Operative treatment of paralytic hip dislocation in myelomeningocele by Dega transiliac osteotomy combined with iliopsoas transfer: technique and historical case series.

The technique of one stage procedure - open reduction, Dega transiliac with or without femoral subtrochanteric osteotomy combined with iliopsoas transfer according to Mustard - has been described for the treatment of paralytic dislocation of the hip in myelomeningocele patients. Historical series of 16 children (26 hips) operated on between 1987 and 2003 were analyzed retrospectively. There were nine boys and seven girls with upper and lower lumbar level lesions (15 with Sharrard groups 3 and 4 and one with Sharrard 2) and 20 dislocated and six subluxated hips.

The significance of the Dega osteotomy.

Wiktor Dega has significantly impacted contemporary pediatric orthopedics by developing transiliac osteotomy - Dega's pelvic osteotomy. The global implementation of the surgery technique gained dynamism in the 2000s after being published by Ward and Grudziak. Since then, derivative operative techniques called Dega, Dega-like or Dega family osteotomies have been developed.

Ankle arthrodesis from lateral transfibular approach: analysis of treatment results of 23 feet treated by the modified Mann's technique.

Background: The aim of the study was to analyze the results of treatment by ankle arthrodesis by modified Mann's technique.

Methods: The study included 23 patients, and a total of 23 feet were treated. Stabilization of arthrodesis was performed by two screws going from the sinus tarsi to the talus and tibia.

Surgical Treatment of Active Amniotic Band Syndrome (ABS) by Z-plasty and Radical Excision of the Overgrown Tissue: A Report of 2 Cases With Progressive Lymphedema Causing Vascular Insufficiency.

Unlabelled: The study describes 2 children at risk of limb amputation due to lower extremity active amniotic band syndrome, in which the constriction bands were released surgically using the extensive approach. Both patients presented almost the same clinical appearance: a deep constriction band localized in one third of the distal part of the leg and a pseudoconstriction at the ankle joint level resulting from the tightening of the retinaculum of extensors. In both the cases, after birth amniotic band syndrome caused progressive enlargement of the distal part of the foot, which was associated with edema and vascular insufficiency.

Joint preserving surgery versus arthrodesis in operative treatment of patients with neuromuscular polyneuropathy: questionnaire assessment.

The purpose of the paper was to present the results of surgical treatment of foot deformities in peripheral neuropathies using bone procedures: both joint preserving and with joint arthrodesis. The study included 26 patients, 14 males and 12 females (43 feet). The age of the patients at surgery ranged from 5 to 55 years (average 23 years).

Knowledge of participants of the 5th Polish Foot and Ankle Society (PFAS) Congress about the diagnosis and treatment of plano-valgus feet secondary to posterior tibial tendon dysfunction (PTTD).

Background: Posterior tibial tendon dysfunction (PTTD) ranks among the most common causes of adult acquired flatfoot deformity. The deformity develops gradually through characteristic stages and its early manifestations are often ignored or mis-diagnosed. The aim of the study was to gain an insight into what the participants of the 5th Polish Foot and Ankle Society Congress knew about the diagnosis and treatment of flatfoot.

Congenital posteromedial bowing of the tibia and fibula: treatment option by multilevel osteotomy.

Few papers have described patients treated surgically with single osteotomy for congenital posteromedial bowing of the tibia and fibula. Only one paper has described two-level osteotomy for deformity correction: the first for deformity correction and the second for bone lengthening. There are no publications describing the surgical correction of deformation only by the method of multilevel tibial and fibular osteotomy.

Methods of diagnosis and treatment of ankle fractures--the opinion of members and supporters of the Polish Foot and Ankle Society.

Background: The present paper is based on a survey distributed among the participants of the 3rd Congress of the Polish Foot and Ankle Society in Jastarnia on April 22-24, 2010.

Material And Methods: A clinical description and imaging data of a hypothetical patient with a typical ankle fracture were used to identify current methods of diagnosis and treatment of such injuries in Poland. The participants were orthopaedists.

Triple arthrodesis of the foot after calcaneal fractures. Twelve patients treated using K wires stabilization.

The most frequent problem following intra-articular calcaneal fracture is pain from the subtalar joint. Subtalar arthrodesis is not considered to be an optimal solution because it can lead to degenerative changes in the ankle joint. The aim of this study was to evaluate patients with such fractures treated by triple arthrodesis.

Corrective arthrodesis to treat sequelae of compartment syndrome and ischaemic syndromes of lower leg and foot.

Background: There is a scarcity of studies concerning the treatment of foot and talocrural deformities secondary to a compartment syndrome or ischaemia.

Material And Methods: Five patients (4 males and 1 female) were treated by talocrural arthrodesis (1 foot) and triple tarsal arthrodesis (4 feet) due to equinovarus foot deformity secondary to compartment syndrome or ischaemia. The age at surgery ranged 28 to 50 years (mean 39 years).

[Arthrodesis of the lisfranc joint as salvage procedure after trauma injury].

Dislocations and fractures of the tarsometatarsal joints (Lisfranc joint) are rare, often non properly diagnosed and treated. Lack of proper diagnosis and postponed operative treatment causes painful deformity of the foot. There are presented results of operative treatment in 6 patients (6 feet) with fracture/dislocation of the Lisfranc joint.

[Triple arthrodesis of the foot after treated talar fracture--report of 3 cases].

Fracture of the talus, especially talar neck associated with talar dome necrosis, due to serious disorders of the ankle and subtalar joints. Disorders are so great that they often suggest to perform arthrodesis of the ankle joint. Disorders of subtalar joint are not so much visible on standard X-rays.

