János Kránicz

Long-Term Results of the Operative Treatment of Clubfoot: A Representative Study

This study reports the long-term results of operative treatment of clubfoot. Of the patients who underwent posteromedial release for congenital clubfoot between 1972 and 1975 at the Medical University in Pécs, Hungary, 41 feet of 30 patients have been under control examination. Control consisted of the distribution of questionnaires, physical examination, and in some cases, radiologic analysis. At an average of 20 years postsurgery, good clinical results were observed in 31 (75%) feet. In these patients, satisfying foot form and good function were achieved, yet the characteristic atrophy of the calf and shortening of the foot were visible. Abnormal conditions were found in 10 feet, consisting of overcorrection in 6 and undercorrection in 4 cases. Subjective judgment of the patients was considerably better; only 5 (12%) feet had no satisfying results. Data of feet in an incorrect position were analyzed and compared with other cases. In cases of feet operated on in patients aged > or = 1 year and in patients who underwent multiple operations, abnormalities were found in a significantly higher percentage.

DSC analysis of the abnormalities of human leg skeletal muscles: A preliminary study

Abstract The standard calorimetric properties of the healthy human skeletal muscle are presented and compared to the same of human skeletal muscles in primary peripheral leg deformities (congenital clubfeet) and secondary deformities caused by the malfunction of the central nervous system (cerebral palsy). To our best knowledge no calorimetric analysis of either the healthy or pathologic human skeletal muscles have been reported previously. Eleven muscle samples from the three groups of patients were analyzed and compared. We hope to add to the understanding of the primary and consecutive functional behavioral changes of the human skeletal muscle due to different etiologic reasons. It has been found that the human muscles have different DSC scans than the rabbit skeletal ones and they are very characteristic for the actual functional and structural state, they behave as a fingerprint. To find the precise biochemical and structural explanation of these alterations there is need for further detailed examinations.

Prevalence of degenerative joint complaints of the lower extremity: a representative study

As part of the international campaign of the bone and joint decade, we aimed to present epidemiological data on the prevalence of major joint complaints in a Central European region. Ten thousand subjects aged between 14 and 65, selected randomly by the Hungarian central office of statistics from three counties in southern Hungary, were surveyed using our own questionnaire based on widely accepted scoring systems in the literature, focusing on major degenerative joint complaints, and using the short form 36 (SF-36) questionnaire. We found that the prevalence of hip pain in the observed group was 22.2%, the prevalence of knee pain 30.3%, and frequent ankle pain occurred in 9.7%. The results of the SF-36 questionnaire showed that with the exception of social function, neither of the values of the examined health dimensions reached levels of other international surveys. Details of the survey and the possible causes of the higher prevalence are discussed, along with the results of the SF-36 questionnaire.RésuméEn collaboration avec la campagne internationale sur la bone and joint decade, notre but a été de mettre en évidence des données épidémiologiques sur la prévalence des lésions articulaires, dans une région du centre Europe. Pour cela, 10.000 patients âgés entre 14 et 65 ans ont été sélectionnés par l’Office Cental Hongrois de Statistiques, patients provenant de trois comtés du Sud de la Hongrie en usant d’un questionnaire, rempli par les patients eux-mêmes et basé sur des scores largement acceptés par la population orthopédique et, notamment, le score SF 36. Nous avons trouvé une prédominance de douleur de la hanche dans ce groupe, avec un taux de 22,8%, le pourcentage de douleur du genou étant de 30,8% et, celle de la cheville, de 9,7%. Les résultats du questionnaire SF 36 ont montré qu’en dehors des problèmes sociaux, les valeurs retrouvées se situaient à des niveaux comparables à ceux d’autres études internationales. Les détails de cette étude et les étiologies possibles sont discutés avec les résultats du questionnaire SF 36.

Radiographic parameters of the hip joint from birth to adolescence

BackgroundVarious qualitative and quantitative radiological geometrical parameters can be of great help when assessing dysplasia of the hip joint and in understanding developmental processes of the infant hip. There are few data on the normal values of the hip joint at different ages.ObjectiveTo perform radiographic measurements on hip joints considered to be anatomically normal and to provide data for each age group, thus describing features of the radiographic development of the hip.Materials and methodsRadiographs were examined from 355 children (age 0–16 years) undergoing examination for scoliosis (long film), urography or plain abdominal radiography. Qualitative and quantitative signs were observed and measured, focusing on the Hilgenreiner, Wiberg and Idelberger angles and the decentric distance.ResultsBefore the age of 9 years measurable data from neighbouring age groups differed significantly, indicating typical radiological changes of the joint. For the same age range, qualitative changes could also be observed. After 9 years of age, radiological development of the normal hip joint during childhood is much slower.

Long-term results of derotational femoral varus osteotomy in Legg-Calvé-Perthes disease: 26-year follow-up.

