Validation of the Polish versions of the Lower Limb Task Questionnaire, Lower Limb Functional Index, and Lower Limb Functional Index-10.

BACKGROUND: Physicians who treat patients with lower limb diseases should pay attention not only to the patients' clinical condition but also to their individual needs and expectations. For this purpose, many different questionnaires can be employed. This study aimed to validate the Lower Limb Task Questionnaire (LLTQ), Lower Limb Functional Index (LLFI), and Lower Limb Functional Index-10 (LLFI-10) for their use in Polish conditions and to perform a mutual comparison and analysis of differences in subjective assessments by patients who undergo hip or knee arthroplasty. METHODS: The LLTQ, LLFI, and LLFI-10 were translated into Polish. A total of 103 patients who qualified for hip or knee arthroplasty at a University Hospital in from 2019 to 2021 were included in this study. The patients were asked to complete the Polish versions of the LLTQ, LLFI, LLFI-10, Lower Extremity Functional Scale (LEFS), and Short Form-36 four times - twice before and twice after their surgeries. RESULTS: The Polish versions of the LLTQ, LLFI, and LLFI-10 had good psychometric properties. One year after surgery, the Cohen's standard response mean revealed high improvement of limb functionality and thus quality of life among all patients. We observed better treatment outcomes among patients who had hip osteoarthritis. CONCLUSIONS: The questionnaires were validated and can be used both in everyday health practice and in further research in Poland.

The adaptation of Polish version of Six-Item Carpal Tunnel Syndrome Symptoms Scale.

BACKGROUND: The Carpal Tunnel Syndrome is one of the most common peripheral neuropathy. The diagnosis could be made by taking the medical history from a patient or by physical examination or by performing electroneurography. The aims of the study were (1) to translate and adaptate the Polish version of the Six-Item Carpal Tunnel Syndrome Symptoms Scale (CTS-6 SS) and (2) to analyse the associations between different Patients-Reported Outcome Measures and nerve conduction studies (NCS). METHODS: One-hundred and fifty patients consistent with inclusion criteria filled the CTS-6 SS, Boston Carpal Tunnel Questionnaire (BCTQ), Disabilities of the Arm, Shoulder and the Hand (DASH) and Michigan Hand Outcomes Questionnaire (MHQ) during their first visit to the clinic. Then, they had the NCS done. After two weeks, 99 patients filled the CTS-6 SS for the second time. RESULTS: The Polish version of CTS-6 SS revealed good psychometric properties: high values of internal consistency, test-retest reliability and validity. The construct validity showed strong correlation with BCTQ - R = 0.87 (p < 0.05) for Symptoms Severity Scale (SSS) and R = 0.64 (p < 0.05) Functional Status Scale (FSS). Additionally CTS-6 SS has at least moderate correlation with DASH R = 0.53 (p < 0.05). CONCLUSIONS: The Polish version of translated scale was adapted and used together with NCS complete the overall picture of patients suffering from CTS. STUDY DESIGN: Prospective study.

The superficial temporal artery: A meta-analysis of its prevalence and morphology.

INTRODUCTION: The superficial temporal artery (STA) is a terminal branch of the external carotid artery. It supplies the regions of scalp and face. The morphometrical data concerning STAs are not consistent; therefore, in this systemic review and meta-analysis, we aimed in this to provide an up-to-date data on its anatomic features. MATERIAL AND METHODS: In order to do this, PubMed, Embase, ScienceDirect, and Web of Science were searched. We followed the Preferred Reporting Items and Review and Meta-Analyses guidelines for the meta-analysis. Studies that reported the prevalence and anatomical data regarding STA were included in further analyses. RESULTS: Out of 1,446 studies initially evaluated, 21 were included in the meta-analysis (874 patients/donors). The STA diameter was 1.5 mm (95% confidence interval [CI]: 1.47-1.53 mm). The frontal and parietal branches of the STA were present in 97.6% (95% CIs: 94.6-99.5%) and 96.4% (95% CIs: 93.5-98.5%) of the cases, respectively. The STA bifurcation point was located above the zygomatic arch in 79.1% (95% CI: 68.0-84.3), below the zygomatic arch in 6.7% (95% CI: 2.4-12.1), and on the zygomatic arch in 11.1% of the cases (95% CI: 5.4-17.5). There was no bifurcation of the STA in 3.1% of the cases (95% CI: 0.4-7.3). CONCLUSION: The most comprehensive analysis of STA morphological features is presented. The results from this evidence-based anatomical study will improve understanding of the clinical STA anatomy, which in turn has major implications for understanding the STA in clinical practice.

