Correlations between Crawl Kinematics and Speed with Morphologic, Functional, and Anaerobic Parameters in Competitive Swimmers.

The purpose of this study was to examine the relationship between a unique complex of predictors and 100 m front crawl race kinematics and swimming speed. In 28 male competitive swimmers (age: 19.6 ± 2.59 years), the following groups of predictors were assessed: (a) the morphologic, (b) the functional upper limb range of motion, and (c) the anaerobic indices of arm-cranking and a series of countermovement jumps. The Pearson product-moment correlation coefficient was calculated to distinguish the predictors and the swimming results. The main finding was that the indices of the power (arm-cranking) and the work (countermovement jump) generated in the anaerobic tests showed a significant and higher correlation with stroke length and stroke index than total body length, upper limb range of motion, or hand and forearm surface area. These results were obtained in accordance with the high swimming economy index relation to clear surface swimming speed. This study reveals that the strength generated by the limbs may represent a predictor of swimming kinematics in a 100 m front crawl performance.

One year of the COVID-19 pandemic in Poland-the incidence of osteoporotic forearm, arm, and hip fractures.

The study attempts to analyse whether the COVID-19 pandemic affected the incidence of forearm, arm, and hip fractures during a 1-year observation period. Additionally, changes in the overall treatment costs of those fractures were estimated. During the COVID-19 pandemic, the incidence of forearm, arm, and hip fractures remained statistically unchanged, neither were any significant changes observed in the expenditure, incurred for the treatment of the fracture cases. PURPOSE: The purpose of the study was to find out and evaluate if the consequences of COVID-19 pandemic (including lockdown and the fear of infection) influenced the incidence of osteoporotic forearm, arm, and hip fractures and to estimate the changes in the costs of their management during one-year observation period. METHODS: The incidence of forearm, arm, and hip fractures was collected for the population, aged ≥ 50, residing at the district of Tarnowskie Góry and the Town of Piekary Slaskie, Poland, during 1 year of COVID-19 pandemic (from March 16th 2020 to March 15th 2021). The obtained results were compared with the number of corresponding limb fractures, recorded before the pandemic during five consecutive yearly periods, each starting from 16th March and ending on the 15th March of a subsequent year, the entire period covering the years 2015-2020. The rates of the analysed fractures were calculated per 100,000 inhabitants together with their economic impact. RESULTS: The mean numbers and the incidence rates of upper extremity fractures were slightly lower during the COVID-19 pandemic than in the previous 5 years, whereas hip fracture figures remained almost stable. The observed changes were not statistically significant. That annual observation revealed a slight decrease in expenditure volumes, when compared to the analysed period before the pandemic (-0.33%). CONCLUSION: The decreased incidence rate of forearm, arm, and hip fractures, observed during the first months of the COVID-19 pandemic, was not statistically significant in the 1-year observation. After several weeks/months under the shock, caused by government limitations and the fear of infection, the number of patients remained unchanged during the one-year observation.

Body composition and specific and general strength indices as predictors of 100-m front crawl performance.

PURPOSE: The purpose of this research was to examine the impact of body composition on the anaerobic ability to generate strength and power produced separately by upper and lower limbs during dry-land and in-water (propulsion force) tests. Further examination included the influence of all gathered anaerobic strength indices on the results of 100-m front crawl race. METHODS: The study involved 26 male swimmers (age: 19.8 ± 2.48 years). Fat-free mass, total body water and muscle mass of arms, legs, and trunk were measured. Dry-land average work, maximal power generated in 40-second arm-cranking test, and work generated in 20 countermovement jumps were evaluated. The forces generated separately by arms and legs were assessed during 40-second tethered swimming. All indices of body composition were found strongly correlated with indices of average work and maximal power generated by arms and legs in dryland tests. RESULTS: Muscle mass of arms and trunk moderately and strongly (r = 0.44-0.64) influenced the force generated by arms in tethered swimming. There was no significance in the relationship of leg muscle mass and force generated by legs in tethered swimming. Significant relationships were observed between the results of the 100-m front crawl and the muscle mass of the arms, trunk, legs, as well as the average work and maximal power in the arm-cranking test (r: 0.39-0.54). The average impulse of arm force and maximal leg force in tethered swimming moderately and significantly correlated with 100-m swimming results. CONCLUSIONS: The study concludes the relevance of developing muscle mass balanced to the body size, which is involved in propulsion force production in sprint front crawl swimming.

Correction to: Atraumatic femoral neck fracture during bisphosphonate treatment: case report and review of the literature.

