Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low.

The aim of the study was to investigate the leukocyte- and platelet-rich plasma (L-PRP) antimicrobial activity. The studied sample comprised 20 healthy males. The L-PRP gel, liquid L-PRP, and thrombin samples were tested in vitro for their antibacterial properties against selected bacterial strains using the Kirby-Bauer disc diffusion method. Two types of thrombin were used (autologous and bovine). Zones of inhibition produced by L-PRP ranged between 6 and 18 mm in diameter. L-PRP inhibited the growth of Staphylococcus aureus (MRSA and MSSA strains) and was also active against Enterococcus faecalis and Pseudomonas aeruginosa. There was no activity against Escherichia coli and Klebsiella pneumoniae. The statistically significant increase of L-PRP antimicrobial effect was noted with the use of major volume of thrombin as an activator. Additionally, in groups where a bovine thrombin mixture was added to L-PRP the zones of inhibition concerning MRSA, Enterococcus faecalis, and Pseudomonas aeruginosa were larger than in the groups with autologous thrombin. Based on the conducted studies, it can be determined that L-PRP can evoke in vitro antimicrobial effects and might be used to treat selected infections in the clinical field. The major volume of thrombin as an activator increases the strength of the L-PRP antimicrobial effect.

BackgroundThe aim of this study was to analyze the causes that lead to secondary damage of the radial nerve and to discuss the results of reconstructive treatment.Material/MethodsThe study group consisted of 33 patients treated for radial nerve palsy after humeral fractures. Patients were diagnosed based on clinical examinations, ultrasonography, electromyography, or nerve conduction velocity. During each operation, the location and type of nerve damage were analyzed. During the reconstructive treatment, neurolysis, direct neurorrhaphy, or reconstruction with a sural nerve graft was used. The outcomes were evaluated using the Medical Research Council (MRC) scales and the quick DASH score.ResultsSecondary radial nerve palsy occurs after open reduction and internal fixation (ORIF) by plate, as well as by closed reduction and internal fixation (CRIF) by nail. In the case of ORIF, it most often occurs when the lateral approach is used, as in the case of CRIF with an insertion interlocking screws. The results of the surgical treatment were statistically significant and depended on the time between nerve injury and revision (reconstruction) surgery, type of damage to the radial nerve, surgery treatment, and type of fixation. Treatment results were not statistically significant, depending on the type of fracture or location of the nerve injury.ConclusionsThe potential risk of radial nerve neurotmesis justifies an operative intervention to treat neurological complications after a humeral fracture. Adequate surgical treatment in many of these cases allows for functional recovery of the radial nerve.

BackgroundWe investigated whether the duration of postoperative physiotherapy supervision by a physiotherapist affects clinical outcome, speed, and agility in males 8 months after anterior cruciate ligament reconstruction (ACLR).Material/MethodsFrom a group of 248 patients 8 months after ACLR, we used strict exclusion criteria to identify 2 groups of men who were well trained and frequently participated in sports pre-injury, with different durations of postoperative physiotherapy supervision: Group I (n=15; x=27.40 weeks) and Group II (n=15; x=8.07 weeks). Group III (n=30) were controls. Clinical evaluation (manual ligament assessment, knee joint and thigh circumferences, range of motion), pain assessment, and run test with maximal speed and change-of-direction manoeuvres, was performed.ResultsNo clinically significant abnormalities were noted in any studied groups in terms of clinical and pain assessments. The time of the run test was significantly increased in Group II (x=23.77 s) compared with Group I (x=21.76 s) and Group III (x=21.15 s). The average speed was significantly reduced in Group II (x=2.05 m*s−1) compared with Group I (x=2.22 m*s−1) and Group III (x=2.27 m*s−1). The duration of physiotherapy supervision was significantly negatively correlated with the time results of the run test (r=−0.353; p=0.046) and positively correlated with the average speed (r=0.360; p=0.049).ConclusionsBoth shorter and longer duration of postoperative physiotherapy supervision resulted in successful clinical outcomes in terms of studied features in males 8 months after ACLR. Nevertheless, longer physiotherapy supervision was more effective for improving speed and agility to the level of healthy individuals.

The anterior cruciate ligament (ACL) is cited as the most frequently injured ligament in the knee. The standard treatment of ACL injury remains ligament reconstruction followed by a postoperative physiotherapeutic procedure. During the reconstruction, the torn ligament can be replaced with an autograft or an allograft.