Piotr Zakrzewski

Osteochondrosis of the capitellum of the humerus (Panner's disease, Osteochondritis Dissecans). Case study.

The article presents a case of an adolescent patient suffering from osteochondritis of the humeral capitellum. Early symptoms of this disease appeared at an age typically associated with the onset of both Panners disease and Osteochondritis Dissecans (OCD) of the humeral capitellum. About two years after the onset of the early symptoms, the patient reported to a specialised clinic. He was followed up for almost two years and was hospitalised and underwent surgical treatment during that period. Both diseases bear multiple similarities, which may entail diagnostic errors. The paper presents differences between these two similar clinical entities, in particular in terms of treatment and prognosis. Essential details potentially allowing for early diagnosis and classification of both conditions are described and discussed. Resolving the discussion may significantly contribute to improving performance and quality of life of patients suffering from necrosis of the humeral capitellum.

Surgical management of congenital radial head dislocation: a case report.

Congenital radial head dislocation is a rare condition which is, however, the most common of all congenital pathologies of the elbow joint. This paper is a case report on a patient presenting with moderate pain and discomfort in one of his elbow joints, both of which were found to be affected by this condition. He was treated by surgery which consisted of resection of the proximal radius and partial anterior capsulectomy of the elbow joint. This treatment led to a significant improvement in pain and elbow function compared to the preoperative status.

Femoral insufficiency fractures with bisphosphonate therapy. Cases study.

The aim of this paper is to analyze on clinical cases specific features of femoral insufficiency fractures during bisphosphonates therapy. We are presenting two insufficiency femoral fractures (2 patients) in patients receiving bisphosphonate therapy. These two cases represent new type of femoral fractures. These are low energy or spontaneous fractures of diaphysis and subtrochanteric region. Prodromal pain is often observed. On x-rays thick lateral cortex, its ellipsoid thickening and transverse or oblique fracture line is observed. Many authors link such fractures to long-term bisphosphonate therapy. Patients on long term bisphosphonate therapy present with new and specific fracture pattern of femoral bone. Fractures of this pattern are extremely rare. The risk benefit ratio of bisphosphonates therapy is not changed.

Hallux checkrein deformity resulting from the scarring of long flexor muscle belly - case report.

A case of posttraumatic checkrein deformity of the hallux is presented. This deformity is most often caused by scarring of the muscle belly or tethering of the tendon. A 22-year old woman developed a hallux checkrein deformity after a bimaleolar fracture. Intraoperatively, a linear scar tethering the muscle belly to the posterior tibia was observed. Resection of the scar allowed for full flexor hallucis longus mobility. Full hallux range of motion as well as foot function was restored. The cause of the checkrein deformity in our patient was a scar tethering the flexor hallucis belly to the posterior tibia.

Chronically unreduced posterior dislocation of the elbow.

BACKGROUND Chronically unreduced posterior dislocation of the elbow is a complex and difficult problem for the surgeon and its treatment significantly influences future functional performance of the patient. There are few reports in the literature regarding chronically unreduced dislocations, and most of them are based on observations of individual patients. MATERIAL AND METHODS A total of 9 patients with chronically unreduced posterior dislocations of the elbow were treated in the Department of Orthopaedics and Traumatology between 2004 and 2012. The mean time between injury and reduction was 5.6 weeks. Eight of the patients had a concomitant fracture of the radial head, 5 had a fracture of the coronoid process, and 8 demonstrated significant damage to the lateral collateral ligament complex. All patients were qualified for surgical reduction of the dislocation, and then, after a maximum of 2 weeks of immobilization in a plaster cast, the patients were referred for intensive physiotherapy. Stability, range of motion and elbow function according to the MEPI score were evaluated during follow-up visits. RESULTS Elbow instability did not occur in any of the patients during the follow-up. Complications in our patients included a posttraumatic contracture of the elbow, periarticular ossifications and loosening of the radial head endoprosthesis. CONCLUSIONS Recommendations for the management of these difficult cases are formulated.