2024, Morasiewicz, Piotr, Leyko, Paweł, Tomczyk, Łukasz, Kazubski, Krystian

(1) Background: The purpose of this study was to assess the effects of sex and age on the outcomes of hemiepiphysiodesis performed for genu valgum and varum deformity correction. (2) Methods: We analyzed patients who had undergone O-Plate hemiepiphysiodesis due to genu valgum or varum in the period of 2020–2023. The study group comprised 22 females and 20 males aged between 3 and 14 years at the time of surgery. Age-stratification yielded a subgroup of 3–10-year-olds (16 patients, 20 treated limbs) and a subgroup of 11–14-year-olds (26 patients, 28 treated limbs). We assessed the following parameters: hospital stay duration, deformity correction time, MAD correction, amount of angular correction, correction velocity, correction rate, complete deformity correction, deformity recurrence, surgery duration, and complications. (3) Results: The mean follow-up was 19 months. The mean surgery time in the subgroup of 3–10-year-olds (25.62 min) was significantly longer than that in the subgroup of 11–14-year-olds (22.81 min, p = 0.018). The mean deformity correction time in the male subgroup (11.33 months) was significantly shorter than that in the female subgroup (15.87 months, p = 0.013). A comparison of the subgroups stratified by age yielded a mean amount of angular correction of 10.5° in the younger children, which was significantly higher than that of 7.2° achieved in the older children; p = 0.027. The difference in mean correction velocity between 3–10-year-old children (4.03 mm/month) and that in 11–14-year-old children (1.39 mm/month) was statistically significant; p = 0.031. The mean rate of correction was 0.49°/month in females and 0.89°/month in males, with the latter rate significantly greater; p = 0.023. The difference in the mean rate of correction between the younger (1.08°/month) and the older subgroup (0.59°/month) was also significant; p = 0.018. A significant difference in terms of deformity recurrence rates was observed between the younger subgroup (66.67%) and older subgroup (only 10.53%); p = 0.005. (4) Conclusions: Patient sex had no significant effect on hemiepiphysiodesis outcomes; patient age has a considerable effect on hemiepiphysiodesis outcomes.

2024, Pelc, Marcin, Hryniuk, Władysław, Bobiński, Andrzej, Kochańska-Bieri, Joanna, Tomczyk, Łukasz, Pili, Daniele, Urbański, Wiktor, Lech, Marcin, Morasiewicz, Piotr

Background: Up to 75% of calcaneal fractures are intra-articular fractures, which may severely impair foot function and lead to disability. Methods: We retrospectively analyzed 21 patients with intra-articular calcaneal fractures who had been treated with the Ilizarov method in the period 2021–2022. The mean patient age was 47 years (range 25–67 years). We analyzed the following functional parameters: foot function with a revised foot function index (FFI-R) questionnaire and the level of physical activity, with the University of California Los Angeles (UCLA) activity scale, a visual analog scale (VAS), and a Grimby physical activity level scale; and ankle range of motion. Results: We observed a significant improvement in the UCLA activity scores and Grimby activity score at long-term follow-up. Functional outcomes based on the FFI-R questionnaires showed an improvement, from 292 points prior to surgery to 127 points at follow-up, p = 0.013. The post-treatment follow-up measurements revealed a median dorsiflexion at the treated ankle joint of 20 degrees, whereas that at the intact ankle was 40 degrees, p = 0.007. The plantar flexion showed asymmetry, with a median 15 degrees at the treated ankle and 30 degrees at the intact ankle, p = 0.007. The median range of inversion at the ankle joint was 5 degrees in the treated limb and 15 degrees in the intact limb, p = 0.039. Conclusions: Patients with calcaneal fractures treated with the Ilizarov method are recommended to have a longer and more intensive rehabilitation. The range of ankle motion in the treated limb was limited in comparison with that in the intact limb; however, this did not greatly affect the patients’ return to their earlier, pre-injury level of physical activity.