The Arteries of the Central Forehead: Implications for Facial Plastic Surgery.

BACKGROUND: The forehead has substantial importance as an aesthetic unit. The central and supraorbital parts of this area are supplied by the supratrochlear (ST) and supraorbital (SO) arteries as well as the recently defined paracentral (PA) and central arteries. OBJECTIVES: The authors aimed to assess the morphometry of the vessels of the forehead in the context of plastic surgery and minimally invasive cosmetic procedures. METHODS: This research included 40 cadavers directed for forensic autopsy and subjected to postmortem computed tomography angiography. In total, 75 hemifaces were examined for the course and location of arteries relative to the bones and surrounding structures. RESULTS: The arteries were observed as follows: ST in 97.3%, SO in 89.3%, and PA in 44.0%. The PA can be expected in the 13-mm-wide zone starting 2 mm laterally from the midline. The ST should be expected in the 10-mm-wide area extended laterally from the tenth millimeter from the midline, and the SO should be expected in the slightly wider (11 mm) area extending laterally from the 20th millimeter from the midline. For the proximal main trunks of the ST and SO arteries, we observed no overlap between the zones of occurrence, whereas the zones for the PA and ST main proximal trunks did overlap. No distinctive central artery was observed in the midline region of the forehead, but instead a network of small vessels in the midline region was visible. CONCLUSIONS: The ST is the main and most conservative artery of this region and the PA is the most variable. A unique and detailed anatomical map was created to better understand the vasculature of the forehead area.

Polish version of the Patient-Rated Ulnar Nerve Evaluation in preoperative patients: Translation and psychometric testing.

STUDY DESIGN: Cross-sectional design. INTRODUCTION: This study examined the translated English to Polish version of the Patient-Rated Ulnar Nerve Evaluation (PRUNE) for its internal consistency, test-retest reliability, and construct validity. METHODS: During the first assessment validity testing, a total of 39 consecutive patients with cubital tunnel syndrome completed the PRUNE, Michigan Hand Outcome Questionnaire, Disabilities of the Arm, Shoulder, and Hand questionnaire, and Patient Evaluation Measure in conjunction with the grip and key pinch tests and pain score (by Visual Analogue Scale). Cronbach's alpha (CA), intraclass correlation coefficient (ICC), and the Bland-Altman plot were used to evaluate internal consistency, test-retest reliability, and agreement, respectively. Analysis of variance compared the PRUNE score with the McGowan clinical stages. RESULTS: After a 1-day interval, 19 patients completed the PRUNE for the second time. The total PRUNE score was 44.4 ± 20.4, CA = 0.93, and ICC = 0.921. The total PRUNE score limits of agreement varied from -9.87 to 7.55 points. PRUNE subscale CA ranged from 0.79 to 092; the ICC varied from 0.738 to 0.911. The construct validity revealed a strong association with Michigan Hand Outcome Questionnaire (R = -0.83; P < .000), and moderate with Disabilities of the Arm, Shoulder, and Hand (R = 0.75; P < .000), Patient Evaluation Measure (R = 0.75; P < .000), and Visual Analogue Scale (R = 0.69; P < .000). The grip and pinch tests had low and no correlation with the total PRUNE score, respectively. CONCLUSION: The Polish version of PRUNE showed good psychometric properties for use in both clinical and research practice in patients with cubital tunnel syndrome of varying intensity.

Anatomical Map of the Facial Artery for Facial Reconstruction and Aesthetic Procedures.