[Surgical treatment of hallux valgus in Poland---analysis based on opinion of Polish Foot and Ankle Society members].

The purpose of this study was to determine the current techniques of hallux valgus surgery by orthopaedic surgeons who have special interest in foot and ankle problems in their daily practice. The questionnaire survey was conducted during I-st Polish Foot and Ankle Society Congress which took place in Jastarnia on 2 to 4 of October 2008. The pictures of two hypothetical patients were created, with moderate and severe hallux valgus deformity.

Intravertebral deformation in idiopathic scoliosis: a transverse plane computer tomographic study.

Background: The scoliotic vertebrae are submitted to (1) the displacement in the 3-dimensional space and (2) the bone remodeling, which results in a 3-dimensional intrinsic vertebral deformation. Both phenomena are most expressed inside the apical zone of the curve and can be measured in a computer tomographic (CT) scan. A comparative study of CT thoracic scans in scoliotic and normal children was performed to provide a better description of the altered anatomy with respect to patomechanism of scoliosis.

Psychological aspects of Ilizarov method treatment.

This article discusses the impact of certain factors on the psychological status of a patient treated by Ilizarov method. These include the etiology of the disease, the patient's age when treatment by the Ilizarov method is commenced, the attitudes of parents and caregivers, anesthetic methods, surgical technique, methods of rehabilitation and pain management, duration of hospitalization, and patient involvement.

The surgical treatment of short stature: management strategy and local experience.

Background. This article presents the indications and counterindications for the application of limb lengthening using distraction osteogenesis in the treatment of patients with short stature. Various treatment strategies are described.

Catterall and Herring classifications in assessing Perthes disease - inter- and intra-observer study.

Background. The purpose of this study was to compare the inter-observer validity and intra-observer reliability of the Catterall and Herring classification systems used in assessing pathological changes in Perthes' disease. Material and methods.

Double osteotomy in the surgical treatment of Perthes' disease: Dega's transiliac osteotomy and subtrochanteric osteotomy.

Background. The combination of Dega transililiac and femoral subtrochanteric is used in our department in the treatment of Legg-Calvé-Perthes' disease. Subtrochanteric osteotomy, initially performed as varus-derotation osteotomy, is now mainly extension osteotomy with shortening.

The effect of the therapeutic approach on the course of Perthes' disease and its outcome: Conservative vs. surgical treatment.

Background. The aim of our study was to compare the outcome of Perthes' disease in children treated conservatively or surgically, and to attempt to answer the question as to whether surgery shortens the duration of the disease and its treatment. Material and methods.

Transverse plane of apical vertebra of structural thoracic curve: vertebra displacement versus vertebral deformation.

CT transversal scans of the trunk provided at the level of Th8 or Th9 (apical vertebra) of 23 patients with structural thoracic scoliosis were reviewed. The following parameters were studied: 1) alpha angle formed by the axis of vertebra and the axis of spinous process, 2) beta concave and beta convex angle between the spinous process and the left and right transverse process respectively, 3) gamma concave and gamma convex angle between the axis of vertebra and the left and right transverse process respectively, 4) rotation angle to the sagittal plane according to Aaro and Dahlborn, 5) Cobb angle. Values of measured parameters demonstrated a common pattern of intravertebral deformity: counter clockwise deviation of the spinous process (alpha angle 15,0 +/-8,5 degrees), beta concave (69,8 +/-8,5 degrees) significantly greater than beta convex (38,8 +/-8,5 degrees), gamma concave (54,3 +/-7,8 degrees) not different from gamma convex (56,0 +/-8,0 degrees).

Torsional deformity of apical vertebra in adolescent idiopathic scoliosis.

CT scans of structural thoracic idiopathic scoliosis were reviewed in nine patients admitted to our department for scoliosis surgery. The apical vertebra scans were chosen and the following parameters were evaluated: 1) alpha angle formed by the axis of vertebra and the axis of spinous process 2) beta concave and beta convex angle between the spinous process and the left and right transverse process, respectively, 3) gamma concave and gamma convex angle between the axis of vertebra and the left and right transverse process, respectively, 4) the rotation angle to the sagittal plane. The constant deviation of the spinous process towards the convex side of the curve was observed.

[Chronic exertional anterior compartment syndrome of the leg with fascial hernia--case report and review of the literature].

18-year-old female with chronic exertional anterior compartment syndrome was described. Pain was localized on the anterior part of the leg after long distance walking or another physical activity. Disorder was confirmed by electromyography and using Compartmental Pressure Monitor System (Stryker, USA).

[Flexible flatfoot in children--a controversial subject].

In this review article authors present current opinion on flexible flatfeet in children. In young generation the incidence of flexible flatfeet is different according to investigator and evaluation method and ranges from 3 to 90 percent. The high percentage of appearance of flatfeet in healthy population is recognized mainly by investigators who are not orthopaedic surgeons.

Opening wedge osteotomy of the medial cuneiform before age 4 years in the treatment of forefoot adduction.

Thirty-seven feet in 25 children (12 girls, 13 boys) treated surgically with medial cuneiform opening wedge osteotomy to correct forefoot adduction were assessed. Thirteen patients had unilateral deformity. Primary diagnoses were congenital clubfoot (33 feet), congenital forefoot adduction (3 feet), and skewfoot (1 foot).

Fibular shortening in clubfeet.

Seventy-eight children (105 feet) operated on for congenital clubfoot with two different procedures - limited posteromedial-lateral release and complete subtalar release - were analysed. For all of them the age at operation ranged from 3 to 76 months (mean 17 months) and follow-up from 41 to 84 months (mean 58 months). The control group consisted of 42 opposite feet from the patients with a unilateral deformity.