2023, Bobiński, Andrzej, Tomczyk, Łukasz, Pelc, Marcin, Chruścicki, Damian Aleksander, Śnietka, Bartosz, Morasiewicz, Piotr

Background: Pes planovalgus, or flexible flatfoot, deformity is a common problem in pediatric orthopedic patients. There is no consensus on using the technique of arthroereisis in the treatment of symptomatic pes planovalgus. The aim of our study was to prospectively assess the functional outcomes following symptomatic pes planovalgus treatment with the use of the Spherus talar screw. Methods: Twenty-seven patients (11 females, 16 males), at a mean age of 10.5 years (7–14 years) were included in the prospective study. We assessed the level of physical activity (including sports) based on the University of California, Los Angeles (UCLA) activity scale, a 10-point level-of-activity VAS scale, and the Grimby physical activity scale. Pain was assessed based on a VAS pain scale; foot function was assessed with the revised Foot Function Index (FFI-R); and ankle joint mobility was measured. Results: The mean follow-up period was 18 months (14–26 months). There was a significant improvement in VAS-measured physical activity scores from 5.47 to 7 at follow-up, p = 0.048. There was a significant improvement in UCLA activity scale scores from 4.78 to 6.05 at follow-up, p = 0.045. Pain levels decreased from a mean VAS score of 4.73 prior to surgery to a mean score of 2.73 at follow-up, p = 0.047. The functional FFI-R scores showed a significant improvement from 140 points prior to surgery to 97.75 points at follow-up, p = 0.017. Comparison of the preoperative and follow-up values of the range of plantar flexion, adduction, and abduction in the operated limb also showed no significant changes in those individual parameters. The mean values of dorsiflexion, plantar flexion, adduction, and abduction at the ankle joint at follow-up, compared individually between the operated and non-operated foot showed no statistically significant differences. Conclusions: The use of a talar screw in the treatment of symptomatic pes planovalgus helps reduce pain and improve functional outcomes after treatment. Foot function assessments showed diminished pain, improved levels of physical and sport activity, and no effect on the range of motion after surgery in comparison with preoperative data. Arthroereisis with a talar screw is a valid surgical technique for the treatment of symptomatic pes planovalgus.

2023, Bobiński, Andrzej, Tomczyk, Łukasz, Reichert, Paweł, Morasiewicz, Piotr

Background: There have been no reports on arthroereisis screw insertion into the talus in patients with flexible flatfoot. We aimed to conduct a clinical and radiological assessment in patients with symptomatic pes planovalgus deformity treated with a talar screw. Methods: This study involved a prospective assessment of 27 patients treated surgically for symptomatic flexible flatfoot deformity in the period 2021–2022. The following parameters were assessed in this study: Meary’s angle, the Costa–Bartani angle, the calcaneal pitch angle, surgery duration, the length of hospital stay, patient satisfaction, patients’ retrospective willingness to consent to the treatment they received, postoperative complications, and the use of analgesics. Results: The mean follow-up period was 14.76 months. Meary’s angle decreased from 18.63° before surgery to 9.39° at follow-up (p = 0.004). The Costa–Bartani angle decreased significantly from 154.66° before surgery to 144.58° after surgery (p = 0.012). The calcaneal pitch angle changed from 16.21° before to 19.74°. Complications were reported in three patients (11.11%). The mean surgery duration was 32 min. The mean hospital stay was 2.2 days. Fourteen patients (51.85%) were highly satisfied with the treatment, and 12 patients (44.44%) were quite satisfied with treatment. Twenty-five (92.59%) of the evaluated patients would choose the same type of treatment again. Six patients (22.22%) needed to use analgesics prior to surgical treatment, whereas none of the patients needed to use them by the final follow-up. Conclusion: Spherus screw arthroereisis helps improve radiological parameters in patients with flexible flatfoot. We observed good clinical outcomes after treatment with a talar screw, with a majority of patients reporting moderate-to-high levels of satisfaction with treatment. Both short- and medium-term treatment outcomes of pes planovalgus treatment with the use of Spherus screw are good.