BACKGROUND: The facial artery (FA) is the main blood vessel supplying the anterior face and an understanding of its anatomy is crucial in facial reconstruction and aesthetic procedures. OBJECTIVES: The aim of this study was to assess the many anatomical features of the FA utilizing a multidimensional approach. METHODS: Head and neck computed tomographic angiographies of 131 patients (255 FAs) with good image quality were evaluated. The FA was classified according to its termination pattern, course, and location with reference to soft tissue/bone surrounding structures. RESULTS: In total, each branch was present as follows: the submental artery (44.8%), the inferior labial artery (60%), the superior labial artery (82.2%), the lateral nasal artery (25.1%), and the angular artery (42.5%). The most common FA course was the classic course, situated medially to the nasolabial fold (27.1%). In total 65.5% of the arteries were located medially to the nasolabial fold, and only 12.3% of them were totally situated lateral to the nasolabial fold. The median distance (with quartiles) from the inferior orbital rim reached the FA after the superior labial artery branched off in 50.2% of cases and was 36.6 mm (33.4; 43.3). The angle between the FA and the inferior border of the mandible was 49.8o (31.9; 72.4). The horizontal distances between the oral commissure and naris to the FA were 8.5 ± 4.0 mm and 12.1 ± 6.7 mm, respectively. CONCLUSIONS: An anatomical map summarizing the major measurements and geometry of the FA was generated. The detailed anatomy and relative positioning of the FA should be considered to avoid any unexpected complications in plastic surgery.

The Superficial Temporal Artery: Anatomical Map for Facial Reconstruction and Aesthetic Procedures.

BACKGROUND: The superficial temporal artery (STA), a terminal branch of the external carotid artery, supplies multiple regions of the scalp and face. Knowledge of the STA is important for reconstructive and aesthetic procedures of the head and face. OBJECTIVES: The aim of this study was to map the STA in relation to anatomical landmarks. METHODS: Computed tomographic head angiographies of 215 patients were included in this study; the final analysis comprised 419 STAs. The STA's main branches and variants were identified. The diameters of the STA and its frontal and occipital branches were measured, and the distance between the STA tree and anatomical landmarks was delineated. RESULTS: Frontal and parietal branches were recorded in 98.1% and 90.7% of patients, respectively. The mean diameters, measured 1 and 7 cm from the STA bifurcation for the frontal branch, were 0.97 ± 0.32 and 0.81 ± 0.26 mm, respectively, and for the parietal branch, the diameters were 0.96 ± 0.28 and 0.76 ± 0.23 mm, respectively. The STA bifurcation point was located above the zygomatic arch (ZA) in 75.6%, below in 14.7%, and on the ZA in 9.7% of patients. The mean distance from the ZA center to the STA bifurcation was 16.8 ± 16.0 mm. CONCLUSIONS: The STA artery and its main branches follow a conservative course, and serious anatomical variations are relatively rare. The STA and its main branches may be localized using simple anatomical landmarks. An anatomical map showing artery-free zones in the lateral forehead region was presented, which may prove useful for plastic, reconstructive, and aesthetic surgeons.Level of Evidence: 4.

[Carpal tunnel syndrome- etiology and treatment].

The paper presents the etiology, diagnostics, management, treatment and prognosis of carpal tunnel syndrome. The mechanism of the median nerve compression as well as the predisposing factors that cause the syndrome are discussed, as well as the sequence of specific symptoms and the classification of the level of severity of disease. The diagnostic methods are presented with both the benefits and consequences of each method. The treatment of carpal tunnel syndrome is divided into conservative and surgical approaches. Conservative treatment consists of keeping the wrist immobile using wrist splints, physiotherapy, systemic and local pharmacotherapy, as well as local steroid injections into the carpal tunnel. The results of conservative treatment are often short-term. Operative treatment consists of cutting the flexor retinaculum tendon. This directly eliminates the cause of CTS, the increased pressure in the carpal tunnel of the wrist. A certain percentage of patients experience complications post treatment or disease recurrence.

