[Treatment of congenital clubfeet by the Goldner method]. / Leczenie wrodzonych stóp konsko-szpotawych metoda Goldnera.

The authors present an overview of Goldner's concept of clubfeet pathology and treatment. Goldner stresses the role of the talus in this foot deformity. According to this author full correction of the deformity can be achieved only by posterior, medial, plantar and lateral release.

[Focal fibrocartilaginous dysplasia of the femur. A case report and review of the literature]. / Ogniskowa dysplazja wlóknisto-chrzestna kosci udowej--opis przypadku i przeglad pismiennictwa.

A case of focal fibrocartilaginous dysplasia of the femur is presented. Varus femoral malalignment progressed from 30 degrees in 5th month of life to 51 degrees in 27th month of life. CT revealed flattening of the bone in the frontal plane, sclerotic marrow cavity with focal change resembling nidus of osteoma osteoides. Longitudinal defect filled with compact fibrous tissue was found below it. Corrective osteotomy has been done at the age of 32 months with good cosmetic result.

[Surgical treatment of congenital cleft foot]. / Leczenie operacyjne wrodzonego rozszczepu stopy.

Results of surgical treatment for congenital cleft foot in 3 patients (5 foot) are reported. Two foot were classified type IIIA, 1--IIIB and 2--IVB according to Blauth and Borisch. Mean age of the patients at the surgery was 97 months, mean follow-up was 39 months. Wedge resection of the metatarsals with screw fixation was followed by performing skin syndactyly in all patients. No complications occurred, all patients wear commercial shoes and are satisfied with the result of surgery.

[Osteopetrosis: a case report and review of literature]. / Osteopetrosis--opis stanu chorego i przeglad pismiennictwa.

A case of type II autosomal dominant osteopetrosis is presented. The boy was admitted to the hospital at the age of 7 years and 6 months due to bilateral leg pain. Apart from radiography no pathology has been found.

[Results of treatment of traumatic elbow dislocation in children]. / Wyniki leczenia urazowego zwichniecia stawu lokciowego u dzieci.

Between 1987 and 1997 the authors treated 49 children with traumatic dislocation of the elbow joint. The study presents the results of treatment of 26 children, mean age of 10.7 years (ranging from 5.5 to 14.5 years) at the time of trauma. The mean follow-up time was 4.3 years (ranging from 1 to 10.5 years). In one case an anterior dislocation was observed, while in the remaining cases posterior dislocation was diagnosed. Twenty-five children were treated with closed reduction of the dislocation, followed by immobilization in a plaster cast. One case with a chronic dislocation was treated surgically. Concurrent injuries were observed in 18 (69.2) children. The most common concurrent trauma was a fracture of the medial epicondyle (44% of cases with additional trauma). The following additional fractures were also noted: fracture of the lateral epicondyle, fractures of the forearm, of the neck of the radius, of the olecranon, epiphyseolysis of the distal epiphysis of the radius with a concomitant fracture of the medial epicondyle. In 19 cases very good result was achieved. In 7 cases sequels of the dislocation were noted. These were: in 3 cases flexion contractures (5 degrees, 10 degrees, 15 degrees) of the elbow joint, in two cases periarticular ossification (in 1 case this entity was treated surgically with very good result), in 1 case an asymptomatic non-union of the medial epicondyle with a 30 degrees flexion contracture in the elbow joint, and in 1 case (treated surgically) a 90 degrees flexion contracture with a movement range up to 105 degrees with degenerative changes visible on X-ray in the joint was noted.

[Chondrosarcoma arising in a solitary osteochondroma--case report and literature review]. / Chondrosarcoma na podlozu pojedynczej wyrosli chrzestno-kostnej--opis chorego i przeglad pismiennictwa.

Treatment of 13 years old boy with chondrosarcoma arising in solitary osteochondroma located within distal 1/3 of the femur is presented. Two local, nonradical excisions resulted in dissemination of the tumor within soft tissues making salvage procedure unfeasible. An above the knee amputation has been performed. At 1.5 years follow-up no recurrence of the neoplasm have been found.

[Percutaneous method for achilles tendon lengthening in treatment of spastic equinus deformity with progressive muscular dystrophy]. / Metoda przezskórnego wydluzania sciegna Achillesa w leczeniu stopy konskiej spastycznej oraz w postepujacej dystrofii miesniowej.

Surgical technique of percutaneous lengthening of Achilles tendon has been presented. Thirty-seven feet in 26 children have been operated on. There was no intraoperative inadvertent tenotomy or excessive lengthening, no complications occurred in the postoperative course. An average follow-up was of 18 months. The procedure resulted in 7 degrees of dorsal flexion on an average. The authors recommend this method in the treatment of the spastic pes equinus.

