[The modified Elmslie-Trillat procedure for the treatment of recurrent patellar dislocation and instability]. / Korekcja nawykowych zwichniec i niestabilnosci rzepki zmodyfikowana metoda Elmslie-Trillat.

UNLABELLED: Habitual patella dislocation and instability in the absence of effective conservative treatment requires surgery. Surgical procedures can be divided into bone, soft tissue and mixed methods. In many studies the authors emphasize the good results of Elmslie-Trillat procedure. METHODS: In 2005-2008, we operated 20 patients by modified Elmslie-Trillat procedure but 2 patients were excluded from the study because of lack of control after surgery. We modified surgical technique by type of tibial tuberosity osteotomy and reconstruction of soft tissues. RESULTS: We used a subjective clinical evaluation (evaluation of Q angle, patella traction in the dynamic tests) and the Tegner and Lysholm scale. In the Tegner scale, we obtained an average improvement of 3.4 points (from 0 to 8), and in Lysholm scale average of 46.7 points (from 14 points to 65 points). CONCLUSIONS: Correction of recurrent patellar dislocation and instability by a modified Elmslie-Trillat method is effective and good results are obtained. Only the appropriate selection of surgical procedure depending on the cause of disease provides a permanent cure.

[Locked posterior shoulder dislocation]. / Tylne zastarzale zwichniecie stawu ramiennego.

Posterior shoulder dislocations are diagnosed rarely in every-day practice. Although the methods of radiological imaging have been developing and becoming commonly available, the cases of late diagnosis are still happening. Proper clinical examination and properly conducted and interpretated radiographs allow for identification and implementation of appropriate medical procedures. In spite of fact that such cases are identified expectionally rarely, a few types of procedural have been analised and numerous therapeutic methods have been described. The choice of an appropriate treatment is complicated and requires in-depth theoretical knowledge as well as the knowledge of specific conditions within the shoulder surgery. Based on an algorithm, proposed by Griggs, between 2000-2006 seven patients with locked posterior instability were treated, for all of them defect of the proximal humerus did not exceed 30%. In all these cases the goals of improving stability and range of motion were obtained.

[Outcomes of treatment and rehabilitation of recrudescence periprosthetic femur fractures after operative stabilization using Mennen plate]. / Wyniki leczenia i rehabilitacji ponownych zlaman okoloprotezowych kosci udowej po leczeniu operacyjnym z zastosowaniem plyty mostujacej Mennena.

The authors present outcomes of treatment and rehabilitations of recrudescence periprosthetic femur fractures after operative treatment using Mennen plate. Clinical material of 2000-2007 years are 31 patients including 26 female (83.9%) and 5 male (16.1%), aged between 54 and 78 years, on average 62-years-old. Recrudescence periprosthetic femur fractures took place in 7 patients (22.5%) including 6 female (19.3%) and 1 male (3.2%). Evaluation of obtained outcomes the authors making in base on Harris rating score criteria and radiological confirmation of implant stability and periprosthetic fractures differentiated according to Vancouver classification. They pointed that recrudescence periprosthetic femur fractures occurred the most in patient after revision hip replacement, after primary type B3 fracture and the most frequent are secondary type C fracture nature.

[Distant functional outcomes of treatment and physiotherapy of tibial eminence fractures in adults]. / Odlegle wyniki czynnosciowe leczenia i fizjoterapii zlaman wynioslosci miedzyklykciowej kosci piszczelowej u doroslych.

Authors of paper present distant functional outcomes of treatment and physiotherapy of tibial eminence fractures basing on clinical material covering years from 1998 to 2006, that make up 15 patients, 7 women (46.7%) and 8 men (53.3%), aged between 18 and 57 years, on average 37.5-years-old. Subject fractures ware classified basing on Meyers i McKeever criteria, however obtained outcomes basing on IKDC (International Knee Documentation Committee) system. Obtained outcomes persuade authors to standpoint, that inoperative treatment of fractures type I leads to good functional outcomes, operative treatment of fracture type II leads to good functional outcomes too and operative treatment of fracture type III and III+ leads to sufficient outcomes.