Comparison of treatment results of acute and late injuries of the lisfranc joint.

OBJECTIVE: A retrospective comparison of treatment difficulties and treatment outcomes in Lisfranc joint injuries with late and early diagnosis. METHODS: The study group consisted of 10 patients diagnosed and treated properly within six months to 20 years of the accident causing the injury (mean six years). The control group consisted of the same number of randomly selected patients with a similar type of injury treated immediately after the accident. Mean follow-up was 13 years in the study group and eight years in the control group. The analysis evaluated the causes of the delay and the foot function at the time of follow up, measured using the AOFAS Midfoot Scale and the Lublin Foot Functional Score. The scores of the patients were analyzed using the non-parametric Mann-Whitney U test and the non-parametric Wilcoxon test. RESULTS: The control group had statistically significantly better scores on both scales. CONCLUSION: The main cause of treatment delay was misdiagnosis by the primary care physician. Level of Evidence III, Retrospective Comparative Study .

Comparação dos resultados do tratamento de lesões agudas e tardias da articulação de Lisfranc / Comparison of treatment results of acute and late injuries of the Lisfranc joint

OBJETIVO: Comparação retrospectiva das dificuldades do tratamento e de seus resultados em lesões na articulação de Lisfranc com diagnóstico tardio e precoce.MÉTODOS: O grupo de estudo consistiu em 10 pacientes diagnosticados e tratados adequadamente em seis meses a 20 anos do acidente que causou a lesão (média de seis anos). O grupo de controle foi composto por igual número de pacientes selecionados randomicamente, com o mesmo tipo de lesão tratada de imediato e após o acidente. A média de acompanhamento foi de 13 anos no grupo de estudo e oito anos no grupo de controle. A análise avaliou as causas do atraso e a função do pé no momento do acompanhamento, medidos pela escala AOFAS para o mediopé e pelo escore funcional do pé de Lublin. Os escores dos pacientes foram analisados utilizando o teste não-paramétrico de Mann-Whitney U e o teste não-paramétrico de Wilcoxon.RESULTADOS: O grupo de controle apresentou resultados melhores com significância estatística em ambas as escalas.CONCLUSÃO: A principal causa de atraso do tratamento foi diagnóstico errado pelo médico de atendimento primário. Nível de Evidência III, Estudo Comparativo Retrospectivo.

OBJECTIVE: A retrospective comparison of treatment difficulties and treatment outcomes in Lisfranc joint injuries with late and early diagnosis.METHODS: The study group consisted of 10 patients diagnosed and treated properly within six months to 20 years of the accident causing the injury (mean six years). The control group consisted of the same number of randomly selected patients with a similar type of injury treated immediately after the accident. Mean follow-up was 13 years in the study group and eight years in the control group. The analysis evaluated the causes of the delay and the foot function at the time of follow up, measured using the AOFAS Midfoot Scale and the Lublin Foot Functional Score. The scores of the patients were analyzed using the non-parametric Mann-Whitney U test and the non-parametric Wilcoxon test.RESULTS: The control group had statistically significantly better scores on both scales.CONCLUSION: The main cause of treatment delay was misdiagnosis by the primary care physician. Level of Evidence III, Retrospective Comparative Study.

[Large diameter femoral heads in primary alumina/alumina and XSPE/alumina total hip arthroplasty. A follow-up study of 50 hips after average 40 months and review of literature]. / Pierwotna calkowita bezcementowa endoprotezoplastyka stawów biodrowych--ceramika/ceramika i ceramika/polietylen XSPE z uzyciem glów o duzej srednicy. Ocena 50 bioder po okresie srednio 40 miesiecy i przeglad pismiennictwa.

INTRODUCTION: The aim of the study was a preliminary report of the use of large diameter alumina femoral heads in total hip arthroplasty. MATERIAL AND METHODS: In the years 2005-2008 50 THRs were implanted in 48 patients with the use of 36 mm alumina femoral heads. 5 women and 43 men in the age from 35 to 75 years (average 61 years) were operated on. Primary osteoarthritis was the cause of 41 arthroplasties, and AVN of femoral head of 9 surgeries. 18 alumina/alumina and 32 polyethylene/alumina THRs were implanted. The prospective study consisted of clinical examination with Harris Hip Score and X-ray evaluation. AP and lateral view X-rays were evaluated. The incidence of radiolucent lines around acetabular cups were noted with DeLee and Charnley zones and around stems with Gruen's zones. RESULTS: The follow up is from 24 to 58 months (average 40 months). There was an increase in Harris Hip Score from average 37 points (from 25 to 49 points) before operation to average 94 points (from 90 to 100 points) after the surgery. The incidence of postoperative dislocation have not been noted. Long-term postoperative X-ray examination have showed proper geometry of endoprostheses without radiolucent lines. Neither visible wear of bearing surfaces nor breakage of alumina components have been noted. CONCLUSIONS: 1) The use of 36 mm femoral heads in total hip arthroplasty decrease the risk of postoperative dislocation. 2) Innovative biomaterials: alumina ceramics and cross-linked polyethylene give chance for decrease the incidence of osteolysis.