[Orthopedic management in children with fibrous dysplasia of bone]. / Leczenie ortopedyczne dzieci z dysplazja wlóknista kosci.

The method and results of treatment in 9 children with fibrous dysplasia of bone and 3 children with Albright syndrome are presented. Curettage and filling of the defect with autologous and/or lyophilized grafts failed in all 5 attempted cases. Due to pathological fracture or deformity Rush nailing combined with multilevel osteotomies has been performed within 5 femoral bones and 4 tibial bones. Healing was undisturbed, neither fracture nor deformity recurred. Valgus osteotomy has been done in 2 children with pseudoarthrosis of the femoral neck. In one case osteotomy healed, in another bony union is not completed yet but the neck-shaft angle remained unchanged. In authors' opinion curettage and grafting proved ineffective; Rush nailing rendered good results in both fracture and deformity treatment.

[Orthopedic problems in children with congenital insensitivity to pain]. / Problemy ortopedyczne u dzieci z wrodzona niewrazliwoscia na ból.

Three children with congenital insensitivity to pain are described. Self-injuries of the tongue and fingers occurred during dentition. At infancy and early childhood fever of unknown origin and/or pneumoniae were observed in all children. All of them also suffered from osteomyelitis of various bones treated with antibiotics and surgery. The tibia and metatarsals were involved in one case, the tibia, metatarsals and the femur in second child and the jaw plus metatarsals in the third case. In one child the hip has been dislocated twice after minor trauma, lumbar arthropathy, distal femoral epiphyseal fusion causing shortening of the extremity by 4.5 cm, osteochondritis dissecans of the medial femoral condyle, elbow deformity after displaced fracture of the lateral humeral condyle and post-traumatic cataract were observed.

[Transient osteopenia of the hip in children]. / Przemijajaca osteopenia stawu biodrowego u dzieci.

The course and results of treatment of 4 boys with transient osteopenia of the hip are presented. Mean age of patients at the onset of symptoms was 9 years 5 months (range 5 years 3 months-14 years 6 months). Pain at exertion and limp dominated in all cases. Quadriceps atrophy was a constant finding and hip rotation was restricted in 3 cases. Laboratory findings were normal except for the elevated ESR. Radiography and CT showed diffused osteopenia within femoral neck and head. Bone scan was abnormal in 3 cases. Weight bearing restriction and exercises introduction resulted in ceasing of the symptoms within 3 months.

[Septic arthritis in newborns and infants. Treatment of hip arthritis]. / Ropne zapalenia stawów u noworodków i niemowlat Leczenie zapalen stawu biodrowego.

Results of treatment of 83 septic hip joints in 75 newborns and infants have been presented. Mean age at the onset of symptoms was 41 days (from 1 to 330 days), mean follow-up was 72 months (from 12 to 252). In 26 cases systemic antibiotics were administered. Single joint puncture was done in 7 cases, in 23 patients multiple puncture and intraarticular antibiotic therapy were employed, arthrotomy and drainage of the joint was performed in 27 joints. Radiographic results achieved, according to Hunk classification were as follows: Type I-26 joints, Type IIA-6 joints, Type IIB-18 joints, Type III-5 joints, Type IVA-7 joints, type IVB-8 joints, Type V13 joints. The authors conclude, that in majority of cases the treatment of choice should include arthrotomy from antero-lateral approach, suction drainage for 24-48 hours, systemic intravenous antibiotic therapy, abduction position of extremity in Frejka pillow and early physiotherapy.

[Radius neck fracture in children]. / Zlamania szyjki kosci promieniowej u dzieci.

Results of treatment of 19 children with radial neck fracture and 1 with head fracture have been presented. In the group of 12 children managed with an open reduction 50% results were poor. In all children treated conservatively good results have been achieved. The technique for percutaneous reduction of the fracture with the use of Kirschner wires has been discussed.

Capsulorrhaphy versus capsulectomy in open reduction of the hip for developmental dysplasia.

Capsulorrhaphy and capsulectomy were prospectively compared in open reduction of the hip for developmental dysplasia. There were 39 patients: 16 capsulorrhaphy and 23 capsulectomy. Follow-up averaged 22 months postsurgery. The surgical technique included innominate osteotomy, and femoral shortening and derotation. Avascular necrosis developed in one capsulorrhaphy patient. Postoperative redislocation occurred in three capsulorrhaphy and no capsulectomy patients. Three capsulorrhaphy and three capsulectomy patients had acetabular dysplasia. Neither capsulorrhaphy nor capsulectomy produced superior hip motion at last examination.

