Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · Aug 2017
Case ReportsEvaluation of Strength Recovery after Traumatic Acute Compartment Syndrome of the Thigh. A Case Study.
Acute compartment syndrome of the thigh is an underestimated serious pathology which can cause long term morbidities. The management, recovery and follow-up of the case of a 20-year-old Caucasian man, who presented an acute compartment syndrome of the thigh, are described. After femoral fracture reduction and fixation by nail, intramuscular pressure measurements confirmed the diagnosis before treatment by fasciotomies. 12-months' follow-up showed the presence of neurological femoral complications and physical impairment in spite of rehabilitation care. Because compartment syndrome of the thigh after a trauma is rare but potentially devastating, prompt diagnosis is required for performing early fasciotomies.
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Ortop Traumatol Rehabil · Aug 2017
Predicting Functional Outcomes in Patients with Femoral Neck Fractures Treated by Hemiarthroplasty.
A femoral neck fracture leads to serious health-related, social and economic consequences and, according to the con-temporary doctrine of medical management, should be treated surgically. Data provided by the Agency for Health Technology Assessment and Tariff System indicate that there were 1534 patients with femoral neck fractures treated by arthroplasty with a Moore's endoprosthesis and 4744 with a bipolar endoprosthesis in Poland in 2014. Since the risk of femoral neck fracture increases exponentially with the patient's age, and population aging is undoubtedly a real demographic trend, we believe that there is a need to develop criteria for taking treatment decisions to ensure the best possible outcomes. The aim of this paper is to identify factors influencing the functional outcomes of hemiarthroplasty measured with the Harris Hip Score (HHS) in patients with femoral neck fractures. ⋯ 1. Evaluation of the quality of life of patients who underwent surgery after femoral neck fractures utilising the Harris Hip Score (HHS) in one-fac-tor correlations (age, sex, type of endoprosthesis, general condition) revealed significantly superior results for men who received the bipolar endo-prosthesis. There was also a moderately strong and negative correlation with the patients' age. 2. The functional outcomes in patients with low energy femoral neck fractures treated with two types of partial hip endoprosthesis at the Ortho-paedic Department of the Regional Hospital in Sieradz, assessed by multiple factor analysis, showed a significant correlation only with the patient's baseline overall health status.
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Ortop Traumatol Rehabil · May 2017
Evaluation of Complications from Stainless-Steel Flexible Intramedullary Nailing in Children's Femoral Shaft Fractures and Recommendations for Continued Use.
[b]Background.[/b] Flexible intramedullary nailing is currently considered the treatment of choice for femoral diaphyseal fractures in school-aged children. The purpose of our study was to critically evaluate and analyze the complications of stainless steel flexible intramedullary nailing in children's femoral shaft fractures. (mean age, 8.2 years) with a femoral shaft fracture treated with stainless steel flexible intramedullary nailing from January 1, 2009 to July 31, 2015 and evaluated for complications.[b]Results.[/b] All fractures united in a mean time of 9.2 weeks. Minor complications were noted in 19 patients, and major complications were noted in two patients. ⋯ Stainless steel flexible intramedullary nailing in children's femoral shaft fractures is associated with minimal complications. 2. These complications are not related to the alloy of the implant and are mostly due to the long nail end; these complications can be prevented easily. 3. Stainless steel flexible intramedullary nailing is also cost effective, and we recommend its use be enhanced for the treatment of femoral shaft fractures in children.
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Ortop Traumatol Rehabil · Jan 2017
Economic Analysis of 4221 Revisions Due to Periprosthetic Joint Infection in Poland.
Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. ⋯ 1. The system of reporting periprostheticjoint infections currently in use in Poland does not adequately reflect the current classification of PJI and reimbursement for septic revision of joint prosthesis does not match the actual costs. 2. The Polish DRG system does not distinguish between early and late PJI and fails to acknowledge basic guidelines for infection treatment currently followed in Poland and worldwide. 3. According to the DRG system, patients requiring different treatment are placed in one category. 4. Until the year 2013, the less expensive treatment of early infections had been reimbursed on the same basis as the more costly two-stage revision procedures.
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Ortop Traumatol Rehabil · Nov 2016
Review Comparative StudyPredicting Persistent Unclear Pain Following Primary Total Knee Arthroplasty.
Chronic post-surgical pain can be a considerable issue for patients undergoing primary total knee arthroplasty. According to the literature, persistent knee pain is experienced by up to 44% of patients. Most studies on total knee arthroplasty (TKA) outcomes have mainly investigated the biomechanics or function of the operated knee, but chronic pain has never been a primary issue. ⋯ Despite the considerable number of patients suffering from chronic postsurgical pain after TKA, available data is scarce, and well controlled prospective studies are lacking. Predictors of chronic postsurgical pain after total knee arthroplasty have yet to be identified. Thus, this article is aimed at reviewing current knowledge on persistent pain after knee arthroplasty.