[Treatment of scaphoid fractures and other intra-articular fractures with the Herbert screw: a preliminary report]. / Zastosowanie sruby Herberta w leczeniu zlaman kosci lódeczkowatej i zlaman sródstawowych--doniesienie wstepne.

Treatment of scaphoid fractures and other intraarticular fractures with the Herbert screw is presented. It was used in 23 patients--17 with scaphoid fractures, 5 with radial head fractures and 1 with a Bennett fracture. The surgical technique is described. Stable fixation and early post-operative rehabilitation are the most important advantages of this technique.

[The USS (Universal Spine System) in the treatment of thoraco-lumbar spine fractures]. / Zastosowanie USS (Universal Spine System) w leczeniu zlaman czesci piersiowo-ledzwiowej kregoslupa.

The paper present the results of surgical treatment of 15 patients (11 males and 4 females--average age 35.3 years) with thoraco-lumbar spine fractures. Pre-op neurological disorders were found in 4 patients with narrowing of the spinal canal, including 1 case of paraplegia. The decrease of vertebrae height was on average 45%. All patients underwent surgical treatment with transpedicular fixation by means of USS (Universal Spine System). In 7 patients 4 vertebrae were instrumented, the rest of the patients had only 3 vertebrae instrumented. In this latter case arthrodesis was not performed. Post-op, the neurological symptoms receded completely in 3 patients and partially in the case with paraplegia. In 76% of the cases vertebra height was restored completely. Patients were allowed to stand on the 3-4 day post-op. Follow-up was 22 months, and the neurological status of the patients was stabile. No decrease in vertebra height was noticed.

[Treatment of pseudoarthrosis of long bones by surgical stabilization and a transfer of in-vitro cultivated bone marrow interstitial cells]. / Leczenie stawów rzekomych kosci dlugich stabilnym zespoleniem odlamów i przeszczepianiem komórek podscieliska szpikowego z hodowli in vitro.

The paper presents the results of surgical stabilization of pseudoarthrosis of long bone augmented by a transfer of in vitro cultivated bone marrow interstitium cells in 4 patients. In three cases a Zespol external fixation device was applied without opening the pseudoarthrosis. One patient was treated by open reduction of the bone fragments with the use of frozen spongiose bone grafts. The mean age of the patients was 30.2 years. In two cases the pseudoarthrosis had developed in the tibia, in the remaining two cases it developed in the ulna. The pseudoarthrosis was present for a mean time of 2.5 years. In all cases healing of the pseudoarthrosis was observed after a mean time of 3.7 months.

[Knee dislocation treatment with temporary tibio-patellar fixation (patellar olecranization)]. / Leczenie zwichniec stawu kolanowego metoda czasowego zespalania rzepkowo-piszczelowego (olekranizacji rzepki).

Four patients with traumatic dislocation of the knee has been treated with olecranization of the patella. Mean age was 44.4 years (range 27-75 years). Three of them were politrauma patients, but none had popliteal artery injury or peroneal nerve palsy. Olecranization of the patella was performed on the day of injury. Results were assessed according to the Marshall scale. Three results were rated excellent and good with near normal knee function. In one case result was rated fair since despite stable knee and full range of motion pain persisted and marked vascular changes, not related to the injury were present.

[Results of Bankart arthroplasty procedure in the treatment of recurrent dislocation of the shoulder]. / Ocena wyników artroplastyki sposobem Bankarta w leczeniu nawykowego zwichniecia stawu ramiennego.

The Bankart procedure is considered to be the common treatment for anterior instability of the shoulder but despite its popularity there have been no studies on the long-term outcome of this method. Results in 16 patients (14 males, 2 females, aged 19-35) treated with Bankart procedure are presented. Assessment of the results was based on postoperative clinical examination and a questionnaire (filled by a patient) inclusive of history of instability, level of pain, ability of the patient to function at home, at work and during sports. No instability has been found after the operation. Mean restriction of external rotation was 15 degrees, no other movement restriction occurred. Good clinical results were achieved in all cases, majority of patients admit high level of satisfaction.

[Mineral changes in the intervertebral disc and facet joints during aging]. / Zmiany mineralogiczne zachodzace w krazku miedzykregowym i stawach kregoslupa w czasie starzenia sie.

