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.

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.

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.

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.

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 transverse facial artery anatomy: Implications for plastic surgery procedures.

BACKGROUND: The transverse facial artery (TFA) perfuses the lateral face. Knowledge of topographical anatomy of the lateral face is crucial for safe procedural performance in aesthetic and plastic surgery, especially the face lift flap and face transplant. The aim of the present study was to assess detailed TFA morphometrical features. PATIENTS AND METHODS: One-hundred computed tomography head angiographies were analyzed. TFA numbers and origins were recorded bilaterally (200 cases). TFA diameters and lengths in addition to their positions in relation to neighboring vessels and the zygomatic arches were measured. RESULTS: TFA was present in 96% of cases (192/200, left = 97, right = 95). A single TFA was present in 95.3% and double TFAs were present in 4.7% of cases. In 91.7%, the TFA originated from the superficial temporal artery, and in 3.1%, it originated from the external carotid artery. One left TFA originated from the maxillary artery. The TFA was significantly longer on the right than on the left side (56.6±26.0 versus 47.3±22.2 mm; p = 0.03). The TFA mean diameter was 1.0±0.4 mm (range: 0.4-2.2 mm) with no difference between face sides. TFA length correlated with its diameter (r = 0.46, p <0.05). The TFA always originated below the zygomatic arch, and it should be found in the 8.8 mm wide area beginning 17.0mm below the lower border of the zygomatic arch. CONCLUSIONS: The TFA has a significant role in lateral face vascularization, and absence of this vessel is very uncommon.

The Polish version of the Boston Carpal Tunnel Questionnaire: Associations between patient-rated outcome measures and nerve conduction studies.

PURPOSE: The aim of this study was to investigate the associations between nerve conduction studies and three commonly used patient-reported outcome measures (Disabilities of the Arm, Shoulder and Hand [DASH], Michigan Hand Outcomes Questionnaire [MHQ], and the Polish version of the Boston Carpal Tunnel Questionnaire [BCTQ]) METHODS: A total of 218 consecutive patients with carpal tunnel syndrome (CTS) completed the BCTQ, MHQ, and DASH questionnaires followed by nerve conduction studies on their first visit to the clinic. RESULTS: After a 14-day interval, 189 of these patients completed the BCTQ for the second time. The Polish version of the BCTQ was shown to have excellent internal consistency, test-retest reliability, and validity. The BCTQ's construct validity revealed a strong correlation with MHQ and DASH (both R>0.7; P<0.05). Generally, compound motor action potential amplitudes correlated slightly with MHQ (R=0.22; P<0.05) and its subscales, while sensory nerve action potential conduction velocities had a low correlation with the BCTQ's symptom severity scale (R=-0.16; p<0.05). CONCLUSION: The Polish BCTQ version demonstrated good psychometric properties. It can be used both in clinical and research practice. Objective results of diagnostic procedure influenced patients' lives as measured by subjective questionnaires.

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.

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.

Morphological variations of the interatrial septum in ovine heart.

Smooth septum interatrial septum, patent foramen ovale (PFO) channel and atrial septal pouches (SPs) are commonly described variants in humans. Recent discoveries on the clinical significance of left-sided SP may encourage the creation of new strategies and devices for the management of SPs. However, these strategies may first be tested in the ovine model before implementation in humans. Unfortunately, little is known about the presence of SPs in ovine. In this study a total of 60 ovine (Ovis aries) hearts were examined. The interatrial septum morphology was assessed and the PFO channel and SPs were measured. The most commonly occurring variant were PFO channels (25.0%) with channel lengths of 5.4±2.3 mm. Smooth septums were observed in 18.3% of hearts. In the remaining cases, septums had a left septal ridge (15.0%), left SP (11.7%), left septal bridge (10.0%), right SP (10.0%), or had both a right SP and left septal ridge (10.0%). No double SPs were observed. The mean right SP depth was 3.4 ± 1.2 mm, and its mean ostium width and height were 7.9±1.8 mm and 2.8±1.0, respectively. For the left SP, the mean depth was 6.0±1.7mm, the ostium width was 7.9±2.4mm, and the ostium height was 4.1±1.6mm (range: 2.3-6.4mm). In conclusion the interatrial septum of ovine hearts exhibit morphologies that are more similar to humans than they are to swine, which should be taken into account during experimental studies. The presence of a left SP in sheep hearts make ovine models a promising alternative to the human heart for developing left-sided SP management devices and techniques.

Comparison of Patient-Reported Outcome Measurements and Objective Measurements after Cubital Tunnel Decompression.

BACKGROUND: The aims of this study were (1) to compare the responsiveness of disease and hand-related issues, including health status-related questions, in patients with cubital tunnel syndrome; and (2) to assess whether these tools and objective hand tests are associated with the results of nerve conduction studies after a simple cubital tunnel syndrome decompression. METHODS: Forty-seven patients with diagnosed condition were enrolled in the study. The following tools were used preoperatively and again at 3 and 6 months: the Patient-Rated Ulnar Nerve Evaluation; the Michigan Hand Outcomes Questionnaire; the Disabilities of the Arm, Shoulder, and Hand; the 12-Item Short-Form Health Survey; the pain visual analogue scale with activity; the grip and key pinch test, two-point discrimination, and the ulnar nerve conduction studies test. RESULTS: All questionnaires and pain visual analogue scale, two-point discrimination, and nerve conduction studies improved significantly at the 6-month follow-up (p < 0.05) compared with preoperative outcomes. Correlations were observed between preoperative motor conduction velocity, preoperative work of the Michigan Hand Outcomes Questionnaire (R = -0.38; p = 0.049), and pain visual analogue scale during activity (R = 0.47; p = 0.025). A correlation was found between motor conduction velocity change after 6 months and the hand function of the Michigan Hand Outcomes Questionnaire after 6 months (R = 0.57; p = 0.017). CONCLUSION: The Patient-Rated Ulnar Nerve Evaluation and the Michigan Hand Outcomes Questionnaire were more responsive for short-term recovery compared with other measures; however, only the latter correlated with motor conduction velocity.

The Polish version of the Michigan Hand Outcomes Questionnaire: Cross-cultural adaptation, reliability, construct validity, and measurement error.

The aims of this study were to translate the Michigan Hand Outcomes Questionnaire into the Polish language and to test the measurement properties of its quality criteria. A total of 120 patients with hand complaints completed the Polish Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire on the first assessment, along with the grip test, pinch test, and pain sore assessed using a visual analogue scale during activity. After 7 days, 76 patients completed the Michigan Hand Outcomes Questionnaire the second time. The Cronbach alpha of the Michigan Hand Outcomes Questionnaire subscales ranged from 0.79 to 0.96. The intraclass correlation coefficient varied from 0.82-0.97, and the Bland-Altman method indicated the Michigan Hand Outcomes Questionnaire total score limit of agreement was -13.2-12.3 and -9.18-9.62 for the right and left hand, respectively. The construct validity revealed a moderate to strong correlation between every subscale of the Polish Michigan Hand Outcomes Questionnaire and Disabilities of the Arm, Shoulder, and Hand, but they only correlated with the grip test and the visual analogue scale, and neither correlated with the pinch test. The study demonstrated properties similar to the original version, validating the belief that the use of this questionnaire in medical practice in Poland is justified.

[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.

[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 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 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.

[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.

[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.