The long-term results of 30 patients (31 hips) who underwent derotational femoral varus osteotomy for Legg-Calvé-Perthes disease are presented. Pain, leg-length discrepancy, Trendelenburg sign, and range of motion at the operated hip were examined clinically. Radiographic analysis included measurement of the Wiberg angle, epiphyseal index, acetabular index, and the Mose index. All were found to be satisfactory for patients in the good/fair category. Good/fair results were obtained in 27 (87%) of 31 hips according to Catteralls postoperative classification. Four patients were classified in the poor category due to severe restriction of movement and constant hip pain. Therefore, derotational femoral varus osteotomy is recommended for the treatment of patients with Legg-Calvé-Perthes disease.

Utilization of physiotherapy services in case of trauma disorders of the lower extremity in the outpatient care

Bevezetes: Az also vegtagi serulesek ellatasanak orvosi aspektusai jol dokumentaltak, azonban keves informacioval rendelkezunk e korkepek fizioterapias ellatasarol. Celkitűzes: A szerzők az also vegtag seruleseihez kapcsolodo fizioterapias jellegű tevekenysegek igenybeveteli mutatoinak elemzeset tűztek ki celul eletkor es nemek szerinti bontasban a jarobeteg-szakellatasokban. Modszer: Az Orszagos Egeszsegbiztositasi Penztar adatbazisabol a 2009-ben tortenő jarobeteg-ellatasokbol az alsovegtag-serulesekhez kapcsolodo fizioterapias tevekenysegek esetszamait elemeztek. Eredmenyek: 2009-ben az also vegtag seruleseit kovető fizioterapias tevekenysegek 10 000 főre juto atlagos esetszam a ferfi es a női nemnel „a csipő es a comb serulesei” csoportban 249,75 es 443,7, „a terd es a labszar serulesei” csoportban 927,64 es 668,25, „a boka es a lab serulesei” csoportban 307,58 es 245,75 volt. Az also vegtag seruleseinel mindharom regio vonatkozasaban megallapithato volt, hogy a 15–49 ev kozotti korosztalyban a ferfiak esetszamai, mig idősebb korban a nők ertekei voltak magasabbak. Kovetkeztetesek: A tanulmany alapjan az alsovegtag-serulesek kezeleseben a fizioterapias tevekenysegek szama jelentős, nemek kozotti eltereseket mutatott. Orv. Hetil., 2013, 154, 985–992. | Introduction: Limited information is available on physiotherapy treatment of lower extremity injuries. Aim: The purpose of this study included analysis of the utilization of outpatient physiotherapy services in case of injuries of the lower extremity. Method: Data derived from the database of the National Health Insurance Fund Administration, Hungary. The number of cases undergoing physiotherapy activities after lower extremity injuries were determined. Results: In 2009 the average number of cases undergoing physiotherapy activities following lower extremity injuries per 10,000 persons were the following: „hip and thigh injuries” 249.75 male cases and 443.7 female cases; „knee and leg injuries” 927.64 male cases and 668.25 female cases, and „ankle and foot injuries” 307.58 male cases and 245.75 female cases. Conclusions: According to this study, the number of physiotherapy activities for patients with injuries of the lower extremity showed significant differences between genders. Orv. Hetil., 2013, 154, 985–992.

Utilization of physiotherapy services for traumatic disorders of the lower extremity in ambulatory care

Bevezetes: Az also vegtagi serulesek ellatasanak orvosi aspektusai jol dokumentaltak, azonban keves informacioval rendelkezunk e korkepek fizioterapias ellatasarol. Celkitűzes: A szerzők az also vegtag seruleseihez kapcsolodo fizioterapias jellegű tevekenysegek igenybeveteli mutatoinak elemzeset tűztek ki celul eletkor es nemek szerinti bontasban a jarobeteg-szakellatasokban. Modszer: Az Orszagos Egeszsegbiztositasi Penztar adatbazisabol a 2009-ben tortenő jarobeteg-ellatasokbol az alsovegtag-serulesekhez kapcsolodo fizioterapias tevekenysegek esetszamait elemeztek. Eredmenyek: 2009-ben az also vegtag seruleseit kovető fizioterapias tevekenysegek 10 000 főre juto atlagos esetszam a ferfi es a női nemnel „a csipő es a comb serulesei” csoportban 249,75 es 443,7, „a terd es a labszar serulesei” csoportban 927,64 es 668,25, „a boka es a lab serulesei” csoportban 307,58 es 245,75 volt. Az also vegtag seruleseinel mindharom regio vonatkozasaban megallapithato volt, hogy a 15–49 ev kozotti korosztalyban a ferfiak esetszamai, mig idősebb korban a nők ertekei voltak magasabbak. Kovetkeztetesek: A tanulmany alapjan az alsovegtag-serulesek kezeleseben a fizioterapias tevekenysegek szama jelentős, nemek kozotti eltereseket mutatott. Orv. Hetil., 2013, 154, 985–992. | Introduction: Limited information is available on physiotherapy treatment of lower extremity injuries. Aim: The purpose of this study included analysis of the utilization of outpatient physiotherapy services in case of injuries of the lower extremity. Method: Data derived from the database of the National Health Insurance Fund Administration, Hungary. The number of cases undergoing physiotherapy activities after lower extremity injuries were determined. Results: In 2009 the average number of cases undergoing physiotherapy activities following lower extremity injuries per 10,000 persons were the following: „hip and thigh injuries” 249.75 male cases and 443.7 female cases; „knee and leg injuries” 927.64 male cases and 668.25 female cases, and „ankle and foot injuries” 307.58 male cases and 245.75 female cases. Conclusions: According to this study, the number of physiotherapy activities for patients with injuries of the lower extremity showed significant differences between genders. Orv. Hetil., 2013, 154, 985–992.

