1. PRP is effective in the treatment of delayed union of long bones. 2. The highest incidence of delayed bone union was seen after the treatment of long bone fractures by open reduction and plate fixation whereas the lowest number of such cases was observed in patients treated by closed reduction with intramedullary nail fixation. 3. The mean time between surgical treatment and diagnosis of delayed bone union followed by PRP administration was 4.05 months.

Purpose The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate. Methods A retrospective analysis of treatment of 45 patients was made. Patients were divided into two subgroups regarding surgical approach (medial vs anterior) and fixation method (bridge plating vs rigid fixation). Time from injury to full bone union was noted, and clinical outcome was assessed by AOFAS score. Results Nonunion was the most prevalent complication and was observed in 26.6 % of patients. Infection rate was 11.1 %. Higher rate of bone union complications was noted in the anterior approach group with anterolateral anatomical plate. Infection and re-operation rates were similar in all subgroups. There were no correlations between fracture extension, length of plate and screw placement with bone healing time and AOFAS score. Conclusions Outcome of plate fixation of distal tibia fracture did not depend on the fixation method or surgical approach but, when possible, the medial plating via MIPO technique is a favourable method of treatment.

STRESZCZENIEWstęp. Właściwe leczenie złamań głowy kości promieniowej nadal jest obszarem wielu sporów i kontrowersji. W niniejszym badaniu staramy się ocenić wyniki operacyjnej stabilizacji tych obrażeń oraz zidentyfikować najczęstsze powikłania.Materiał i metody. Retrospektywnej analizie poddano dokumentację 63 chorych (25 kobiet i 38 mężczyzn), leczonych w latach 2011-2014. Wyniki leczenia oceniono w skali Broberga i Morreya oraz quickDASH.Wyniki. Spośród 21 chorych ze złamaniem izolowanym, wszyscy ze złamaniem typu II uzyskali wynik bardzo dobry. W typie III złamania, 11 chorych uzyskało wynik zadowalający, a 4 wynik niezadowalający. Spośród 19 chorych, którzy doznali złamania ze zwichnięciem stawu łokciowego, w grupie ze złamaniem typu II odnotowaliśmy same wyniki b. dobre, natomiast w typie III złamania -8 wyników zadowalających i 4 niezadowalające. U 23 chorych ze straszliwą triadą Hot chkissa, w typie II złamania odnotowaliśmy 7 wyników zadowalających, a w typie III -12 wyników zadowalających i 4 wyniki niezadowalające. Powikłania, jakie wystąpiły, to ograniczenie ruchomości stawu łokciowego (59% chorych), dolegliwości bólowe (52,9%), osłabienie siły (35,3%), pourazowa artroza (29,4%), skostnienia pozaszkieletowe (11,8%), brak zrostu (1,5%). Jedenastu chorych wymagało reoperacji.Wnioski. 1. Współcześnie stosowane materiały do zespalania odłamów pozwalają na stabilne zespolenie niemal wszystkich złamań głowy kości promieniowej. 2. O ile istnieją techniczne możliwości zespolenia złamania głowy kości promieniowej, warto podjąć próbę wykonania otwartej repozycji i stabilizacji wewnętrznej. 3. W przypadku braku możliwości zespolenia, leczeniem z wyboru powinna być endoprotezoplastyka głowy kości promieniowej.Słowa kluczowe: głowa kości promieniowej, złamania, straszliwa triada Hotchkissa SUMMARY Background. Appropriate treatment of radial head fractures remains an area of disputes and controversy. The present paper aims to assess the outcomes of surgical fixation of these injuries and identify the most common complications.Material and methods. The medical records of 63 patients (25 women and 38 men) treated in 2011 -2014 were analysed retrospectively. The treatment outcomes were assessed according to the Broberg and Morrey rating system and the QuickDASH score.Results. Of 21 patients with isolated fractures, all those with Type 2 fractures demonstrated excellent outcomes. In the group with Type 3 fractures, 11 patients showed satisfactory and 4 unsatisfactory outcomes. Of 19 patients with a fracture combined with elbow dislocation, all those with Type 2 fractures achieved excellent results while in the group with Type 3 fractures 8 patients had satisfactory and 4 had unsatisfactory outcomes. 23 patients were diagnosed with Hotchkiss' terrible triad; 7 of them had sustained Type 2 fractures and showed satisfactory outcomes while those with Type 3 fractures demonstrated 12 satisfactory and 4 unsatisfactory results. Complications included limited elbow mobility (59% of the patients), pain (52.9%), lower muscle s...

1. Articular step-off and widening of the lateral condyle strongly correlates with the clinical outcome of tibial plateau fracture treatment. 2. The presence and extent of subchondral bone defects in the tibial plateau are related to knee pain in patients but have no effect on the range of motion and the IKDC score. 3. Bone graft remodeling cannot be fully assessed despite the use of MARS in CT imaging.

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1.Two-stage operative treatment produces good or very good results in most patients. Nevertheless, there is a risk of complications in some cases, mostly in patients aged 40 years. Accordingly, two-stage treatment is currently recommended in younger individuals. 2. A complete MCL tear at the distal attachment should be given particular attention. Although such injury is rare, due to the anatomical determinants and the risk of Stener-like lesions, i.e. unhealed ML, surgery is recommended. Surgery produces good clinical and functional results.

Open reduction and internal fixation using two perpendicular plates allows for achieving good stability of fixation, early rehabilitation and quick return to the desired level of activity, which contributes to a high percentage of good objective and subjective results of treatment. Subjective assessment of upper limb function after DHF surgery fully correlates with objective assessment.

1. Subjective evaluation of treatment of fractures of the distal femur using the KOOS scale per form edworse than a clinical evaluation using the KSS. 2. Post-operative management should emphasise pain relief and restoration of the performance of the treated lower limb to ensure good mobility without crutches. 3. Despite the use of modern operational methods of fracture fixation, treatment of distal femur fractures is still a challenge.