Correction to: Aging Clin Exp Res https://doi.org/10.1007/s40520-017-0846-0.

The 13-year observation of hip fracture in Poland-worrying trend and prognosis for the future.

INTRODUCTION: Hip fractures are often considered to be one of the most common osteoporotic fractures. In our previous study, we noted the increasing trend in the total number of hip fractures as well as crude and standardized rates, for both women and men. This observation enabled us to delve deeper into the study of osteoporotic fractures. METHODS: Hospital records between 1.01.2002 and 31.12.2014 with ICD-10 codes S72.0. S72.1 and S72.2 (femoral neck. intertrochanteric, subtrochanteric, and inter and subtrochanteric fracture) were analysed. All fractures occurred in citizens who lived in the district Tarnowskie Góry and the city of Piekary Slaskie aged 50 years and more. RESULTS: 1507 fragility hip fractures (400 in men, and 1107 in women) were registered. The rates increase in both sexes was still observed. The tendency to sustain fractures was lower in female (29.3%) than in the male population (63.6%). We observed a lower increase in urban (35.8%) population when compared to rural (40.8%) population. Incidence rate ratios for female gender were 1.89 (95% CI 1.65-2.18). The rates in 2014 were as follows: crude rate of 216.2 (men 140.9; women 276.5) and standardized 183.9 (131.6 and 219.4, respectively). This observation allowed as to project a total crude rate of 467.2 (men 329.6; women 584.7) for the year 2050. CONCLUSIONS: The number of osteoporotic hip fractures in Polish men and women is still relatively low, but the epidemiological situation is getting worse. The over 13 years of follow-up demonstrated that the trend to increase in total number of hip fractures for men and women is still observed. This prognosis is of a major concern.

Intermittent hypoxic training improves anaerobic performance in competitive swimmers when implemented into a direct competition mesocycle.

The main objective of this research was to evaluate the efficacy of intermittent hypoxic training (IHT) on anaerobic and aerobic capacity and swimming performance in well-trained swimmers. Sixteen male swimmers were randomly divided into a hypoxia (H) group (n = 8), which trained in a normobaric hypoxia environment, and a control (C) group (n = 8), which exercised under normoxic conditions. However, one participant left the study without explanation. During the experiment group H trained on land twice per week in simulated hypoxia (FiO2 = 15.5%, corresponding to 2,500 m a.s.l); however, they conducted swim training in normoxic conditions. Group C performed the same training program under normoxic conditions. The training program included four weekly microcyles, followed by three days of recovery. During practice sessions on land, the swimmers performed 30 second sprints on an arm-ergometer, alternating with two minute high intensity intervals on a lower limb cycle ergometer. The results showed that the training on land caused a significant (p<0.05) increase in absolute maximal workload (WRmax) by 7.4% in group H and by 3.2% in group C and relative values of VO2max by 6.9% in group H and 3.7% in group C. However, absolute values of VO2max were not significantly changed. Additionally, a significant (p<0.05) increase in mean power (Pmean) during the first (11.7%) and second (11.9%) Wingate tests was only observed in group H. The delta values of lactate concentration (ΔLA) after both Wingate tests were significantly (p<0.05) higher in comparison to baseline levels by 28.8% in group H. Opposite changes were observed in delta values of blood pH (ΔpH) after both Wingate tests in group H, with a significant decrease in values of ΔpH by 33.3%. The IHT caused a significant (p<0.05) improvement in 100m and 200m swimming performance, by 2.1% and 1.8%, respectively in group H. Training in normoxia (group C), resulted in a significant (p<0.05) improvement of swimming performance at 100m and 200m, by 1.1% and 0.8%, respectively. In conclusion, the most important finding of this study includes a significant improvement in anaerobic capacity and swimming performance after high-intensity IHT. However, this training protocol had no effect on absolute values of VO2max and hematological variables.

Do we need orthogeriatrics in Poland? Changes in the age structure and location of hip fractures.

