Background: Physicians who treat patients with lower limb diseases should pay attention not only to the patients' clinical condition but also to their individual needs and expectations. For this purpose, many different questionnaires can be employed. This study aimed to validate the Lower Limb Task Question-naire (LLTQ), Lower Limb Functional Index (LLFI), and Lower Limb Functional Index-10 (LLFI-10) for their use in Polish conditions and to perform a mutual comparison and analysis of differences in subjective assessments by patients who undergo hip or knee arthroplasty. Methods: The LLTQ, LLFI, and LLFI-10 were translated into Polish. A total of 103 patients who qualified for hip or knee arthroplasty at a University Hospital in from 2019 to 2021 were included in this study. The patients were asked to complete the Polish versions of the LLTQ, LLFI, LLFI-10, Lower Extremity Func-tional Scale (LEFS), and Short Form-36 four times -twice before and twice after their surgeries. Results: The Polish versions of the LLTQ, LLFI, and LLFI-10 had good psychometric properties. One year after surgery, the Cohen's standard response mean revealed high improvement of limb functionality and thus quality of life among all patients. We observed better treatment outcomes among patients who had hip osteoarthritis. Conclusions: The questionnaires were validated and can be used both in everyday health practice and in further research in Poland. (c) 2022 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

PURPOSE OF THE STUDY To evaluate hand function deficiency in patients with Dupuytren's disease (DD) in addition to assessing the improvement of function after palmar fasciectomy by using different hand-related questionnaires. MATERIAL AND METHODS A total of 121 hands (95 patients) underwent surgery. Disease severity was designated using Tubiana's Staging System. The Tendency of changes of Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), Patient Evaluation Measure (PEM), and Hand Function Score (HFS) scores of patients with DD undergoing palmar fasciectomy were assessed prior to, 3 months after, and 1 year after the operation. Moreover, total loss of extension (TLoE) was evaluated using a goniometer in the same time intervals. Repeated measure ANOVA Friedman's test were used. Responsiveness to clinical change was calculated by using standardized response means (SRMs). RESULTS The results showed statistically significant improvement of the originally obtained questionnaire results after 3 months for DASH and HFS and 12 months for all forms; only the PEM and DASH score significantly changed between 3 and 12 months. TLoE before surgery was 144.1 degrees +/- 99.6 degrees; 3-month and 1-year after surgery: 14.3 degrees +/- 58.0 degrees and 19.3 degrees +/- 34.7 degrees respectively. SRMs for 1 year after surgery was large for PEM (1.11) and medium for DASH (0.7) and HFS (0.79). CONCLUSIONS DASH, PEM, and HFS are valuable tools to monitor the hand function of patients with DD after surgery.

The aims of this study were to translate the Michigan Hand Outcomes Questionnaire into the Polish language and to test the measurement properties of its quality criteria. A total of 120 patients with hand complaints completed the Polish Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire on the first assessment, along with the grip test, pinch test, and pain sore assessed using a visual analogue scale during activity. After 7 days, 76 patients completed the Michigan Hand Outcomes Questionnaire the second time. The Cronbach alpha of the Michigan Hand Outcomes Questionnaire subscales ranged from 0.79 to 0.96. The intraclass correlation coefficient varied from 0.82–0.97, and the Bland–Altman method indicated the Michigan Hand Outcomes Questionnaire total score limit of agreement was −13.2–12.3 and −9.18–9.62 for the right and left hand, respectively. The construct validity revealed a moderate to strong correlation between every subscale of the Polish Michigan Hand Outcomes Questionnaire and Disabilities of the Arm, Shoulder, and Hand, but they only correlated with the grip test and the visual analogue scale, and neither correlated with the pinch test. The study demonstrated properties similar to the original version, validating the belief that the use of this questionnaire in medical practice in Poland is justified.

The aim of this study was evaluation of distribution microelements in human articular cartilage and to determine factors influencing it. The following elements were taken under consideration: Mg, Ca, Zn, Fe, Pb. Their concentration was assessed in the articular cartilage harvested from the loaded an unloaded area of human femoral heads. Initial results indicate that mechanical loadings are one of the important factors influencing distribution of microelements in human articular cartilage.

The paper contains an analysis of the treatment outcomes of intramedullary nailing for femoral shaft non-union.Twenty-two patients were treated between 1999 and 2005 with locked intramedullary nailing for femoral shaft non-union. The average age was 38.2 years (range 17-79). The study group comprised 20 males and 2 females. The right femur was affected in 12 patients, and the left in 10 patients. All patients had undergone multiple operations to treat the non-union. At the time of the study, non-union had been present for a period ranging from 9 months to as much as 10 years. Stabilisation with an intramedullary nail was preceded by reaming of the medullary cavity. Nails of different diameter were used (11-16 mm, usually 11 or 13 mm). Both static and dynamic locking was used. Surgery was confined to stabilization with an intramedullary nail in 13 patients, and 9 patients additionally underwent the Judet-Forbes decortication procedure, bone grafting or internal plate fixation and osteomuscular decortication.The non-union healed in 19 patients and was not achieved in the remaining 3. A detailed analysis was performed in 9 cases in which the bone union was not achieved despite reaming the medullary cavity, nailing and additional procedures, which did not lead to bone healing in 3 patients.Despite being an acknowledged method of treatment for delayed union of long-bone shafts, intramedullary nailing following reaming of the medullary cavity did not result in bone healing in all of our patients and additional procedures were often required. Therefore, the use of this procedure for femoral shaft pseudoarthroses should be decided on a case-by-case basis.

Treatment of bone union disturbances is one of the most difficult therapeutic challenges in any orthopaedic and trauma department.An analysis of causes of bone union disturbances in a series of 136 patients treated between 1999 and 2005 at the Orthopaedics and Traumatology Department of Jagiellonian University's Collegium Medicum is presented with particular regard to the type of primary stabilisation.An inappropriate primary stabilisation technique was the cause of bone union disturbances in nearly all of the patients. All errors identified in the series, such as wrong classification of fracture, failure to account for fracture biomechanics, wrong implant choice, incorrect reduction of bone fragments, wrong implant positioning and brutal surgery technique, were associated with primary stabilisation of the fractures.1. Operator errors committed during primary fracture stabilization are the most common cause of bone union disturbances. 2. Elimination of errors committed during primary stabilization is the most effective prophylaxis of bone union disturbances.

The evolution of AO/ASIF views on fracture treatment, which has occured within last 50 years, is described in the present paper. In that time AO principles has been changed from mechanical approach to fracture care to methods considering first of all the biological aspects of injury. It has been manifested in invention of new implants of lower affect on bone tissue and emphasizing of soft tissue and atraumatic surgery technique importance. Described changes were based on careful analysis of obtained treatment results, creation of trauma centers collecting the large numbers of trauma patients and on broad experimental researches on bone biology, it's vascularisation and healing as well as on bone pathology.

The aim of this paper was assessment of utility of serum osteocalcin levels in monitoring early stages of bone healing and early detection of bone healing disorders. Serum osteocalcin level and alkaline phosphatase activity was assessed with acute long bone fractures and with delayed bone union and pseudoarthroses. 25 patients underwent the trial. The analysis of the results confirmed the utility of serum osteocalcin level as a prognostic factor in early detecting of union disorders and its correlation to radiological examination.

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.

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.

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.

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.