ABSTRACT
BACKGROUND: LISS, the newest surgical method, makes it possible to completely regain knee function after knee fractures. We share our experience of the most frequently occurring errors during LISS-based treatment and ways of avoiding them. MATERIAL AND METHODS: Our sample consisted of patients treated with the LISS method between 2007 and 2012 in the Department of Orthopedics and Traumatology of the 4th Military Hospital in Wroclaw, Poland. We analysed the patients' radiographic records. RESULTS: We analysed follow-up radiographs of 28 patients with fractures of the distal femur. We identified the following seven errors in reduction and fixation of fractures of the distal femur occurring during treatment using the LISS method: 1. Valgus or varus fracture fixation. 2. Malrotation of the fracture fragments. 3. Fixation in malrotation in the sagittal plane. 4. Non-axial placement of the LISS plate in the sagittal plane. 5. The use of K wires not recommended in the LISS method. 6. Screws penetrating into the joint. 7. Drilling holes for unicortical screws. CONCLUSIONS: 1. The most common errors in the treatment of fractures of the distal femur by LISS method relate to inadequate reduction of the fracture. 2. Intraoperative fluoroscopy should be used at all stages of the surgical procedure. 3. The surgical technique recommended by the creators of the LISS method must be strictly followed.
Subject(s)
Femoral Fractures/surgery , Fracture Fixation, Internal/methods , Medical Errors/statistics & numerical data , Minimally Invasive Surgical Procedures/adverse effects , Minimally Invasive Surgical Procedures/statistics & numerical data , Postoperative Complications/etiology , Bone Plates , Bone Screws , Female , Fracture Healing , Humans , Male , Minimally Invasive Surgical Procedures/methods , PolandABSTRACT
Decompression sickness is a group of pathological processes occurring in the body, following its exposure to an excessive drop in atmospheric pressure. The paper presents a case of a 62-year-old patient with no substantial disease history, a long-standing professional military pilot who was diagnosed with multifocal, bone manifestation of decompression sickness during the diagnosis of right knee joint injury following a torsion injury. The case was presented to draw attention to the usefulness of occupational history in the process of diagnosing osteoarticular system diseases.
Subject(s)
Aviation , Decompression Sickness/diagnosis , Altitude , Atmospheric Pressure , Decompression Sickness/complications , Humans , Knee Injuries/complications , Male , Medical History Taking , Middle Aged , Military PersonnelABSTRACT
Among the population over the age of 65 years joint diseases constitute more than 50% of chronic diseases and most often apply to the hip. Endoprosthetics is one of the methods for treating this condition and is considered one of the best--clinically and economically--interventions of the modern medicine. However, it is not free of complications among which the loosening of the endoprosthesis is commonest. In publications, a full discussion has been going on arguing whether the complication is caused by biological or mechanical factors. The authors--aiming to answer this question based on CT--tested the influence of the implantation of the acetabular component on the pelvic bone density in Hounsfield units within a 6-month period after the operation. The test results indicate the bone density decrease. The statistical analysis shows, however, that the changes are not statistically significant.
Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Adult , Aged , Biomechanical Phenomena , Bone Density , Female , Humans , Male , Middle Aged , Pelvic Bones/diagnostic imaging , Pelvic Bones/physiopathology , Prosthesis Failure , Time Factors , Tomography, X-Ray ComputedSubject(s)
History, 20th Century , Humans , Orthopedic Procedures/history , Orthopedics/history , PolandABSTRACT
Authors, on the base of own material, analyse a pathogenesis of the knee haematoma and ways and possibilities of the treatment in these cases. From 1991 to 2001 we performed 2950 knee arthroscopies. Knee haematoma was the main indication to perform arthroscopy in 382 patients. Reasons of knee haematoma were: ACL isolated injury in 154 patients, ACL injury connected with MM injury and/or chondral surface rupture in 88 patients, only chondral surface rupture in 52 patients, meniscus injury in 42 patients, osteochondrosis dissecans in 24 patients, synovial fold disruption in 11 patients, patellar lateral retinaculum disruption in 11 patients. The mean age of the patients was 23.5 years (range from 15 to 47 years). We performed: meniscus suturing in 21 cases, arthroscopic meniscectomy in 31 cases, suturing of injured ACL attachment in 65 cases, resection of injured ACL in 80 cases, stabilization of separating osteochondrous part by thin wire in 24 cases, suturing of the injured lateral retinaculum in 8 cases.