The mineralogic examinations of intervertebral disc and cartilages of facet joints, taken from corps of the accidents victims, from the level L4-L5, were performed. At the moment of accident the middle age of victim was 41.2 years (4-87 years). Scanning microscopy, atom absorption, chemical analyses and electron microprobe analyses were used in the examinations. As the result of examinations we found: demineralisation of nucleus pulposus in the intervertebral disc and two kinds of mineralisation of anulus fibrosus--invisible and visible. Invisible mineralization was found as the initial stage of visible mineralization. In the cartilages of fact joints, similarly as in the anulus fibrosus, the visible mineralization was found, characterised by the presence of the different shaped mineral deposits in the microscope. The invisible mineralization characterised by increased content of Ca and P and by changes in the chemical composition of basic cartilage substance Fe, Cu, Pb, Zn, Sr, Na, K. It was detected with very sensitive methods. The very close relations between mineralogic changes in the intervertebral disc and facet joints cartilages were also found. Mineralogic changes in degenerative changes of vertebral column outstrip the radiologic ones.

[Relationship between osteocalcin serum level and radiologic changes in long bone fracture healing--preliminary conclusions]. / Zaleznosc pomiedzy poziomem osteokalcyny w surowicy krwi a obrazem rentgenowskim w przebiegu gojenia zlaman kosci dlugich--doniesienie wstepne.

The osteocalcin serum level was monitored in 6 patients with long bone fracture. Immunohistochemical method was used at the day of fracture and also 7, 10, 14, 21, and 28 days after. In 3 cases an autogenic bone marrow grafting was done and osteocalcin level was monitored. The progressive increase was observed in the 4th week after fracture.

Bone healing after bone marrow stromal cell transplantation to the bone defect.

In experimental studies on rabbits, osteogenic properties of stromal cells were confirmed after in vitro growth for 7 and 14 d. The cell suspension was percutaneously transplanted into a surgically produced bone defect in the rabbit's radius. The bone scar produced was X-rayed, and histologically and mineralogically examined after 10, 20 and 40 d follow-ups. Differences in the bone defect healing process (the healing rate and the type of bone tissue produced) were shown between the experimental and the control foreleg. Within the experimental foreleg, healing was considerably accelerated with compact bone formation on a membranous matrix, whilst in the control foreleg, a coarse, fibrous woven bone on a cartilaginous matrix was dominant.

[Effect of bone marrow on healing of fractures, delayed unions and pseudoarthroses of long bones]. / Wplyw szpiku kostnego na gojenie zlaman, zrostów opóznionych i stawów rzekomych kosci dlugich.

Healing of long bones after autogenic bone marrow grafting have been monitored in 96 patients aged 36.6 on an average. Bone marrow was harvested from iliac crest and after mixing it with heparin grafted transcutaneously into the fracture site in 24 fracture patients. 42 delayed unions and 30 cases of pseudoarthrosis. Pseudoarthroses were managed by bone marrow transplantation combined with the use of Zespol fixator but no intervention within pseudoarthrosis itself. In all cases union has been achieved in fractures, delayed unions and pseudoarthroses on an average 2.8, 3.2 and 3.4 months after bone marrow transplant respectively. Transplanted bone marrow proved to speed up healing process, what turned out to be especially useful in treating of delayed unions. Its combination with Zespol fixation has brought about new method of managing pseudoarthroses.

[Mineralogic research of bone union formation after transplantation of autogenic bone marrow and stromal cells into the bone defect from in vitro culture. Experimental studies. III]. / Badania mineralogiczne tworzacego sie zrostu kostnego po przeszczepieniu do ubytku kostnego autogennego szpiku kostnego i komórek zrebowych z hodowli in vitro. Badania eksperymentalne. Cz. III.

In experimental studies on 3 groups of rabbits (1. with autogenic bone marrow transplantation, 2. with stromal cells from in vitro culture transplantation, 3. control group) the mineralogic changes within healing fracture have been observed. These changes were investigated with scanning microscope and chemically using Cameca electronic microprobe and X-ray diffractometer. In each group there were differences in the time of arising of trabecular structures and their mineralization. Bone trabeculae were visible first in a group of rabbits with performed transplantation of stromal cells. They were present in a great number and their structure was homogeneous. They contained prominent quantity of apatites similar to the one found in normal bone. In the final phase of observation, trabeculae of external part of union demonstrated a parallel orientation and a tendency to transformation into a compact bone. After some time trabeculae arose in rabbits after autogenic bone marrow transplantation. They were less numerous and their structure was disordered. They were characterized by a significant chemical heterogeneity. The content of Ca and P was similar to their content in a normal bone. At the very and trabeculae arose in the control group. Their structure however was heterogeneous. In the final phase of observation the content of Ca and P did not reach the level found in a normal bone. Within the whole bone union a spongy bone arose.