2024, Widłak, Patrycja, Tomczyk, Łukasz, Woldańska-Okońska, Marta, Bartnicki, Piotr

2022, Klepacki, Krzysztof, Tomczyk, Łukasz, Miękisiak, Grzegorz, Morasiewicz, Piotr

Background. Ankle joint injuries are an important orthopedic issue due to their high incidence and the variety of treatment methods available. This study assessed the effect of the COVID-19 pandemic on the epidemiology and treatment of ankle joint injuries. There is lack of papers which address this problem.Material and methods. This study compared epidemiological data on ankle joint injuries in adults and children collected during the period of the COVID-19 pandemic (2020) and a corresponding prepandemic period (2019). Epidemiological data, demographic data, treatment methods, hospital stay duration, and injury-to-surgery time were analyzed.Results. The total number of patients hospitalized for ankle fractures in the evaluated pandemic period was lower by 34% than that in the corresponding prepandemic period in 2019. The pediatric patient subpopulation showed a 70% decline during the analyzed period of COVID-19 pandemic. The number of hospitalized females declined by 12%, and the number of hospitalized males dropped by 53%. Conclusions. 1. Our study showed the impact of the COVID-19 pandemic on the epidemiology and treatment of ankle joint injuries. 2. The COVID-19 pandemic effected a decrease in the number of patients with ankle joint injuries, particularly pediatric and male patients with these injuries. 3. National lockdown measures had a considerable effect on lowering the numbers of pediatric patients with ankle joint injuries treated conservatively. 4. Importantly, the tendency can be noted among orthopedic surgeons and emergency room doctors to more readily qualify orthopedic patients for a trial of conservative treatment. This only prolongs the duration of treatment and time to the ultimate therapeutic surgery.

2022, Konieczny, Piotr, Andrzejewski, Wojciech, Yang, Tianyu, Urbańska, Maria, Stangierski, Jerzy, Tomczyk, Łukasz, Mikołajczak, Beata

The aim of this study was to describe the quality attributes of a freeze-dried preparation obtained from freshwater mussel Sinanodonta woodiana (SW) soft tissue in respect to its potential as a novel pet food ingredient. After ecotoxicological testing of the raw material with MARA (Microbial Assay for Risk Assessment), the basic physico-chemical properties of the powder, such as approximate composition, bulk density, color parameters, water activity, electrophoretic analysis (SDS-PAGE), solubility, gelling and emulsifying capacity, were analyzed. The powder with a water activity of 0.43 offers a toxically safe preparation that contains over 34% protein/100 g of dry matter (DM). The SDS-PAGE profile showed twelve protein bands with a molecular weight (MW) ranging from >250 to 10 kDa. Taurine content has been estimated at an essential amount above 150 mg/100 g of DM. The powder possessed desirable emulsifying properties with 230 mL per 1 g and demonstrated the ability to form a firmer gel with a strength of 152.9 g at a temperature above 80 °C with at least 10% protein content. The L*, a*, and b* values characterizing powder color were found to be 69.49, 16.33, and 3.86, respectively. The SW mussel powder seems to be a promising ingredient that can be added with other binding or gelling agents in order to improve both the taste and acceptance of the final pet food products.

2024, Stangierski, Jerzy, Kawecka, Agata, Rezler, Ryszard, Tomczyk, Łukasz, Siejak, Przemysław

This study was conducted on vegetable soup with rabbit meat and vegetable soup with rabbit meat, beef balls, and carrots. The qualitative characteristics of the soups were adapted to the needs of elderly consumers. The soups used in the experiments were industrially produced. The aim of this study was to analyse changes in the mechanical, sensory, and microbiological properties of the soups occurring during their storage (1, 7, 14, and 21 days). Strength tests were performed at temperatures of 20 °C and 55 °C. Both soups had a high protein content (4.7–6.5%), low sugar (0.3–0.5%) and salt content (0.8%), and a fibre content of 1.4%. The texture analysis showed great similarity in the mechanical characteristics of both soups. The samples were characterised by low measured values for firmness (0.72 N) and cohesiveness (−0.14 N) in both temperatures. The average shear force of the beef balls with carrots at 20 °C was 12.3 N, but after heating, it decreased to 8.8 N (p < 0.05). The rheological tests on the soups showed that they were characterised by a relatively high viscosity (15–20 Pas at 55 °C). Storage of the soups for 21 days did not significantly affect their rheological parameters (p > 0.05). The soup with beef balls and carrots was rated higher by the sensory panel. On the 21st day of storage, the permitted limit of the count of bacteria was not exceeded in either of the samples. This study shows that the soups had desirable structural, nutritional, and sensory characteristics, which are important for this group of consumers. The values of the mechanical parameters of all the samples were low, and they were even significantly more reduced when the products were heated. This may suggest that the products should not be difficult to consume for seniors.

