The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.
Sixty patients with unilateral distal radius fractures were managed conservatively. Clinical assessment included objective and subjective evaluations of the outcome of treatment. Radiographic evaluation included fracture classification using the AO/ASIF system and measurement of volar tilt, radial inclination and radial height shortening at the end of treatment. Clinical signs of carpal tunnel syndrome were confirmed electrodiagnostically in 12 patients (20%) during the recovery period. Each patient had electrodiagnostic studies of both upper limbs performed to confirm the diagnosis. The mean time between injury and the onset of symptoms was 10 months (range 6.5 weeks-27 months). A statistically significant correlation between the final clinical results of treatment and post-traumatic median nerve compression neuropathy was found, but the occurrence of the neuropathy correlated with neither fracture type nor with the final radiographic findings. No clinical signs of ulnar or radial nerve compression occurred in this study.
Concentration of lead in bone, unlike in soft tissues, increases during the lifetime and reflects severity of exposure to this element. The main aim of the study was to determine concentrations of lead and calcium and to find possible relationship between calcium and lead in the tissues of the hip joints obtained from inhabitants of the Upper Silesian Industrial Area. We also attempted to identify factors that might affect this relationship. The samples were harvested intraoperatively during total hip replacement procedures; in most cases, the indication for the surgery was hip osteoarthritis. Concentrations of lead and calcium were measured with a Pye Unicam SP-9 acetylene-oxygen flame atomic absorption spectrometer. The highest mean concentration of lead was found in the cancellous bone from the femoral head, followed by articular cartilage, cortical bone and the intertrochanteric cancellous bone (0.75 μg/g). The smallest concentration was found in the joint capsule (0.19 μg/g). The highest mean concentration of calcium was found in cancellous bone from the femoral head, followed by cancellous bone from the intertrochanteric area, cortical bone, articular cartilage and joint capsule. The concentration of lead showed no correlation with sex. The bone concentration of calcium decreased with age. In the analysed hips, this finding was true in the cortical bone, as well as in the cancellous bone of the intertrochanteric area. Statistically significant correlation between calcium and lead was found only in the hip articular cartilage.
Our analysis provides evidence to suggest that two-stage revision endoprosthesoplasty is an effective method of treatment of periprosthetic infections.
1. Positioning of the femoral component of the knee joint endoprosthesis parallel to the transepicondylar line requires resecting the femur at approximately 3° of external rotation relative to the line tangential to the posterior aspect of the femoral condyles. This angle, however, may vary from 3.6° of internal rotation to 9.0° of external rotation which should be taken into consideration by the operating surgeon. 2. The values of the Posterior Condylar Angle do not correlate with gender, age, Body Mass Index and body side (with notable, near-perfect symmetry between the contralateral limbs). 3. In female patients, height and body weight may influence the Posterior Condylar Angle, but these correlations would require further studies of larger groups of patients. In male patients, we were unable to find such correlations.
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