[Evaluation of influence of Dupuytryen contracture's operative treatment on increase of quality of hand's function basing on research in use PEM (Patient Evaluation Measure) questionnaire]. / Ocena wplywu operacyjnego leczenia przykurczu Dupuytrena na poprawe funkcji reki w oparciu o badania przeprowadzone z zastosowaniem kwestionariusza PEM (Patient Evaluation Measure).

INTRODUCTION: Dupuytren's contracture is a progressive fibrosis of facial structures of the palmar surface of the hand, gradually leading to a reduction of its functions by impaired range of motion of fingers. MATERIALS AND METHODS: Clinical material consisted of 95 patients treated surgically in the Second Department of Surgery of the Jagiellonian University in 2006 - 2011 because of Dupuytren's contracture. Based on a study using PEM questionnaire (Patient Evaluation Measure) an assessment of the quality of life before and after surgery was made. RESULTS: The average numeric value obtained in the PEM questionnaire before surgery was 30 points (SD ± 14.35). The postoperative controls were found of gradual decrease in the value and so after three months it was 22.39 points (SD ± 14.23), and after a year it reached the value of 18.12 points (SD ± 12.43). Statistically significant correlations (p < 0.001) were demonstrated between test results of PEM taken before and after 3 and 12 months after surgery. CONCLUSIONS: It has been shown that Dupuytren's contracture has negative impact on quality of life but the quality of life improves after surgical treatment.

Validation of the Polish version of the Hand Function Scoring system.

BACKGROUND: The Hand Function Scoring (HFS) system was created to assess the results of rehabilitation treatment after hand injuries. A perceived hand function improvement in patients who underwent carpal tunnel syndrome surgery prompted us to use the Watts HFS questionnaire in our study. OBJECTIVES: The study aimed to: 1) translate and validate the new questionnaire into Polish; 2) analyze the usefulness of the scale in the preand post-operative assessment of patients with carpal tunnel syndrome; and 3) compare the results with other questionnaires recognized as the gold standard in carpal tunnel treatment evaluation. MATERIAL AND METHODS: Patients with electromyographically confirmed carpal tunnel syndrome (n = 317) were enrolled in the study. Participants completed the HFS, Boston Carpal Tunnel Questionnaire (BCTQ), Michigan Hand Outcomes Questionnaire (MHQ), and the Quality-of-Life Scale (QoLS) on their first visit to our clinic. Two weeks later, 84 patients completed the same questionnaires again, and 6-12 months after the operation, we received 90 additional responses. RESULTS: The analysis showed that the HFS questionnaire met the validation criteria and had a strong correlation with the BCTQ questionnaire for the Symptoms Severity Scale (SSS) (Rho = 0.70, p < 0.001) and the Functional Status Scale (FSS) (Rho = 0.89, p < 0.001). CONCLUSIONS: The HFS questionnaire was successfully employed in the subjective assessment of carpal tunnel symptom syndrome severity and the analysis of treatment results, and would complement the clinical assessment of patients during treatment. The questionnaire could also be used in future scientific research.

[Evaluation of influewnce of Dupuytryen contracture's operative treatment on increase of quality of hand's function basing on research in use DASH (disability of the arm, shoulder and hand) questionnaire - own experience]. / Ocena wplywu operacyjnego leczenia przykurczu Dupuytrena na poprawe funkcji reki w oparciu o badania przeprowadzone z zastosowaniem kwestionariusza DASH (disability of the arm, shoulder and hand) - doswiadczenia wlasne.

