New clinical observations connected with "biomechanical aetiology of so called idiopathic scoliosis" (2006-2007).

Over the last few years, an etiological cause of scoliosis has been developed at Lublin, Poland. This is based on the findings of was limited adduction or abduction contracture of right hip, coupled to asymmetry of movements between right and left hip which influences growth of spine through "asymmetrical gait" and asymmetrical standing.

[Postero-medial release in surgical treatment of congenital clubfeet: a comment to Turco's method based on personal experience]. / Leczenie operacyjne wrodzonej stopy konsko-szpotawej technika uwolnienia tylno-przysrodkowego--odniesienie do metody turco na podstawie wlasnych obserwacji.

Complete correction of congenital clubfeet by conservative treatment is often impossible. Surgical treatment plays a major role in treatment of this deformity. At the Department of Pediatric Orthopedics in Lublin between 1970 and 1999 1041 children (1253 feet) were treated surgically with Turco's method, in the authors' own modification. The paper presents the technically optimal procedure, the range of tendon elongation. The way the wound is closed is particularly stressed, as well as the need to achieve muscle balance, along with a description of proper post-op care. The material was analysed as a whole, although particular attention was given to three periods: 1970-1975, 1980-1985, 1990-1995. The results were assessed according to the Turco classification, the Magone classification in accordance with the injunctions of the Scientific Committee Meeting of the Pediatric Section of the Polish Orthopedic Society held in Poznan. Good and very good results were achieved in 65-67% of the cases, while satisfactory and bad results were found in 23-30% of the cases.

[Personality changes in children treated by the Ilizarov device]. / Zmiany osobowosci u dzieci leczonych aparatem Ilizarowa.

The treatment of children and youth by Ilizarov's method is very long. During this treatment there appear psychological problems which, on the one hand, are the effects of the features of personality but, on the other hand, they are the effects of emotional lability which is characteristic of adolescence. This paper basing on analysis of questionnaires and chosen personality features attempts to find correlation between these features and the effects of treatment. The obtained findings suggest that patients who are treated by Ilizarov's method should undergo psychological therapy.

[Hip dislocation in children with cerebral palsy--the result of illness or treatment error]. / Zwichniecie biodra u dzieci z mózgowym porazeniem--wylaczny skutek choroby czy takze wynik bledów leczenia.

The authors inform about dangerous complications in the children with cerebral palsy-secondary dysplasia, subluxation or luxation of the hip. Among 326 children treated in the Orthopaedic Paediatric Department in Lublin in the years 1993-1996, 67 children had problems with hips. Paralytic hip luxation leads to the loss of walking abilities among many children. The operative reconstruction of the hip luxation is very difficult and does not allow the complete rebuilding of the joint.

[Contractures and growth disturbances in the hip and pelvis as the cause of "idiopathic scoliosis". Biomechanical considerations]. / Przykurcze i zaburzenia rosniecia w obrebie biodra i miednicy przyczyna rozwoju tzw. "skolioz idiopatycznych". Rozwazania biomechaniczne.

Author's own observations on etiology of "idiopathic scoliosis" in children and adolescents are presented. Abduction or flexion-abduction contracture of the hip, mainly right one, is the chief cause of "idiopathic scoliosis". Scoliosis is the final deformity in the chain of malformations commencing in newborns and infants, known as "contracture syndrome". This condition is described by many authors, Mau and Green-Griffin were the first ones. Adduction contracture of the left hip leads to secondary dysplasia of this joint. Coexisting abduction contracture of the right hip is usually neglected. Insufficient adduction in the right hip in extension causes functional elongation of the right extremity and oblique positioning of the pelvis, thus initiating left hand side lumbar, thoraco-lumbar or lumbo-sacral scoliosis. As the next step thoracic scoliosis develops. Early and late clinical and radiographic symptoms are presented, prophylactics and treatment is discussed.

[Modern anesthesia--one of the factors after surgical treatment of congenital dislocation of the hip]. / Nowoczesne znieczulenie--jednym z czynników postepu operacyjnego leczenia wrodzonego zwichniecia biodra.

The work presents methods of anaesthesia used with the children being operated on in the Clinic of Children's Orthopedy in Lublin in 1970-1989 because of congenital dislocation of the hip. Methods of anaesthesia have been deeply changing for years. The introducing of the NLA method made difficult and long-lasting hip operations possible. Thanks to this method the patient's recovery becomes easy and without complications, and post-operational period is characterized by long-lasting analgesia.

[Activities of the podiatric group in the Lublin orthopedic departments under the direction of Professor Stanislaw Piatkowski]. / Dzialalnosc Zespolu Podologicznego Lubelskich Klinik Ortopedii pod kierunkiem Profesora Stanislawa Piatkowskiego.

The development of podology in the Lublin society as well as the personal achievements of prof. Stanislaw Piatkowski have been presented. The originated in the 60-ies activities concerning podology have included scientific research, cooperation with shoe industry institutions, and wide prevention of the foot health in the Lublin region.

[The role of static-dynamic factors in genesis of femoral head and neck deformation in dysplastic hips. A physical-mathematical interpretation ]. / Rola czynników statyczno-dynamicznych w powstawaniu deformacji glowy i szyjki kosci udowej w biodrach dysplastycznych. Interpretacja fizyczno-matematyczna.

The clinical material for a physical-mathematical analysis of femoral head and neck deformations in subluxated and luxated hips consisted of 1.574 case histories of children operated on in 1954-1988. In that material 21.9 per cent of the children had preoperative growth disorders of the head, and in the half of the cases also the femoral neck was involved. In 10.79 per cent of the children pre- and postoperative trophic disorders were also observed. On the basis of the physical-mathematical analysis of static-dynamic factors of the hip, it has been determined that the disordered shape of the femoral head and neck is most of all the result of defective formation of the roof. The oblique roof changes the static and dynamic forces acting on the femoral head and neck in such a way that large overloading of the growth zones of the medial side occurs and is followed by development of proximal femur deformation.

Experience in the conservative treatment of congenital clubfoot in newborns and infants.

We studied 323 children with congenital clubfoot from 1970 to 1987. The principles of conservative treatment of congenital clubfoot in newborns have completely changed since 1973. The present principles we follow are to begin treatment immediately after birth; and adduction and varus removal by manipulation. In each case, we use a plaster cast, which is changed after a few days as long as the foot is limp and well corrigible. The knee is immobilized at 60 to 70 degrees in a plaster cast. During the manipulations, the surgeon's hand presses only the plantar side of the foot. The results can be described as good, since in each child we have removed adduction and varus as operation by posterior release and Achilles lengthening was necessary in only 50% of the children.