Arthroscopic Fixation of Osteochondral Fracture of Head of Femur. Case Study.

This article describes the case of an 18-year-old male after hip dislocation caused by snowboard injury, which resulted in osteochondral fracture of the head of femur with displacement of a loose body. CT as well as MRI confirmed the presence of a loose osteochondral fragment (20x14x4mm) fractured from the weight-bear-ing superoanterior part of head of femur (Pipkin type II). The surgical management undertaken was only arthroscopic, this representing a very rare case when com-par-ed to the literature. The article describes in detail the technical aspects of the procedure. At 4 months post-surgery, the replanted fragment had healed properly and the patient was pain-free and had the full range of movements. A low-invasive arthroscopic procedure is associated with less local tissue damage, reduced risk of infection and less blood loss. With this approach, it is possible to fix an osteochondral fragment without unnecessary defects in the cartilaginous surface.

[Quadriceps and hamstring atrophy and weakness after knee trauma and treatment]. / Oslabienie i zanik miesni prostowników i zginaczy po urazach i operacjach w obrebie stawu kolanowego.

158 patients after the knee trauma and operational treatment were evaluated. Quadriceps and hamstring isometric strength and thigh circumference 10 cm above the patella were measured. Injured leg was compared to non-injured. PATIENT GROUPS: Group 1 - 43 patients with isolated ACL injury treated non-operatively. Group 2 - 29 patients after ACL reconstruction using Leeds-Keio prosthesis. Group 3 - 29 patients after subtotal arthroscopic meniscectomy. Group 4 - 13 patients with patellar fractures treated operatively and 6 weeks in long leg cast, Group 5 - 31 patients with proximal articular tibial fractures treated operatively and immobilized 6 weeks in long leg cast. Group 6 - 13 patients with distal femoral articular fractures treated operatively without immobilization. Group 7 - 10 patients with habitual dislocation of the patella after the Campbell-Goldwaith operation and 6 weeks in a long leg cast. CONCLUSIONS: 1) No significant correlation between the quadriceps and hamstring strength deficit and thigh atrophy was found. 2) Strength deficits concerns both quadriceps and hamstring muscles. 3) Strength deficits are higher in patients treated in the long leg casts than in non-immobilized.

[Internal fixation in the treatment of radial head fractures]. / Zespolenie odlamów kostnych w leczeniu zlaman glowy kosci promieniowej.

The authors give indications for internal fixation of the radial head fractures. The results in 20 patients, age 18-69 (average 38 years), 12 male and 8 female have been reported. The authors conclude that fixation is a better method of treatment than resection of the radial head. The authors suggest that good fixation is also possible in the case of comminuted fracture. Fracture-dislocation of the elbow joint is not an indication for ligaments repair if the elbow is stable after radial head osteosynthesis.

[Quadriceps and hamstring strength after anterior cruciate ligament rupture treated operatively with Leeds-Keio prosthesis and without surgery]. / Wydolnosc miesnia czworoglowego uda i miesni zginaczy kolana po uszkodzeniach wiezadla krzyzowego przedniego w ocenie dynamometrycznej i klinicznej.

69 patients with the ACL rupture: 40 non-operated, without functional knee instability, and 29 after the ACL reconstruction using Leeds-Keio prosthesis due to knee instability have been evaluated. Isometric dynamometric examination of the quadriceps and hamstring muscles was performed. The mean strength deficit in non-operated group was: quadriceps--18.48%, hamstring--7.19%, in operated group was: quadriceps--11.87%, hamstring--10.30%. The higher strength deficit of the quadriceps and lower of the hamstring in non-operated patients may be the sign of an adaptational mechanism to the ACL deficiency. No statistical correlation between the strength deficit and the deficit of the thigh circumference 10 cm above the patella was found.