
Hip osteoarthritis (OA) is one of the most common causes of pain, physical disability and marked impairment of patients' physical fitness and mobility. Insufficient funding for health care contributes to prolonged waiting times for total hip replacement (THR) surgery, which has been proven to be the only effective treatment for OA. Average waiting time in Poland is estimated at 2-2.5 years. Objective. To carry out a retrospective comparative analysis of the cost of THR surgery vs. conservative treatment for OA in a variety of sociomedical aspects while patients are awaiting THR. ⋯ Pharmacological treatment, rehabilitation, physical therapy and other methods appear to be inefficient in patients with hip OA awaiting THR and their costs are twice as high. Additionally, NSAID drugs produce GI ulcers in 25% of the patients. Psychosocial problems are also common for these patients. Surgical treatment produces a radical improvement of the quality of life and ameliorates psychosocial problems. Therefore, hip OA costs can only be reduced by shorter waiting times, which can be accomplished through an increase in funding resulting in wider access to the procedure.
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Ortop Traumatol Rehabil · Jul 2008
ReviewAlzheimer's disease and osteoporosis: common risk factors or one condition predisposing to the other?
Both Alzheimer's disease and osteoporosis occur mainly in persons aged over 60. Both diseases are often seen to co-occur in clinical practice, yet very few investigators have addressed this problem. ⋯ Furthermore, the effects of vitamin D and calcium preparations with or without bisphosphonates (risedronate) have also been assessed. The authors concertedly emphasise that the treatment of patients with dementia needs to include the prophylaxis of osteoporosis, falls and fractures.
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Ortop Traumatol Rehabil · Jul 2008
Comparative StudyCompartment syndrome of the foot after calcaneal fractures.
A compartment syndrome is a condition in which high pressure within a closed fascial space causes reduced blood flow with nerve and muscle ischaemia. Untreated compartment syndrome leads to ischaemia with necrosis, contractures, myofibrosis and irreversible functional impairment in the involved part of the limb. Calcaneal fractures and other kinds of foot trauma may cause acute compartment syndrome of the foot. This condition may lead to foot deformities, including clawing of the toes, weakness of the foot muscles and, ultimately, a gait disorder. ⋯ Calcaneal fractures are accompanied by elevated intracompartmental pressure and symptoms of compartment syndrome. Acute compartment syndrome of the foot is very rarely diagnosed in Poland and only exceptionally treated by compartmental decompression. If left untreated, combined with deformities directly related to the fracture, it may lead to disability.
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Ortop Traumatol Rehabil · Jul 2008
Comparative StudyComparison analysis of the operative treatment results of the femoral neck fractures using side-plate and compression screw and cannulated AO screws.
Femoral neck fractures are among the most frequent and the most dangerous types of musculoskeletal injuries in the elderly population. There is general agreement that because of the morphology of the fracture, internal fixation is the treatment of choice irrespective of the degree of displacement. The optimal surgical treatment of femoral neck fractures remains controversial despite constant progress in the surgical management of such fractures and still remains a serious therapeutic problem. The goal of the present study was to compare the outcome in patients who underwent surgery of femoral neck fractures with AO screws; a compression screw and a side-plate; and a compression screw and a side-plate with an additional AO screw. ⋯ Irrespective of fracture morphology, compression screw and side-plate fixation provides better stabilisation to the bony fragments and improves early mobilisation in comparison with AO screws.
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Ortop Traumatol Rehabil · Jan 2008
The results of locked intramedullary nailing for non-union of forearm bones.
We report our experience with the use of a full-thickness corticocancellous iliac-crest graft, 1 to 5 centimeters in length - to treat established nonunion of the radius and/or ulna. ⋯ Intramedullary nailing in treatment for forearm bones nonunion with use corticocancellous graft is technically easy, didn't require immobilization in the cast and enable early postoperative rehabilitation.