UNLABELLED: The essence of Dupuytryen's contracture is progressive process of fibrous overgrow of the subfascial sturctures of hand volar's surface. This is the reason of impaired range of the finger movement's and subsequent limitations of their function. MATERIAL AND METHODS: The study group consist of 95 patients treated because of Dupuytryen contracture in the 2nd Chair of Surgery, Medical College of JagielIonian University between 2006-2011. The subjective evalution of increase of hand's function quality was based on DASH (Disability of the Arm, Shoulder and Hand) questionnaire. THE AIM OF THE STUDY: The aim of the study was to determinate an influence of Dupuytren contracture's operative treatment on increase of quality of hand's function using the DASH questionnaire. RESULTS: Average value in DASH before operative treatment was 40.38 points (SD+/-12.53). In postoperative evaluation gradual increase was observed: after 3 month was 33.35 points (SD+/-16.39) and after one year - 32.57 points (SD+/-14.96). Statistically important differences between DASH test's results (P<0.01) were observed. Significantly superior results was before operation, results after 3 month and 1 year were nut statistically important. CONCLUSIONS: The research with the use of DASH questionnaire revealed the influence of Dupuytren's contracture severity on subjection evaluation of hand's function.

[Evaluation of trigger finger operative treatment and quality of life improvement with PEM (Patient Evaluation Measure) questionnaire]. / Ocena wyników leczenia operacyjnego palców trzaskajacych (przeskakujacych) i poprawy jakosci zycia w oparciu o kwestionariusz PEM (Patient Evaluation Measure).

UNLABELLED: One of the most frequent couse of pain and function impairment of the hand is trigger finger. The treatment of this desease can be conservative or operative. The aim of this study was the evaluation of operative treatment and improvement of the quality of life after the procedure with PEM questionnaire. There were 50 patient included into evaluation, all of them were treated in Second Department of Surgery of the Jagiellonian University Medical College between 2008 and 2010. Patients evaluated the function of their hand before surgery and then 3 months and a year after the procedure. There were also the assessment of treatment satisfaction. We analised the results and observed significant improvement of hand function after the surgery and very high satisfaction with the treatment. CONCLUSIONS: 1. Surgery is a very effective treatment method of trigger finger. 2. It is quite simple procedure and followed by very few complications. 3. It allows to significantly improve hand function and early return to work. 4. It can be performed in the outpatient clinic, which considerably reduces the costs of treatment.

[Evaluation of hand injury severity]. / Ocena ciezkosci obrazen rak.

Hand Trauma Severity Scale (HTSS) was created on the basis of our study on 1199 patients who were treated because of the hand injuries in the Second Chair of Surgery Jagiellonian University in Krakow in years 1987-2000. (last examination in 2010, follow-up: 11 to 23 years, mean follow-up: 16 years). Hand Trauma Severity Scale (HTSS) has been created based on We looked at the range of injury, likely total length of treatment, final functional result and possible amount of posttraumatic disability. Created HTSS scale was compared to Hand Injury Severity Score (HISS) and their statistically significant correlation (p < 0,001) was found. We have also found statistically significant correlation between the severity evaluated with HTSS and the circumstances of traumas, their direct cause, necessity of hospitalization after primary reconstructive treatment and total length of treatment. Distant results of treatment such as resuming of previously performed work and permanent posttraumatic disability also correlated with the severity of hand injuries measured with scale described in this study.

[Metrological analysis of stabilization material damages in AO treatment method]. / Analiza metrologiczna uszkodzen materialu zespalajacego przy stabilizacji zlaman metoda AO.

UNLABELLED: The aim of the study was the assessment of the material damages within the AO plates, used in fractures stabilization. Both the fixation material that became fractured and the fixation material removed without essential macroscopic damages were taken into consideration. There were 40 randomly chosen patients in the studied group (20 women and 20 men), who underwent stabilization of the fracture with the use of AO method in Second Department of Surgery of the Jagiellonian University Medical College between 2000-2009, followed by the removal of the fixation material and its metrological analysis. The mean age of patients in the studied group was 38 years. The mean follow-up was 4,3 years (2-11 y.). Complete bone union was achieved in 37 patients after the stabilization. Loosening and fracure of the fixation matierial was observed in 3 patients. Another stabilization surgery was necessary in these cases. After metrological analysis of the fixation material noticeable surface damages were found in 6 patients and damages within the holes in 20 plates, including 3 fractures. Damages of the fixation material were taking place mostly in patients with the femoral bone fractures. CONCLUSIONS: 1) There are two typical damages of the stabilization plates: the surface damage and the damage within the screw holes. 2) Damage and loosening of the plates are mainly caused by its re-modelling and traumatisation during the surgery. 3) No essential surface changes were observed within most of the AO plates and the changes within the screw holes are observed in half of the cases.

