Ortopedia, traumatologia, rehabilitacja
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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.
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Ortop Traumatol Rehabil · May 2007
ReviewCurrent opinion about using the platelet-rich gel in orthopaedics and trauma surgery.
The use of growth factors in combination with tissue engineering seems to be the most promising method in the future for the treatment of tissue, bone and cartilage defect. Growth factors are cytokines with regulatory functions for healing in tissues of the musculoskeletal system. These small peptides are synthesised by resident cells at the site of injury such as mesenchymal stem cells and chondrocytes, or by the infiltrating inflammatory process. ⋯ The activator for PRP is a mixture of thrombin and calcium chloride. After connecting these substances platelet-rich gel (PRG) is formed and numerous regulatory molecules to the injury site such as PDGF, TGF-, VEGF, IGF, EGF and antimicrobial proteins are released. The aim of this article is presentation of present knowledge about properties and possibilities of using platelet-rich plasma in the treatment of soft tissue and bone healing disturbances.
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Ortop Traumatol Rehabil · Mar 2007
Interbody fusion and transpedicular fixation in the treatment of spondylolisthesis.
This is a retrospective analysis of long-term results of treatment of dysplastic, isthmic and degenerative spondylolisthesis with interbody fusion and transpedicular screw fixation. ⋯ 1. Transpedicular fixation with interbody fusion is an effective technique for the treatment of spondylolisthesis. 2. Partial reposition of spondylolisthesis with neural decompression makes it possible to avoid neurological complications. 3. The "Bialstab" fixation system fulfills the criteria for good transpedicular stabilization.
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Ortop Traumatol Rehabil · Mar 2007
Comparative StudyComplications of dislocated calcaneal fractures.
Calcaneal fractures are the most common of all tarsal fractures, with the majority being the result of high energy injuries causing comminution of bone and lesions of the posterior articular surface. If the bone fragments are left dislocated or non-operative reduction is attempted, the outcome is poor, often with chronic disability. On the other hand, operative treatment does not always lead to a good result and there is an inherent risk of devastating complications. ⋯ 1. Complications of calcaneal fractures significantly worsen the therapeutic outcome. 2. Proper care based on meticulous evaluation of the foot in the early period is crucial for reducing the incidence of complications.