2024, Bobiński, Andrzej, Tomczyk, Łukasz, Pelc, Marcin, Chruścicki, Damian, Śnietka, Bartosz, Wójcik, Jarosław, Morasiewicz, Piotr

2023, Kuliński, Patryk, Tomczyk, Łukasz, Pawik, Łukasz, Olech, Jarosław, Morasiewicz, Piotr

2022, Tomczyk, Łukasz, Leśnierowski, Grzegorz, Cegielska-Radziejewska, Renata

2025, Nowaczewski, Sebastian, Grzegrzółka, Beata, Gruszczyńska, Joanna, Szablewski, Tomasz, Stuper-Szablewska, Kinga, Cegielska-Radziejewska, Renata, Tomczyk, Łukasz, Biadała, Agata, Lewko, Lidia, Szulc, Karolina, Kaczmarek, Sebastian, Racewicz, Przemysław Łukasz, Jarosz, Łukasz, Hejdysz, Marcin

Abstract Ten percent of the world’s total edible eggs come from Japanese quail. The popularity of quail eggs is attributed to their high yolk content and hypoallergenic properties. This study aimed to analyze the physical characteristics and selected biochemical parameters of Japanese quail eggs based on shell color (dotted - D group, spotted - S group, and hazy - H group). The heaviest and most elongated eggs were found in the group H. The yolk index was significantly higher in dotted eggs, which also exhibited the highest lysozyme content and activity. The thickest shell (p≤0.05) with the lowest elasticity was observed in hazy eggs. However, no differences were found between eggshell colors concerning their breaking strength. The highest Ca content in the shell was found in the spotted group (S), while hazy eggs exhibited the lowest (p≤0.05) Ca and Mg content, despite having the thickest shells. Hazy eggs were also characterized by the highest crude protein content and the smallest proportion of crude fat and ash. The dotted eggs had the highest (p≤0.05) proportions of C16:1 and C18:2 fatty acids and a higher PUFA content (p≤0.05). Nutritionally, the dotted eggs performed best in terms of fatty acid profile and were also characterized by higher Mg, Ca, Cu, Mn, K, and Na content compared to the other groups. In summary, dotted eggs may be more appealing to consumers due to their advantageous physical and biochemical characteristics.

2024, Pelc, Marcin, Kazubski, Krystian, Urbański, Wiktor, Leyko, Paweł, Kochańska-Bieri, Joanna, Tomczyk, Łukasz, Konieczny, Grzegorz, Morasiewicz, Piotr