[An attempt to objectify the assessment of extension or recurrence of Dupuytren's disease on the basis of ultrasound]. / Próba obiektywizacji oceny nawrotu lub wznowy choroby Dupuytrena w oparciu o badanie ultrasonograficzne.

Dupuytren's contracture is a disease of unknown etiology, leading with time to decreased hand function caused by increasing contracture of fingers. Excision of contracted longitudinal palmar fascia constitutes the most important way of treatment. Due to fact that disease has progressive course in many patients recurrence (i.e. overgrowth of longitudinal palmar aponeurosis apart from the operated site) or extension (i.e. similar process affecting formerly operated site) occurs. An attempt to objectify the assessment of recurrence or extension of Dupuytren's disease on the basis of sonographic examination of palmar surface of the hand during distant (at least 24 months from surgery) followup constituted the aim of the study. 41 patients operated on from January 2000 to February 2009 in 2nd Department of General Surgery in Krakow due to Dupuytren's contracture constituted the study material. Mean age of the patients reached 62,78 years (SD +/- 9,32), and mean follow up time 5,74 years (SD +/- 2,90). Sonographic assessment was performed in 26 operated on left hands and 24 right hands. 9 patients had both hands operated on. In most of the patients during surgery the contralateral hand was also affected by the disease. Extension of Dupuytren's disease was found in 11 hands, recurrence--in 18 hands, while concurrent extension and recurrence was found in 17 hands. Extension usually was found on the radial side and affected mainly I interphalangeal space followed by disease affecting I and III ray of the hand. In one patient 2 independent foci of the disease were found within I interphalangeal space. Recurrences affected mainly ulnar side of the hand: V and IV rays of the hand. Concurrently found extension and recurrence affected 2 or 3 rays. In the cases of 3 rays affected extension dominated (2 rays vs. 1 ray of recurrence). On sonographic assessment mean diameters of lesions during distant follow- up were 12,69 x 4,62 x 3,95 [mm] with recurrent lesions being larger than mean values found in extensions. With partial fasciectomy being the most commonly performed operation in cases of Dupuytren's disease ultrasound can constitute very important technique of assessment of exacerbation of the lesions of palmar aponeurosis allowing for the choice of appropriate surgical technique for particular case, detection of postoperative extension and/or recurrence and for the cases clinically doubtful.

[Concomitance of Ledderhose's disease with Dupuytren's contracture. Own experience]. / Wspólistnienie choroby Ledderhose'a z przykurczem dupuytrena. Doswiadczenia wlasne.

INTRODUCTION: Ledderhose's disease is a rare fibromatosis affecting plantar aponeurosis. Clinical picture and risk factors resemble the ones found in much more common cases of Dupuytren's disease. MATERIAL AND METHODS: The group of 101 patients with Dupuytren's disease qualified for surgical treatment constituted material for the study. Within that group incidence of Ledderhose's disease was assessed on the basis of clinical and ultrasound examination. Estimation of the presence of risk factors common for both forms of fibromatosis was also evaluated. RESULTS: Ledderhose's disease was found in 15 patients (14.85%) suffering from Dupuytren's contracture. Bilateral Ledderhose's disease was found in 10 of them. Established risk factors were similar to the ones found in Dupuytren's disease--tobacco and alcohol dominated. Indications for the surgical treatment were limited to the symptomatic cases of the disease. Two feet in 4 patients were operated on. Surgical technique was presented in broad outline. Pain relief on walking and normalization of feet pressure distribution were achieved in all cases.

[Clinical implication of residual mesoaxial polydactyly of the foot--case report]. / Implikacje kliniczne szczatkowej polydaktylii mesoaxialnej stopy--opis przypadku.

