Morphine or bupivacaine in controlling postoperative pain in patients subjected to knee joint arthroscopy.

Background. We investigated the efficacy of intra - articular bupivacaine with morphine administration after knee joint arthroscopy.
Material and methods. The present study compared intra- arthicular bupivacaine with intra-arthricular morphine for postoperative analgesia in 56 patients (21 women, 35 men) (age 20-70, mean 39.8) undergoing knee joint arthroscopy.
Intraoperatively, the patients received anaesthesia spinaly (0.5 % Marcaine spinal ASTRA) and immediately following surgery received 10 ml intra-arthricular injection consisting either of 0.5 % bupivacaine (group I), 5 mg morphine + 0.9 % saline (group II).Postoperative analgesia was supporeted by intravenous doses of proefferalgan.
In all patients the visual analogue pain score (VAS), PaO2, systolic blood preassure (SABP), diastolic blood preassure (DABP), heart rate (HR), respiratory rate (f), supplemented analgesia and possible side effects were monitored postoperatively.
Results. Intra-arthricular administration of each solution was well toleratede and non side effects were noted.
There was non significant difference among the two groups in monitored parameters. The mean time of postoperative analgesia was 185,7 +/- 25.3 min for bupivacaine group and 390.3 +/- 35,4 min for morphine group.
Total amount proefferalgan supplamentation was the highest in group I.
Conclusions. Postoperative intra- arthricular injections of bupivacaine and morphine for patients undergoing knee joint arthroscopy can provide a safe and effective analgesia and therefore shound be recommended and widely implamented into the clinical use as a standard procedure.

[Evaluation of late results for surgical treatment of chronic lateral epicondylitis]. / Ocena odleglych wyników leczenia operacyjnego przewleklego zapalenia nadklykcia bocznego kosci ramiennej.

The results of surgical treatment of 25 patients with lateral epicondytilis (tennis elbow) were analysed. The mean time before surgery was 2 years and 4 months. The patients' negative attitude towards surgery and the prolonged conservative treatment by general practitioners were the reasons for such a long period of ineffective conservative procedures. Following Hohmann's surgery the flexion in elbow joint and dorsal flexion in radio-carpal joint limitation were the most common residual impairments. The loss of muscle circumference of the operated extremity was observed in 10 (40%) patients. Pain subsided in 20 (80%) and numbness in 11 (44%) patients. Two third of the patients were satisfied with the surgery outcome This moderately good general outcome was probably due to the prolonged time passed since the onset of symptoms and repeated local steroid injections. The majority of manual workers returned to their work.

[The use of the Richard's dynamic hip screw and hip Zespol fixator in the treatment of proximal femoral fracture]. / Zastosowanie sruboplytki Richardsa i stabilizatora biodrowego Zespol w leczeniu zlaman blizszego konca kosci udowej.

A series of 49 patients (27 females, 22 males) aged 24-82 operated on due to proximal end of the femur fracture between 1990 and 1995 were included in this study. There were 23 femoral neck fractures and 26 trochanteric fractures. DHS was used in 35 patients and Zespol hip fixator in 14 cases. Good results have been achieved in 85.7%. Neither method proved superior to the other. Poor results occurred in subcapital neck fractures. DHS seems to offer advantage in trochanteric fractures and Zespol method in femoral neck fractures.

[Axial spondylometer--a device for measurement of the configuration and mobility of the spine in three planes]. / Spondylometr osiowy--przyrzad do pomiaru uksztaltowania i sprawnosci ruchowej kregoslupa w trzech plaszczyznach.

A method of triplanar assessment of the configuration and mobility of the spine with the use of the original axial spondylometer is described. The device allows to present mobility in the plane of two perpendicular axes X and Y in new categories: elasticity, susceptibility and deshaping of the spine.

[Spondylometric assessment of the configuration and flexion-extension mobility of the spine in students]. / Spondylometryczna ocena uksztaltowania i gibkosci zgieciowo-przeprostnej kregoslupa studentów.

An original method of assessment of the configuration and mobility of the spine in the sagittal plane with the use of axial spondylometer allowed reproducible and more objective evaluation of the spinal movement then previously employed methods. A qualitatively new assessment of the spinal mobility was achieved due to the introduction of mathematical indicators of elasticity, susceptibility and reshaping of the spine. The evaluation of the spinal range of motion in 167 students indicated prominent sexual dimorphism. The elasticity and flexion reshaping indicators in males exceeded of 17.6% and 21.6% respectively the females ones. The circular mobility of the spine greater then its distensibility is characteristic for males. In both sexes flexion surpasses extension of the spine from 157% to 215%.

[Evaluation of knee joint function after fracture of the patella]. / Ocena funkcji stawu kolanowego po zlamaniu rzepki.

Clinical assessment of the function of the knee joint after surgically and conservatively treated fracture of the patella was carried out. On the basis of C. Ranawat criteria it was found that regardless the method of treatment applied restriction of the joint function was expressed mainly by limited range of motion and by weakening of the knee extensors. The results of surgical and conservative management are similar. The best results of treatment for fracture of the patella were achieved in patients operated with the use of wire loop-cerclage.

[Pedicle bone grafting in treatment of bone union disorders after femoral neck fracture]. / Uszypulowany przeszczep kostny w leczeniu zaburzen zrostu zlaman szyjki kosci udowej.

Clinical and radiological assessment of 8 patients operated because of femoral neck pseudoarthrosis or delayed union proved the pedicle bone grafting to be very useful method, especially in young patients. Surgical reconstruction of femoral neck with the use of pedicular graft (Judet--Chacha) resulted in all the patients in absence of pain; satisfactory range of movement has been restored in operated hip. Bone union has been achieved in 7 from the 8 operated patients that is in all the cases of posttraumatic union disorders. However, we failed in total reconstruction of anatomy and the radiographs revealed osteoarthritis of the joint.

[Prevention of pain in the lumbosacral segment of the spine]. / Profilaktyka bólów czesci ledzwiowo-krzyzowej kregoslupa.

The principles of prophylaxis of back pain have been presented on the grounds of data from literature on present knowledge in physiology and pathomechanics of the lumbar spine and the authors own experience. Pointing out the most frequent causes of low back pain, proper methods of reduction of spine overloading, to which the 20-century man is exposed, have been suggested.