Background: The biomechanical outcomes of intra-articular calcaneal fracture treatment have not been fully explored. The purpose of this study was to analyze pedobarographic assessments of balance and body weight distribution over the lower limbs in patients following calcaneal fracture treatment with the Ilizarov method and to compare the results with those of a control group. Materials and Methods: The data for our retrospective study came from cases of intra-articular calcaneal fractures treated with the Polish modification of the Ilizarov method in the period between 2021 and 2022. The experimental group (21 patients; 7 women, 14 men) included Sanders classification calcaneal fractures type 2 (n = 3), type 3 (n = 5), and type 4 (n = 13). The control group comprised 21 sex-matched healthy volunteers, with no significant differences from the experimental group in terms of age or BMI. The examination included an assessment of balance and weight distribution over the lower limbs. The device used was a FreeMED MAXI pedobarographic platform (SensorMedica). Results: The mean displacement of the center of gravity in the experimental group was significantly higher at 1307.31 mm than in the control group (896.34 mm; p = 0.038). The mean area of the center of gravity was not significantly different between the groups. An analysis of weight distribution over the operated and uninjured limb in the experimental group and the non-dominant and dominant limb, respectively, in the control group revealed no significant differences. We observed no significant differences in the percentage of weight distribution over the lower limbs between the operated limb in the experimental group and the non-dominant limb in the control group, or between the uninjured limb in the experimental group and the dominant limb in the control group. Conclusions: The use of the Ilizarov method in calcaneal fracture treatment helps normalize the percentage weight distribution in the lower limbs, with the results comparable with those obtained in the healthy control group. The mean displacement of the center of gravity was worse in the experimental group than in controls; whereas the mean area of the center of gravity was comparable between the two groups. Treatment of calcaneal fractures with the Ilizarov method does not help achieve completely normal static parameters of lower-limb biomechanics. Patients treated for calcaneal fractures with the Ilizarov method require longer and more intense rehabilitation and follow-up.

2023, Kuliński, Patryk, Rutkowski, Michał, Tomczyk, Łukasz, Miękisiak, Grzegorz, Morasiewicz, Piotr

Abstract Background Chevron osteotomy is one of the most common approaches to hallux valgus corrective surgery. This procedure is often combined with Akin osteotomy of the proximal phalanx of the hallux. There are no definitive guidelines specifying the indications for a given osteotomy technique nor data on postoperative loss of correction or the effect of the type of first-ray surgery on the development of adjacent-joint arthritis. The aim of this study was to assess radiographic treatment outcomes via chevron osteotomy with and without Akin osteotomy. Methods The study evaluated 117 patients treated in the period 2016–2019. Ninety-nine of those patients underwent distal chevron osteotomy alone, and 18 patients underwent a combined chevron–Akin double osteotomy. The analyzed radiograms had been obtained preoperatively, at 6 weeks after surgery, and after a long-term follow-up. The following parameters were assessed: the intermetatarsal angle (IMA), hallux valgus angle (HVA), interphalangeal angle (IPA), postoperative recurrence of valgus deformity, adjacent-joint arthritis, and complications. Results Chevron-Akin osteotomy helped maintain lower HVA and IPA values in long-term follow-up in comparison with those in the patients who underwent chevron osteotomy alone. The chevron osteotomy group showed a significant increase in the mean HVA from 18.37° at the first follow-up visit to 20.81° at the last follow-up visit. There were no differences between the groups in terms of the remaining assessed radiographic parameters. Hallux valgus surgery does not increase adjacent-joint arthritis. Conclusion The use of combined chevron-Akin osteotomy does not affect HVA or IMA correction. The combination of chevron and Akin osteotomies reduces the risk of increased HVA and IPA in long-term follow-up. The additional Akin osteotomy does not increase the risk of adjacent-joint arthritis. Combining chevron osteotomy with Akin osteotomy is recommended in hallux valgus deformity correction.

2024, Widłak, Patrycja, Malara, Marzena, Tomczyk, Łukasz, Dania, Aspasia, Panagiotakou, Georgia, Papoulia, Georgia

Background/Objectives: Eating habits and behaviors play a central role in maintaining health and overall well-being. In the case of young students, they affect not only appearance and general mood but also cognitive ability, concentration, and broader learning ability. For this reason, it is essential for young people to have well-balanced and wholesome diets. Methods: The study included 186 Polish and 136 Greek university students majoring in sports. The research tool was the validated survey questionnaire FFQ-6, and the data collected were additionally used to calculate the healthy diet index (pHDI-10). Results: Based on the analysis of the collected data, the dietary habits of the students surveyed were assessed, taking into account, among other things, the frequency of consumption of sweets, salty snacks, processed foods, and sweetened drinks, but also healthy products, including vegetables and fruit or vegetable and fruit juices. The data collected made it possible to determine an index of the health value of the participants’ diet. Conclusions: The analysis of the collected data led to the conclusion that, more often than their Greek peers, Polish university students tend to reach for sweets, salty snacks, or sweetened drinks. Greeks were more likely to choose fruit and vegetables and vegetable and fruit juices. However, among both Poles and Greeks, the index of the health-promoting value of the diet is low, indicating a high risk of diet-related diseases of lifestyle. Similar trends can be observed among students of almost all nationalities, which makes it reasonable to consider the implementation of appropriate educational programs on nutrition and healthy lifestyle principles in general.