[Effect of autogenic bone marrow transplantation into the fracture on acceleration of long bone healing. IV]. / Wplyw przeszczepiania autogennego szpiku kostnego do szpary zlamania na przyspieszenie gojenia zlaman kosci dlugich. Cz. IV.

20 cases of long bones fractures healing after autogenic bone marrow transplantation have been observed. The mean age of patients was 39.7 years. Bone marrow was taken from iliac bone and after addition of heparin transplanted percutaneously into the fracture. The bone union was observed in all the cases after the mean period of 2.5 months. The observation performed on the patients treated with bone marrow cells injection and some patients from a control group treated with traditional methods revealed that marrow cells promote acceleration the process of healing.

[Effect of autogenic bone marrow transplantation in fractures on the course of delayed bone union healing. Part V]. / Wplyw przeszczepiania autogennego szpiku kostnego do szpary zlamania na przebieg gojenia zrostów opóznionych. Cz. V.

39 delayed bone unions of long bones shafts in 34 patients treated with autogenic bone marrow transplantation into the fracture has been observed. The mean age of patients was 37.8 years. Bone marrow was taken from iliac bone and after addition of heparin injected percutaneously into the fracture. After transplantation, the previous treatment was continued. The bone union was observed in all cases after the mean period of 3.1 months. On the grounds of the performed observations it was found that bone marrow transplanted into fracture site accelerates the healing process of delayed union.

[Effect of autogenic bone marrow transplantation with "Zespol" technique of osteosynthesis on non-union healing. VI]. / Wplyw przeszczepiania autogennego szpiku kostnego z zespalaniem odlamów metoda "Zespol" na gojenie stawów rzekomych. Cz. VI.

The results of treatment of 25 patients with long bones shafts non-union were showed. Patients were treated with autogenic bone marrow transplantation into non-union together with "Zespol" technique of osteosynthesis, without opening of non-union. The mean age of patients was 35.4 years. Bone union was observed in all the cases after the mean period 3.3 months since the time of bone marrow transplantation. On the ground of clinical and radiologic observation it was found that combination of autogenic bone marrow transplantation with "Zespol" technique is a simple and effective method of long bones non-union treatment.

[Mineral changes occurring with age in the intervertebral disks of L4-L5 vertebrae]. / Zmiany mineralogiczne zachodzace wraz z wiekiem w krazku miedzykregowym na poziomie L4-L5.

The results of mineralogical examination of 26 L4-L5 intervertebral discs taken from cadavers has been presented. Radiology did not reveal marked osteoarthritic changes at this level. The age of the individuals at the fatal accident ranged from 4 to 87 years (mean 41.2). -- Scanning microscopy, atom absorbtion spectroscopy and roentgen microscopy was used in the examination. Two age related phenomena were discovered; demineralisation of the nucleus pulposus and mineralisation of the anulus fibrosus. Two types of mineralisation were found; the microscopic one visible as granules of different shape and size consisting of crystalline hydroxyapatite aggregates and the one detectable exclusively by sensitive chemical methods as an increase of Ca and P content and disturbance of the remaining elements content in biological structures.

[Mineralization phenomena in the area of long bone fracture wound healing]. / Zjawiska mineralogiczne zachodzace w obszarze gojenia zlaman kosci dlugich.

Mineralization changes in the area of fracture healing in experimental rabbits were monitored during 28 days of observation. The changes were evaluated with the aid of microscopy in the polarized light, scanning microscopy, infrared spectroscopy and roentgenographic microanalysis in 7, 14, 21, and 28th day of healing process. Mineralization was found to be parallel to the increase of collagen quantity. In the course of healing an arrangement of atom structure of the phoshate takes place. Increasing mineralization is indicated not only by growing values of Ca and P in newly formed bone but also by Ca/P ratio approaching normal values in the final stage of healing. Despite of clinical and radiological features of bony union the process of mineralization is not yet completed. By the 28th day of healing the mineral structure of bone is still remarkably porous resembling cancellous bone. Cortical bone formation occurs on the basis of cancellous bone by organization of the osseous trabeculae.