BACKGROUND: Patients with hip fractures present a great challenge for surgeons due to multimorbidity, polypharmacy as well as difficulty in communicating. These could be attributed to a recent trend in the aging patient population (80 years and older) as compared to the past. The aim of this study is to analyze age structure and location in male and female patients' population with hip fracture over 50. MATERIALS AND METHODS: Hospital records between 2005 and 2014 with ICD-10 codes S72,0, S72,1 and S72,2 were included in the analysis. All fractures occurred in citizen aged 50 years and over living in the district of Tarnowskie Góry and the city of Piekary Slaskie in Poland. RESULTS: Within the study period, 1258 hip fractures were registered. The mean age of the patients was higher every year, starting from 77.27 ± 9.52 in 2005 to 80.80 ± 9.65 years in 2014 (p < 0.01). The average age also increased in both gender groups from 73.85 ± 8.30 to 77.89 ± 9.52 years in male and from 78.14 ± 9.66 to 81.98 ± 9.49 years in female, respectively. The median age value was changed from 78.00 to 83.00 years in the total population. We noted a significant increase in female with trochanteric fracture; however, the level of neck fracture was almost the same. In men, crude rates for both trochanteric and cervical fractures slightly increased. CONCLUSIONS: As the age of patients increases, fractures were shown to be more complicated. Given the scale of the phenomenon and its determinants, we emphatically conclude orthogeriatrics is needed in Poland.

Endoscopic therapy of oesophageal strictures in children - a multicentre study.

INTRODUCTION: Oesophageal strictures are rare in children but may require endoscopic dilation. AIM: To gather information on centres performing endoscopic oesophageal dilation in Poland. MATERIAL AND METHODS: The data were obtained from questionnaires concerning the relevant data mailed to 22 paediatric endoscopy centres. Completed questionnaires were received from 11 centres. RESULTS: In 2010 the 11 Polish paediatric endoscopy centres performed a total of 10,650 endoscopic procedures. This included 347 oesophageal dilations in 106 paediatric patients aged from 1 month to 18 years. The numbers of patients treated at individual centres ranged from 2 to 40. The indications for oesophageal dilation were as follows: postoperative strictures in 68 children, oesophageal burns in 17 children, postinflammatory strictures in 14 children, achalasia in 4 children, and strictures caused by a foreign body in 3 children. Rigid guidewire dilators were used in the majority of procedures (271), rigid dilators without a guidewire in 32 procedures, and balloon dilators in 45 procedures. A total of 203 procedures were conducted under fluoroscopic guidance, and 144 without the use of fluoroscopy. The number of dilating sessions performed in individual children varied from 1 to 6 and more. CONCLUSIONS: Oesophageal dilation constituted a minor proportion of all paediatric endoscopic procedures. The majority of children requiring dilation were patients up to 3 years of age with postoperative oesophageal strictures. In the majority of the centres rigid guidewire dilators were used, and in one third of the procedures these dilators were introduced without fluoroscopic guidance.

Radiological Evaluation of Treatment of Periprosthetic Femoral Fractures.

BACKGROUND: Periprosthetic fracture of the femur is a common complication of total hip replacement surgery. There are several risk factors, including the female gender, an uncemented implant, the use of a straight or revision stem and secondary osteoarthritis. The aim of the study was a radiological evaluation of treatment of periprosthetic femoral fractures Material and methods. The study group consisted of patients who underwent hip replacement surgery at the Department of Orthopaedics and Traumatology, Medical University of Silesia, between 2002 and 2006. Radiologic evaluation of outcomes was based on the scheme developed by HIP Society, SICOT, AAOS and, additionally, on Beals and Tower's classification. RESULTS: The incidence of pathological findings, such as lucent zones along the stem-bone interface, crack of the cement and focal osteolysis of the greater trochanter and around the cement, did not exceed 10%. Lucent zones were most frequently seen in radiographs of cemented prostheses in Gruen's zones 2, 3 , 4 and 5. Cortical hypertrophy was seen medially in Gruen's zones 4, 5 and 6. Adams' arc osteolysis was found in 15.5% of patients with intraoperative fractures and almost 40% of patients with late fractures. Heterotopic ossification was noted only in 7 patients. CONCLUSIONS: 1. Radiological evaluation of treatment of periprosthetic femoral fractures after hip replacement surgery is one of the most difficult parts of patient status assessment in post-surgical patients. 2. The most common pathological radiographic findings were stem subsidence and the presence of osteolytic foci around Adams` arc. 3. The occurrence of a periprosthetic fracture did not significantly affect Beals and Tower scores.

Standardized incidence and trend of osteoporotic hip fracture in Polish women and men: a nine year observation.