2025, Kowal, Igor, Pelc, Marcin, Pili, Daniele, Tomczyk, Łukasz, Operacz, Radosław, Morasiewicz, Piotr

Background: There is no consensus on the best treatment method for calcaneal fractures. The topic of lower limb biomechanics following calcaneal fracture treatment with various fixation methods has not been fully explored. The aim of the study was to assess the balance and load distribution of the lower limbs in patients after various methods of stabilization of calcaneal fractures. Methods: In this two-center study, we retrospectively collected data from 19 patients treated with internal plate fixation at a mean age of 46 years and 27 patients treated with Ilizarov external fixation at a mean age of 50 years. Using the Zebris Medical pedobarophragmatic platform, we assessed the percentage distribution of lower limb loads and balance. Results: There were no significant differences in total load distribution for both the operated (p = 0.489) and non-operated limb (p = 0.46), between the Ilizarov method group and the internal plate group. In the Ilizarov fixation group, total load distribution was 46.89% on the treated limb, and 53.11% on the uninjured limb, p = 0.077. In the internal plate fixation group, the mean total load distribution was 41.57% in the treated limb, and 57.89% in the uninjured limb, p = 0.008. The median CoG (center or gravity) sway path length was 132.41 cm and 170.21 cm in the Ilizarov and internal plate group, respectively, p = 0.023. The median CoG sway areas were 0.84 cm2 and 7.57 cm2 in the Ilizarov method group and internal plate fixation group, respectively, p < 0.001. Conclusions: The Ilizarov method was associated with more symmetrical load distribution and improved balance performance compared to internal plate fixation. Static biomechanical parameters of calcaneal fracture treatment were better in the Ilizarov group compared to patients with internal plate fixation.

2023, Kazubski, Krystian, Tomczyk, Łukasz, Bobiński, Andrzej, Morasiewicz, Piotr

Background: Bilateral osteoarthritis of the knee is an indication for a bilateral total knee replacement (TKR) procedure. The goal of our study was to assess the sizes of the implants used during the first and second stages of TKR procedures in order to compare their size and identify the prognostic factors for the second procedure. Methods: We evaluated 44 patients who underwent staged bilateral TKR procedures. We assess the following prognostic factors from the first and second surgery: duration of anesthesia, femoral component size, tibial component size, duration of hospital stay, tibial polyethylene insert size, and the number of complications. Results: All assessed prognostic factors did not differ statistically between the first and second TKR. A strong correlation was found between the size of femoral components and the size of tibial components used during the first and second total knee arthroplasty. The mean duration of the hospital stay associated with the first TKR surgery was 6.43 days, whereas the mean duration of the second hospital stay was 5.5 days (p = 0.211). The mean sizes of the femoral components used during the first and second procedures were 5.43 and 5.2, respectively (p = 0.54). The mean sizes of the tibial components used during the first and second TKR procedures were 5.36 and 5.25, respectively (p = 0.382). The mean sizes of the tibial polyethylene inserts used during the first and second procedures were 9.45 and 9.34 (p = 0.422), respectively. The mean duration of anesthesia during the first and second knee arthroplasty was 117.04 min and 118.06 min, respectively (p = 0.457). The mean rates of recorded complications associated with the first and second TKR procedures were 0.13 and 0.06 per patient (p = 0.371). Conclusions: We observed no differences between the two stages of treatment in terms of all analyzed parameters. We observed a strong correlation between the size of femoral components used during the first and second total knee arthroplasty. We noted a strong correlation between the size of tibial components used during the first and second procedure. Slightly weaker prognostic factors include the number of complications, duration of anesthesia and tibial polyethylene insert size.