The aim of our study was to estimate influence of anatomical malformations in foot (characterised by mesoaxial polydactyly) in 26-year old female patient on clinical condition and biomechanical motion. Clinical, radiological and pedobarographic examinations were used in the patient's analysis. The postural pedobarographics examinations revealed persistent disturbances in underfoot pressure distribution despite pain recovered, which has been achieved by discontinued of wearing tight shoes.

BMPR1B gene in brachydactyly type 2-A family with de novo R486W mutation and a disease phenotype.

BACKGROUND: Brachydactylies are a group of inherited conditions, characterized mainly by the presence of shortened fingers and toes. Based on the patients' phenotypes, brachydactylies have been subdivided into 10 subtypes. In this study, we have identified a family with two members affected by brachydactyly type A2 (BDA2). BDA2 is caused by mutations in three genes: BMPR1B, BMP2 or GDF5. So far only two studies have reported the BDA2 cases caused by mutations in the BMPR1B gene. METHODS: We employed next-generation sequencing to identify mutations in culpable genes. RESULTS AND CONCLUSION: In this paper, we report a case of BDA2 resulting from the presence of a heterozygous c.1456C>T, p.Arg486Trp variant in BMPR1B, which was previously associated with BDA2. The next generation sequencing analysis of the patients' family revealed that the mutation occurred de novo in the proband and was transmitted to his 26-month-old son. Although the same variant was confirmed in both patients, their phenotypes were different with more severe manifestation of the disease in the adult.

[Underfoot pressure distribution of female patients with obesity and plantar fasciitis]. / Rozklad nacisków na podeszwowej stronie stóp u kobiet z otyloscia i zapaleniem rozciegna podeszwowego.

OBJECTIVE: Estimation of underfoot pressure distribution of female patients with obesity and bilateral plantar fasciitis. MATERIAL: 45 women aged 58 (SD +/- 9.0) with obesity confirmed by BMI (BMI = 38.2, SD +/- 5.1) and hindfoot-related bilateral pain complaints typical for plantar fasciitis. The control group consisted of 50 women with no obesity and pathologies of motor apparatus found. METHODS: Clinical and radiological examination and postural pedobarography. The underfoot pressure was determined at defined foot regions according to modified Blomgren classification. RESULTS: When compared with the control group, patients with obesity had increased pressure within metatarsus, mainly in its lateral part and within anterior part of hindfoot (MT5, MM, LM, T zone). The maximal value of underfoot pressure was 1052 g/cm2 in patients with obesity and 784 g/cm2 in the control group. There were no statistically significant differences found between underfoot pressures and stronger and lesser pain complaints occurring in one patient. CONCLUSIONS: 1) In obese women with bilateral plantar fasciitis increased underfoot pressure mainly in the lateral part of metatarsus and anterior part of hindfoot was revealed. 2) The above changes correlate with feet dysfunction confirmed during the interview and through the physical examination.

Quality of life as a result of multiple injury in the aspect of limitations of handicaps--social roles.

Aim of the study was the comparison of quality of life after multiple injury using limitations of handicaps--social roles, ICIDH (World Health Organization). The study group comprised 1259 patients in the years 1989-2003 whose degree of injuries amounted to at least 18 scores in the Injury Severity Scores. Patients were evaluated during a 5 year period. The prospective study in the period to three years (to the end of 2006 year) included 827 (65.9%) patients. The results were compared and statistically analyzed. In the first 5 years--72.5% persons presented limitations on handicaps. In the second 5-years period--48.8% were found to have limitation on social roles and in the third 5-years period 50.3% of people. The most common limitations referred to physical activity--50.5% patients, economic self dependence--49.3% and carrying out of everyday routine--45.7% patients. The highest quality of life improvement and the decrease in the amount of people with limitations on social roles was noted in the second 5-year period and was statistically significant related to the first 5 years. The improvement of quality of life was not significant in the third 5-year period related to second 5-year period. The increase of injuries severity and age was one of the reasons of reduction of positive changes in the last 5-year period.