BACKGROUND: Osteoporosis and its consequence of low trauma fracture represent a major health burden in aging population, because it results in increased morbidity, mortality and high health care costs. The number of hip fractures worldwide will approximately double by the year 2025 and more than triple by 2050. The aim of the study was to assess the incidence and trends of osteoporotic hip fracture in women and men aged over 50 years in polish population. MATERIALS AND METHODS: Hospital records in population of 32,100 men and 39,984 women between January 1st, 2002 and December 31, 2010 with ICD-10 codes S72,0, S72,1 and S72,2 (femoral neck, intertrochanteric, subtrochanteric, inter and subtrochanteric fracture) were included in analysis. RESULTS: The study revealed 937 low energy hip fractures (240 in men 697 and in women). Systematic increase in rate over the study period, with the 44% in last year compared to 2002 year can be noticed. The increase was lowest in female (20.7%) than in male population (57.6%), and similarly was lowest in urban (27%) than in rural (67.7%) inhabitants. CONCLUSION: Concluding, the incidence of osteoporotic hip fracture in Polish men and women aged over 50 years is low, but the epidemiological picture is likely to change due to apparent aging of the population. Increasing trend of hip fracture incidence together with changes in age structure will result in an increased need for specialized care including several medical branches (GP, orthopedics, geriatrics, rehabilitation). Levels of evidence - IV.

The effects of treatment the avascular necrosis of the femoral head with extracorporeal focused shockwave therapy.

Background.Avascular necrosis of the femoral head continues to represent a major challenge for the orthopaedist and trauma surgeon. A fully effective method of treatment is yet to be introduced. After femoral head collapse, only total hip replacement can help the patient. Our study aims to assess the effects of treatment of avascular necrosis of the femoral head with extra corporeal focused shockwave therapy.Material and methods. A prospective study was carried out in patients with avascular necrosis of the femoral head, ARCO stage I-III, diagnosed by MRI imaging. Shock waves are applied under x-ray guidance. Four points are marked on the skin above the lesion. Each spot receives a dose of 1500 pulses at an energy flux density of 0.4 mJ/mm2 and a frequency of 4 Hz. Each patient undergoes 5 therapy sessions. A posturometric and stabilometric assessment is carried out before and after the therapy. Other examinations include a tensometric evaluation of the strength of the treated limb, and an assessment of pain intensity (VAS scale)and hip function (Harris hip score). Follow-up visits are scheduled at 6 weeks and 3, 6 and 12 months post-treatment.Results. Nine patients were treated with shockwave therapy at the Department of Orthopaedics and Musculoskeletal Traumatology, Medical Faculty, Medical University of Silesia, between 5 May 2011 and 1 June 2012. The patients demonstrated pain reduction and improved mobility of the treated joint (VAS score decreasing from 6.75 +/- 0.71 to 2.5 +/- 1.7; Harris hip score increasing from 55.21 +/- 15.45 to 89.21 +/- 8.26). Tensometric platform testing carried out after the treatment revealed a statistically significant difference between mean velocity of the centre of pressure (CoP) movement when walking with eyes open and closed (p<0.05) and mean CoP movement along the x (walking with eyes closed) and y (free standing with eyes closed) axes.Conclusions. 1. Extracorporeal focused shockwave therapy resulted in considerable improvement in the patients' quality of life at 6 weeks' follow-up. 2. At 6 months some patients reported intensified pain and worse hip function.

Risk factors for intraoperative periprosthetic femoral fractures during the total hip arthroplasty.

BACKGROUND: Intraoperative periprosthetic femoral fracture (IPFF) is one of the most frequent complication of total hip arthroplasty (THA). This complication is a very important factor affecting rehabilitation, hospitalization time and cost of treatment. It may occur during the intramedullary reaming, removal or fixation of the stem The aim of the study was to identify risk factors of IPFF, in order to devise strategies that would minimize incidence of this complication in the future. MATERIAL/METHODS: The study group consisted of patients who underwent hip surgery at the Department of Orthopaedics and Traumatology, Medical University of Silesia in Katowice between January 2002 and December 2006. We included cases of primary total hip replacement (both cemented and uncemented), hemiarthroplasties, revision THAs with exchange of at least one of the elements and the Girdlestone procedures. RESULTS: The IPFF was diagnosed in 105 cases (101 patients), out of 1188 surgeries. We found the following risk factors for the primary THA: female gender, younger age, uncemented implant, the use of straight or revision stem, secondary osteoarthritis. For revision surgery there were: left hip surgery and implantation of revision stem. CONCLUSIONS: We hope that identification of risk factors for the intraoperative periprosthetic femoral fracture would allow orthopaedic surgeons to select the group of patients with high risk of fracture and to devise strategies that would minimize incidence of this complication in the future.

Fracture status in men assessed by quantitative ultrasound measurements at the calcaneus.

