[Short stature treatment by lower limb lengthening--multicenter study from five centers]. / Leczenie niskiego wzrostu metoda Ilizarowa--zbiorcza analiza wyników z pieciu osrodków w Polsce.

MATERIAL: 26 patients (17 female, 9 male) from 5 centers were evaluated. The age at the beginning of treatment ranged from 6 to 29 years (mean 13.8). The cause of short stature in 19 patients was achondroplasia or pseudoachondroplasia, in next 2--other bone dysplasias. The other 5 patients had not bone pathology and were treated because of cosmetic indications. Preoperative body height ranged from 90 to 149 cm (mean 120). Axial deviations of the lower extremities were noted in 11 patients. Mean follow-up was 3.7 years. METHOD OF TREATMENT: Most of patients were treated with Ilizarov device using cross lengthening strategy (2 stages--opposite femur and tibia lengthening). Mean duration of treatment including interval between two stages (mean 12 months) was 29 months. Planned increase of body height ranged from 10 to 26 cm (mean 16.4). RESULTS: Planned or greater lengthening (mean 14.8 cm) was achieved in 14 patients. Partial planned lengthening (mean 65% of planned lengthening) was achieved in 8 patients (mean 11.8 cm) including two patients who resigned the second stage of treatment. In two patients lengthening was stopped during first month of treatment because of great complications. In 2 patients treatment was not completed (interval between first and second stage). Mean increase of body height of patients with complete treatment was 13.1 cm (from 2 to 28). Problems, obstacles and complications were analyzed according to Paley classification. PROBLEMS: There were 24 problems in 15 patient (inflammation process around K wires--15 patients, bone healing disturbances--3, regenerate fracture--2, transient foot equinus--2 and axial deviation of the lower extremity--1). OBSTACLES: There were 31 obstacles in 19 patients (regenerate's defect--7 patients, premature bone consolidation--6, foot equinus--4 and other--14). COMPLICATIONS: There were 26 complications in 18 patients (axial deviation of the lengthened segment--8, foot equinus--6, paresis of the peroneal nerve--3, fractures--2 and other--5). The most serious complication was hemiparesis after cerebral embolism (1 patient) and damaging of the femoral artery (1 patient) both disrupting bone lengthening. CONCLUSION: The risk of complication in surgical treatment of short stature patients is high. Qualification for short stature treatment because of cosmetic indication should be made very careful and after precise psychological and/or psychiatric investigation.

[Results of surgical correction of congenital talipes equinovarus]. / Operacyjne leczenie wrodzonej stopy konsko-szpotawej--ocena wyników.

Different surgical procedures in the treatment of clubfoot were analyzed, especially in correlation to over-correction and inadequate correction. Indications for surgery, surgical errors and their influence on outcome were assessed. 82 children (28 females and 54 males) with 130 congenital equinovarus underwent surgery between 1988 and 1994. Age at the time of operation ranged from 6 to 13 months (average: 9 months). Posterior release (i.e. partial subtalar release) was conducted in 68 cases of clubfeet and complete subtalar release in 62 cases. During follow-up 44 children with 64 clubfeet were reviewed. Magone's criteria were used to assess final results. 15 (23%) feet showed very good results, 26 (41%)--good results, 14 (22%)--satisfactory and 9 (14%)--poor or no correction.

Diastrophic dysplasia with severe primary kyphosis and 'monkey wrench' appearance of the femora.

The cases of two sisters with severe diastrophic dysplasia who showed some unusual radiographic features (kyphosis secondary to hypoplasia/dysplasia of the lumbar spine and a 'monkey wrench' appearance of the proximal femur) are reported here. Absent patellae were another feature that has not previously been reported in diastrophic dysplasia.

[Fractures of the lateral condyle of the humerus in children: results of surgical treatment of new and old cases]. / Zlamanie klykcia bocznego kosci ramiennej u dzieci--wyniki leczenia operacyjnego przypadków swiezych i zastarzalych.

Twenty three children with fractures of the lateral condyle of the humerus were analyzed. In 20 cases surgery was performed 0 to 8 days after injury. The 3 delayed cases were operated because of one nonunion, one pseudoarthrosis, and one displaced union. All cases which underwent early surgical had a very good outcome with a follow-up observation period ranging from 8 months to 7 years. On long term follow-up of the delayed cases outcome was good in 2 cases. In one case with a 10 year history of pseudoarthrosis, the surgery resulted in a slight improvement. Basing on our observations, the authors believe early surgical intervention in indicated in order to achieve good outcomes. Delayed surgical treatment is justified in cases with elbow dysfunction.

[Use of densitometric measurements for evaluation of bone regeneration in lengthening of the long bone shaft]. / Zastosowanie badania densytometrycznego w ocenie regeneratu kostnego w wydluzeniach trzonów kosci dlugich.

A series of 18 long bone lengthenings in 16 children has been analyzed. To assess new bone formation sonography, DEXA and computerized tomography have been employed. Sonography proved to be most useful for elongation monitoring, but densitometry delivered most data concerning quantity and distribution of the new bone formation especially during stabilization stage. DEXA combined with CT allowed for making decision of the removal of ilizarov apparatus.

[An atypical case of Wegener's granulomatosis complicated by sepsis and coxitis]. / Ziarniniakowatosc Wegenera o nietypowej lokalizacji powiklana posocznica i ropnym zapaleniem stawu biodrowego.

There is presented an atypical case Wegener's granulomatosis of maxillo-nasal region without bony destruction. The case is unusual because of sepsis and purulent coxitis. The patient responded well to treatment with vincristine and cyclophosphamide. ANCA assays have very good sensitivity and specificity for Wegener's granulomatosis.

[Stress-induced and degenerative changes in the upper limbs and cervical spine of textile workers]. / Zmiany przeciazeniowe i zwyrodnieniowo-wytwórcze konczyn górnych i kregoslupa szyjnego u wlókniarzy.

Screening, radiological and oscillometric tests showed, in 758 textile workers, overloaded muscles and osseo-articular system as well as degenerative and productive changes in upper limb and cervical spine. Pains and radiological as well as degenerative and productive changes in acromial girdle joints and cervical spine occurred predominantly in weaving women aged 41-50, employed for over 20 years. The disease has been found to result from occupational exposure. The authors suggest that a greater attention be paid to the prevention of overloading, degenerative and productive pathologies in textile workers.