[Septic arthritis in neonates and infants--treatment of septic arthritis in the shoulder]. / Ropne zapalenia stawów u noworodków i niemowlat--leczenie zapalen stawu ramiennego.

Results of treatment of 55 acute hematogenous arthritis of the shoulder in newborns and infants are presented. There were 14 good results, 15 fair and 26 poor ones. The authors consider arthrotomy as the most efficient mode of treatment.

[Septic arthritis in newborns and infants--the value of arthrography in diagnosis of post-inflammatory knee defects]. / Ropne zapalenia stawów u noworodków i niemowlat--wartosc artrografii w diagnostyce pozapalnych uszkodzen kolana.

Double-contrast arthrography of the knee was performed on 16 knees in 14 children, who after septic arthritis of the knee in newborn and neonatal period, showed defects of the secondary ossification centers of the femur or tibia on plain radiographs. Cartilaginous epiphysis, normal in shape and volume, was present in 11 cases. In 3 cases cartilaginous epiphysis of the femur was present, but had diminished size.

[Septic arthritis in newborns and infants--clinical epidemiology]. / Ropne zapalenia stawów u noworodków i niemowlat--epidemiologia kliniczna.

Septic arthritis in 99 newborns and 58 infants was analyzed epidemiologically. Multiple localization of septic process has been found in 37.4% of newborns and 16.0% of infants included in this study. The hip joint, knee and shoulder were affected most frequently in both groups. In 45.2% of newborns septic condition of the skin and in 37.1% otitis media was the source of infection. In infants septic arthritis was related to otitis media in 36.8%, septic condition of the skin in 23.3% and respiratory tract infection also in 23.3%. Staphylococcus aureus was the most frequent joint aspirate culture finding.

[Modified Van Nes operation for treatment of congenital proximal femoral focal deficiency]. / Zmodyfikowana operacja Van Nesa w leczeniu wrodzonego braku blizszego konca kosci udowej.

Van Nes rotation plasty was done in 5 children with congenital proximal femoral focal deficiency. Mean age at the operation was 8.7 years (range 38 months-16 years), mean follow-up was 16 months (6-30 months). In 3 children full rotation at the level of knee joint was done; in 2 cases additional rotation at the level of tibial shaft was necessary. No neural and vascular complications were observed. In all children the ankle is at the level of the knee of normal extremity. The range of flexion of the prostetic knee is between 70 degrees and 90 degrees. The review of the literature concerning the treatment of the most severe cogenital proximal femoral deficiencies is presented.

[Congenital posterior and posteromedial bowing of the tibia and fibula]. / Wrodzone tylne i tylno-przysrodkowe wygiecie kosci piszczelowej oraz kosci strazalkowej.

Five children with congenital posteromedial bowing of the tibia and fibula and 1 child with posterior bowing of the tibia and fibula have been followed-up. At the final examination age of the patients ranged from 6 months of 16 years (mean 69 months). In most of the cases the angulation had a tendency to decrease, shortening of the tibia remained constant. Pseudoarthrosis appeared in one of the children in 4th month of life at distal tibial diaphysis/metaphysis junction but healed spontaneously in 13 months time.

[Treatment of benign chondroblastoma]. / Leczenie chrzestniaka zarodkowego (chondroblastoma benignum).

Six children have been operated on due to benign chondroblastoma at the mean age at first operation of 14.2 years (range 11-17 years). Mean follow-up was 4 years (2-7 years). Mean delay of the diagnosis was 12 months (6-24 months). One-stage surgery was successful in child with proximal fibula involvement, child with distal femoral epiphysis involvement (knee arthrodesis followed), two children with proximal tibia involvement. In 1 case of distal femoral epiphyseal involvement two revisions were necessary, 1 similar case is in the course of treatment. At the follow-up three children presented with the knee pain and restricted range of motion.

[Personal experience in the use of closed reduction and transcutaneous K-wire fixation for displaced supracondylar fractures of the humerus in children]. / Doswiadczenia wlasne w stosowaniu zamknietej repozycji i przezskórnego zespolenia drutami kirschnera w leczeniu przemieszczonych zlaman nadklykciowych kosci ramiennej u dzieci.

The method of closed reduction and percutaneous K-wire fixation has been used for treatment of 20 children with displaced supracondylar fracture of the humeral bone. No infection, vascular or neural complication has been observed. In all cases good clinical and radiological results have been achieved. The authors conclude the method presented above should be used as a treatment of choice for displaced supracondylar fracture of the humerus in children.