Trunk alignment in different standing positions in healthy subjects and stroke patients -a comparative study with a simple method for the everyday practice.: Trunk alignment in healthy and stroke subjects

ABSTRACT Objectives: Weight-bearing (WB) on the lower extremities is an important outcome parameter in the rehabilitation of poststroke hemiparesis. However, the patients often regain this ability by compensatory movement patterns. Methods: Our goal was to characterize with a simple method the trunk alignment of healthy subjects and stroke patients (n = 17 for both groups) during standing and following lateral weight shift (WS). To describe trunk alignment, five markers were placed on the subjects’ back, and the angles of the trunk at both sides were defined by the lines drawn from the posterior angle of the acromion and the iliac crest on the same body side to the seventh thoracic spinal process. Weight distributions on the lower extremities during standing and lateral WS were determined with a force platform. Results: The patients had significantly limited WB capacity on their paretic limb, which was accompanied with significant asymmetry in the trunk alignment during standing and following WS to the paretic side. Discussion: Our results show that this patient population tends to use abnormal compensatory movement patterns to optimize weight shifting, and changes of trunk alignment play a key role in this. This should be taken into consideration during rehabilitation.

Elhízott populációra jellemző talpnyomásminták vizsgálata

Absztrakt Bevezetes: A testsulynak jelentős szerepe van a lab megnovekedett terheleseben es a nyomasmintak valtozasaiban, de a valtozasok eloszlasa pontosan nem ismert. Celkitűzes: Jelen kutatas celja volt normal es koros testtomegindexű egyenek talpnyomasmintainak vizsgalata, hogy kozelebbi kepet kapjunk a regionalis plantaris terheles valtozasairol. Modszer: A vizsgalatnak 180 alanya volt, a talpnyomas merese dinamikus pedobarograffal tortent. A talp 8 anatomiai regiojat vizsgaltuk, az alabbi parameterek fuggvenyeben: kontakt terulet, csucsnyomas, maximalis erő. Eredmenyek: A lab kozepső teruleten es metatarsusok alatt jelentősen nagyobb csucsnyomas jellemző az elhizott egyenekre (p<0,001). A maximalis erőertekek az ujjaknal alacsonyabb (p<0,001), a kontakt terulet adatai a totalis talpteruleten (p<0,001) es a kozepső talp teruleten szignifikansan nagyobb ertekeket mutatott az elhizottak csoportjaban (p<0,001). Kovetkeztetesek: Elhizas hatasara koros mertekű terhelesnovekedes kovetkezik be a lab kozepső...

Külföldi munkavállalás és pályaelhagyási indítékok a magyar gyógytornászok körében

Absztrakt Bevezetes: A magyar egeszsegugyi szferaban munkat vallalo szakdolgozok koreben novekvő tendenciat mutat a kulfoldi munkavallalas. Celkitűzes: A szerzők celja a magyar gyogytornaszok migracios es palyaelhagyasi magatartasanak, illetve a hattereben levő főbb kivalto tenyezők bemutatasa. Modszer: 2014. aprilistol augusztusig orszagos felmerest vegeztek a Magyarorszagon munkat vallalo gyogytornaszok koreben. Osszesen 215 fő vett reszt a felmeresben. Eredmenyek: Az eredmenyek szerint az eletkor (p<0,05), illetve a munkahelyen tapasztalhato anyagi megbecsules merteke (p<0,01) szamottevő hatast gyakorol a migracios gondolatok megjelenesere. Azon gyogytornaszok, akik nem erzik anyagilag megbecsultnek magukat, tobb mint 55-szoros esellyel vallalhatnak munkat az orszaghataron kivul (OR = 55,28, CI [95%] = 18,85–162,12). Ennek hattereben levő leggyakoribb okok az anyagi es erkolcsi megbecsulessel kapcsolatos elegedetlenseg (p<0,01) mindket esetben). Kovetkeztetesek: Annak erdekeben, hogy megelőzzuk a szakk...