2025, Leyko, Paweł, Zaborska, Monika, Walczak, Agnieszka, Tomczyk, Łukasz, Pelc, Marcin, Mnich, Aleksander, Kowal, Igor, Morasiewicz, Piotr

Background: Biomechanical disorders may result from joint deformities. The purpose of this prospective research was to assess total load distribution over the lower limbs and balance in individuals before and after an hemiepiphysiodesis procedure performed due to valgus or varus knee deformity. Methods: Thirty-five patients, mean age 12 years, who underwent hemiphysiodesis for valgus or varus deformity of the knee were evaluated in comparison to a healthy control group. In patients, the percentage distribution of weight-bearing capacity between the operated and unoperated limbs was analyzed before and after surgery. Balance was assessed based on CoG (center of gravity) sway area and the CoG path length. Results were collected using the FreeMED MAXI pedobarographic platform. Results: Before surgery, statistically significant lower load on the entire affected limb was noted compared to unaffected limb. The values of path of center of gravity improved statistically significantly after surgery, compared to the values before surgery. There were no differences in the load on the treated lower limb in the study group and the non-dominant limb in the control group. There were no differences between the load on the non-operated limb in the study group and the load on the dominant limb in the control group. In the hemiepiphysiodesis group there were no significant differences between the mean total load on the treated and untreated limb after surgery. The median CoG sway area and path length in the group of patients after hemiphysiodesis and in the healthy control group did not differ. Conclusions: After hemiphysiodesis, the percentage load distribution did not differ between the operated and non-operated lower limb. Hemiepiphysiodesis allows for achieving balance similar to the healthy control group. Performing hemiepiphysiodesis allows for the improvement of balance parameters and load distribution in the lower limbs.

2022, Klepacki, Krzysztof, Kowal, Igor, Konieczny, Grzegorz, Tomczyk, Łukasz, Miękisiak, Grzegorz, Morasiewicz, Piotr

Introduction: There is no consensus among orthopedic surgeons on the number of cortical layers (tricortical or quadricortical fixation) involved or the duration of syndesmotic fixation after a tibiofibular syndesmosis (TFSD)-injury treatment. The purpose of this study was to assess radiographic parameters following the treatment of TFSD injuries, with various time-windows of syndesmotic screw removal and numbers of cortical layers involved. Materials and Methods: Fifty-five patients, aged from 25 to 75 years, were included in the study. The follow-up period ranged from 2 years to 4 years and 2 months. The patients were subdivided into groups based on the duration of the syndesmotic fixation (8–15 weeks—19 patients or 16–22 weeks—36 patients) and the number of cortices involved (tricortical—17 patients or quadricortical fixation—38 patients). Results: The quadricortical fixation group showed a significant development of ankle joint arthritis and subtalar joint arthritis at the final follow-up. The mean medial clear space was 2.84 mm in the tricortical fixation group and 3.5 mm in the quadricortical fixation group (p = 0.005). Both groups, with different screw removal times showed significant development of posttraumatic arthritis. A comparison of the two groups (with different time-windows of the screw removal) revealed a significant difference only in terms of the postoperative tibiofibular (TF) overlap and the observed rates of talonavicular arthritis at the final follow-up. Discussion: We found that the duration of the screw fixation had no effect on most of the evaluated radiographic parameters. Only the postoperative TF overlap was lower in the 8–15-week fixation group, and the proportion of patients with talonavicular joint arthritis at the final follow-up was higher in the 16–22-week fixation group. In addition, the number of cortices involved in the screw fixation had no effect on the radiographic outcomes in our patients, apart from the differences in one parameter—the medial clear space—at the final follow-up. Conclusion: We achieved similar radiographic results irrespective of the duration of the screw fixation and the number of cortices involved. All study subgroups showed the development of adjacent-joint arthritis following treatment. Considering the results of our study, the economic and medical aspects of treatment, and the possibility of a faster recovery, the most optimal solution seems to be the use of a tricortical fixation, with the screws being removed after 8–15 weeks.

2025, Malara, Marzena, Widłak, Patrycja, Tomczyk, Łukasz