Purpose Chronic tendinopathy of lateral epicondyle of the humerus, commonly known as Btennis elbow^is one of the most frequent tendinopathies caused by recurrent overload of the muscle origins. The aim of the study was to assess the effectiveness of treating lateral epicondylitis (LE) with autologous conditioned plasma (ACP) and betamethasone injections, and to compare these methods over the course of a one year follow-up. Methods Patients were randomly placed into one of into two groups: 53 were treated with ACP, and 46 with 1 ml betamethasone injections and 2 ml of 1 % lignocaine. Both those groups were comparable in terms of initial DASH score. Results After six weeks and six months, the mean DASH score was significantly better in the betamethasone group, but was better in ACP group after one year. Full recovery (patients with no symptoms) at all time points was more common in the betamethasone group. A comparison of grouped DASH scores revealed more very good and good results in the ACP group after one year. More patients had pain symptoms related to injection in the ACP group than the betamethasone group. Conclusions ACP therapy of LE allows better results to be obtained at 12 months. Betamethasone injections give more rapid improvement, but the therapeutic effect is longer lasting in the ACP group.

BackgroundsNon-traumatic hip dislocation in children is most often observed in the course of developmental dysplasia of the hip (DDH) and infantile cerebral palsy. The risk of pain sensations from dislocated hip joint differentiates the discussed groups of patients. Will every painless hip joint in children with cerebral palsy painful in the future?MethodsMaterial included 34 samples of joint capsule and 34 femoral head ligaments, collected during open hip joint reduction from 19 children with CP, GMFCS level V and from 15 children with DDH and unilateral hip dislocation. All the children were surgically treated.The density of nociceptive fibres was compared between the children with CP and DDH, using S-100 and substance P monoclonal antibodies.ResultsMore frequent positive immunohistochemical reaction to S-100 protein concerned structures of the femoral head ligaments in children with CP and cartilage losses on the femoral head, when compared to the same structures in children with DDH (p = 0.010). More frequent were found positive immunohistochemical reactions for S-100 protein in the joint capsules of children with cartilage losses (p = 0.031) and pain ailments vs. the children with DDH (p = 0.027). More frequent positive reaction to substance P concerned in femoral head ligaments in CP children and cartilage lesions (p = 0.002) or with pain ailments (p = 0.001) vs. the DDH children.ConclusionsSurgical treatment of hip joint dislocation should be regarded as a prophylactics of pain sensations, induced by tissue sensitisation, inflammatory process development or articular cartilage defects.

1) Our results show that clinical examination is reliable to evaluate the healing of meniscal lesions following all-inside repair, as confirmed by repeat arthroscopy. 2) A far greater increase in the Lysholm score seen in patients whose menisci were confirmed to have healed by repeat arthroscopy indicates that such questionnaires may be of help in the evaluation of treatment outcomes.

Congenital vertical talus is a rare foot deformity. The hindfoot is valgus and equinus, the midfoot is dorsiflexed and forefoot is abducted caused by a fixed dorsal dislocation of the navicular on the head of the talus and the cuboid on the anterior part of the calcaneus. The epidemiology and ethiology of vertical talus is unknown. Dobbs et al in 2006 described a minimally invasive alternative avoiding the need for extensive soft tissue release procedures in treatment a congenital vertical talus. The study material contains group of 11 congenital vertical talus feet (group 5 according to Hamanishi) in 8 children (4 boys and 4 girls). The age at the time of the diagnosis varied from 5 to 26 months (mean – 14.6). Treatment involved serial manipulation and casting and then a minimally invasive approach with temporary stabilization of the talonavicular joint by K-wire and Achilles tenotomy. On lateral radiographs measurements include the talocalcaneal angle, tibiotalar angle and talar axis – first metatarsal base angle (TAMBA) and on AP radiographs - the talocalcaneal angle and talar axis – first metatarsal angle. The Wilcoxon test was used for comparison the dependent variables. The final clinical assessment during last follow up (mean 35.8 months, range 25–52) revealed in 10 cases neutral position of the foot and normal range of motion and in one case recurrence of foot deformity. Also X-ray assessment showed normalization all of the radiological parameters except for one case and were statistically significant. The minimally invasive technique described by Dobb`s should be the first option when treating the congenital vertical talus. It allows for reducing the talonavicular joint, gives good results and preserves a mobile foot. The attention should be put on early diagnosis.

Background. The term Monteggia fracture refers to a class of injuries encompassing the fracture of the proximal end of the ulna with subluxation or dislocation of the radial head. These injuries account for 0.4-1% of all forearm fractures in children. Despite its low incidence, Monteggia fractures require particular attention, since as much as 30-50% of the cases may be unrecognized, which subsequently leads to complications. The purpose of this paper is to evaluate treatment outcomes of Monteggia fractures in children. Both conservative treatment and surgery were analyzed. Material and methods. 15 children (7 boys and 8 girls) between the ages of 4-16.3 years (mean age 8.3 years) with Monteggia fractures were hospitalized at our center in the years 2015-2020. Closed reduction and immobilization in a cast were performed in 12 patients, while three children underwent surgical treatment with internal fixation of the ulna. The radial head dislocation was reduced successfully in every patient. Results. Every child from the study group who received conservative treatment regained full elbow mobility as well as normal forearm supination and pronation. Only one of the patients who underwent the surgery demonstrated a 20° deficit in elbow flexion that did not affect limb function. Conclusions. 1. Our experience shows that closed reduction together with immobilization in a cast is usually a sufficient treatment in Monteggia fractures. 2. However, the dislocated radial head should be properly reduced in all patients. 3. Correct diagnosis and treatment followed by appropriate rehabilitation result in full recovery and no mobility limitations in children and teenagers.