Za sto so wa nie ba da nia pe do ba ro gra ficz ne go do oce ny bio me cha ni ki sto py i sta wu sko ko wo -go le nio we go u osób do ro słych -do świad cze nia wła sne STRESZ CZE NIEPe do ba ro gra fia jest nie in wa zyj ną me to dą, uży wa ną do opi su roz kła du na ci sków na po de szwo wej stro nie sto py pod czas sta nia i cho du, a więc uła twia ją cą oce nę bio me cha ni ki głów nie sto py i sta wu sko ko wo-go le niowe go. Znaj du je ona za sto so wa nie w dia gno sty ce scho rzeń na rzą du ru chu i w oce nie ich pro gre sji, mo ni to ro waniu prze bie gu le cze nia re ha bi li ta cyj ne go, a ta kże w oce nie sku tecz no ści le cze nia ope ra cyj ne go. W pra cy tej przed sta wio no wy bra ne za gad nie nia do ty czą ce za sto so wa nia pe do ba ro gra fii w dia gno sty ce i le cze niu scho rzeń stóp i sta wu sko ko wo-go le nio we go u osób do ro słych w opar ciu o do świad cze nia wła sne (ok. 10 ty się cy wy ko nanych ba dań pe do ba ro gra ficz nych) i prze gląd li te ra tu ry. W na szej oce nie, pe do ba ro gra fia po win na zna leźć powszech niej sze, ani że li do tych czas, za sto so wa nie w dia gno sty ce i le cze niu stóp oraz sta wu sko ko wo -go le nio we go.Sło wa klu czo we: na rząd ru chu, dia gno sty ka, na ci ski, chód SUMMARY A non -in va si ve me thod, that can be used to de scri be the un der fo ot pres su re di stri bu tion du ring stan ce and ga it, is pe do ba ro gra phy. This exa mi na tion helps to de scri be bio me cha nics of fo ot and an kle. It has be en used to dia gno se fo ot di sor ders, as sess the di se ase pro gres sion, mo ni tor the pro gress of re ha bi li ta tion and al so evalu ate the ef fec ti vness of un der go ne sur gi cal tre at ment. In this ar tic le we de scri be cho sen is su es of pe do ba ro graphic exa mi na tion in dia gno stics and tre at ment of fo ot and an kle in adults. We ba se on our own expe rien ce (about 10 tho usand exa mi na tions) and re view of li te ra tu re. In our opi nion, pe do ba ro gra phy sho uld be used in diagno stics and tre at ment of fo ot and an kle mo re often and wi de ly than now.
Metastases to distant organs are a frequent occurrence in cancer diseases. The skeletal system, especially the spine, is one such organ. The objective of this study was to apply a numerical modeling, using a finite element method (FEM), for the evaluation of deformation and stress in lumbar spine in bone metastases to the spine. We investigated 20 patients (10 women and 10 men) aged 38-81 years. In women, osteolytic lesions in lumbar spine accompanied breast cancer, in men it was prostate cancer. Geometry of FEM models were built based on CT scans of metastatic lumbar spine. We made the models for osteolytic metastases, osteosclerotic metastases, and metastases after surgery. Images were compared. We found a considerable concentration of strain, especially located in the posterior part of the vertebral body. In osteolytic lesions, the strain was located below the vertebral body with metastases. In osteosclerotic lesions, the strain was located in the anterior and posterior parts in and below the vertebral body with metastases. Surgery abolished the pathological strain. We conclude that metastases to the lumbar spine introduce a pathological strain on the lumbar body. The immobilization of the vertebral body around fractures abolished the strain.
Secondary, post-traumatic, degenerative lesions of the ankle joint remain a serious clinical challenge. This paper presents the case of a 66-year-old patient with secondary, post-traumatic ankle osteoarthritis and subchondral cysts. The use of rapid computer modelling FEM 2D enabled optimization of surgical treatment. A FEM 2D model of biomechanical changes in bones may help in streamlining treatment as well as improve our understanding of the pathomechanism of osteoarthritis.
Posttraumatic pneumothorax still remains to be a serious clinical problem and requires a comprehensive diagnostic and monitoring during treatment. The aim of this paper is to present a computer method of modeling of small closed pneumothorax. Radiological images of 34 patients of both sexes with small closed pneumothorax were taken into consideration. The control group consisted of X-rays of 22 patients treated because of tension pneumothorax. In every single case the model was correlated with the clinical manifestations. The procedure of computational rapid analysis (CRA) for in silico analysis of surgical intervention was introduced. It included implementation of computerize tomography images and their automatic conversion into 3D finite elements model (FEM). In order to segmentize the 3D model, an intelligent procedure of domain recognition was used. In the final step, a computer simulation project of fluid-structure interaction was built, using the ANSYS\Workbench environment of multi-physics analysis. The FEM model and computer simulation project were employed in the analysis in order to optimize surgical intervention. The model worked out well and was compatible with the clinical manifestations of pneumothorax. We conclude that the created FEM model is a promising tool for facilitation of diagnostic procedures and prognosis of treatment in the case of small closed pneumothorax.
The prevalence of malignant pleural mesothelioma is often encountered in the areas highly exposed to asbestos. The aim of this paper was a retrospective analysis of shoulder pain as a rare, first symptom of pleural mesothelioma, which constitutes an interdisciplinary diagnostic problem concerning both orthopedics and pulmonology. The research was based on a retrospective review of the patients' medical records. The considered period of time included the years 2006-2012. The study group included a total of 49 patients. Seven patients (14.3%) presented a complain of shoulder pain, as the first symptom of mesothelioma. The remaining 42 mesothelioma patients, without this symptom, constituted a reference group. The intensity of shoulder pain was, on average, 4/10 on an analog scale. A concomitant limitation of mobility was observed in five out of the seven subjects. In one case, limitation of motion and dysfunction of the shoulder joint were at an advanced stage. Neuralgia of upper limbs was found in two cases. We conclude that shoulder pain may be a manifesting symptom of malignant pleural mesothelioma. The neoplasm appears to have a pleiotropic effect on human body, reflected in different ways of its primary manifestation which may also include the motor system.
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