OBJECTIVES: The aim of the study was to assess fracture status in men by quantitative ultrasound measurements at the calcaneus. The diagnostic accuracy of quantitative ultrasound measurements was evaluated at baseline and follow-up. METHODS: We observed 165 men (baseline age ± SD, 59.84 ± 10.6 years) recruited from an outpatient osteoporosis clinic. The mean follow-up duration was approximately 101.3 ± 35 months. There was no difference in either age or body mass index at baseline between the patients with a fracture history (n = 30) and the others (n = 135). The following fractures were identified at baseline: ankle, 15; wrist, 10; rib, 9; foot, 5; and hip, 1. The speed of sound (meters per second), broadband ultrasound attenuation (decibels per megahertz), and stiffness index (percent) were measured with a quantitative ultrasound device. The date of fracture occurrence at follow-up was defined as the final point. RESULTS: In the patients with a fracture history, the ultrasound variables were significantly lower than those in the rest of the group (P < .05). During the follow-up period, fractures occurred in 21 patients (wrist, 11; ankle, 5; rib, 3; hip, 1; and humerus, 1), and the ultrasound outcomes were nonsignificantly lower in the fractured men. The risk of fracture was estimated by the Cox regression analysis. A prior fracture was the only factor that significantly (4 times) increased the risk of a subsequent fracture (hazard ratio, 4.21; 95% confidence interval, 1.81-9.86; P < .001). CONCLUSIONS: Calcaneus ultrasound measurements can distinguish between patients with fractures and those without. In follow-up, ultrasound measurements did not indicate an increased fracture risk; a prior osteoporotic fracture was the major prognostic factor.

Suitability of imaging methods (X-ray, CT, MRI) in the diagnostics of Ewing's sarcoma in children - analysis of own material.

BACKGROUND: Ewing sarcoma is a malignant, small round cell bone tumor, presenting predominantly in children and adolescents. Ewing sarcoma may develop in every bone; diaphyses of long bones, ribs and flat bones are the main locations. Local and systemic clinical symptoms are nonspecific - pain, swelling, fever or ill-being. The aim of the study was to assess the role of radiography, computed tomography and magnetic resonance imaging in the analysis of bone lesions in children and young adults with Ewing sarcoma. MATERIAL/METHODS: Twenty-seven patients, aged between 1 year and 10 months, and 17 years and 2 months, with histologically verified Ewing sarcoma of the bone, referred to the Radiological Department of University Hospital No 6., John Paul II Upper Silesian Centre for Child Health Katowice, in the period from 1996 to 2007, were included in the study.Plain radiography was performed in every child, CT in 20 and MRI in 12 individuals. Tumour location, extension of the tumour, soft tissue mass, and periosteal reaction were taken into consideration in the evaluation of the lesion. In some cases, pathological features of the MRI and CT were compared. The prevalence of some radiological features was compared to the literature data. RESULTS: THE MOST COMMON SITE OF TUMOR WAS: ribs (6 children), femoral bone (6 children), pelvis (4 children) and tibia (3 children). In 2 children, a primary tumor was diagnosed in the spine (multifocal in 1 child). X-rays revealed: periosteal reaction in 17 children (63%), soft tissue involvement in 19 children (70%), permeative component in 16 children (59%), and sclerotic component in 5 children (19%). In 10 children (37%), periosteal reaction was not detected. The examination revealed: soft tissue calcifications in 7 cases (26%), a well-delineated focus of destruction within bones in 3 children (11%), cortical thickening in 4 children (15%), cortical destruction in 4 children (15%), saucerisation in 3 children (11%), bone expansion in 3 children (11%), pathological fracture in 2 children (7%), cystic component in 1 child (4%), and vertebra plana in 1 child (4%).Reaction of tumors after i.v. contrast administration, shown on CT, was visible in 16 children - it was useful for a better description of the tumor and extension of the mass within the soft tissue. All MRI examinations (12 children) showed a heterogenous mass with ill-defined borders and a violated cortex. Low signal intensity of the tumor in a T1-weighted image and high signal intensity in a T2-weighted image was shown as well. Heterogenous enhancement of signal intensity on T1-weighted images could be observed after i.v. contrast administration. MRI EXAMINATIONS SHOWED: tumor in an adjacent soft tissue in 11 children, and involvement of the epiphyseal plate or of the joint cavity in 6 children. CONCLUSIONS: X-ray and MRI are essential in diagnostics. CT examination is more useful to estimate periosteal reactions and destruction of bone and marrow cavity, especially in flat bones. However, to recognise a malignancy, it is necessary to perform a histopathological examination. In doubtful cases, the examination has to be verified as well.