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The Greek verb deî appears several times in Luke-Acts and in different contexts of 'necessity': the necessity of the mission and the passion of Jesus and Paul; the necessity of the fulfilment of the Scripture; the necessity of moral or religious obligations as well as other necessary actions. The Peshitta does not translate all of occurrences of deî in Luke-Acts in the same way but chooses various verbs and expressions. The most frequent translation is the verb wāle ("to be right", "to be convenient", "one must"), which translates deî in different contexts. Another word used with a certain frequency is the passive participle ʻatid ("one must", "to be necessary", "to be destined"). However, the usage of this word, rich in theological content, is restricted to particular contexts. This paper seeks to give a precise explanation for how the Peshitta deals with the translation of deî in Luke-Acts. [ABSTRACT FROM AUTHOR]

Introduction: Mutations in the TRPV4 gene are associated with neuromuscular disorders and skeletal dysplasias, which present a phenotypic overlap.Methods: Next-generation sequencing and Sanger sequencing were used to analyze the TRPV4 gene.Results: We present 2 Polish families with TRPV4-related disorder harboring the same p.Arg269His mutation. The disease phenotypic expression was extremely variable (from mild scapular winging to severe hypotonia, global weakness, inability to walk unaided, congenital contractures, scoliosis, and respiratory insufficiency), but did not suggest anticipation. The 2 most severely affected patients showed congenital distal contractures of the upper limbs and involvement of cranial nerves (manifesting as facial asymmetry and strabismus). The disease course seemed to be stable, although in later stages it caused respiratory insufficiency and progression of physical disability.Discussion: The phenotypic variability observed in p.Arg269His carriers suggests that an additional modifier or a more complex pathogenic mechanism exists. Muscle Nerve 59:129-133, 2019. [ABSTRACT FROM AUTHOR]

Patients with balance problems often complain about dizziness and vision disorders. The ability to keep vision stable while moving is one of the key factors which enable performing daily activities. This process can be very seriously interfered by vestibular abnormalities and thus cause discomfort to the patient. The function of Vestibulo-Ocular Reflex (VOR) is to stabilize vision while viewing moving objects or during fast head movements. The VOR evaluation is an important element in diagnosing dizziness and balance disorders. This paper provides basic information about the functioning of the VOR system responsible for maintaining static vision and vision stability. It presents the dizziness diagnostic method via inVision? tool, evaluating and describing it in detail based on a number of studies with its use. [ABSTRACT FROM AUTHOR]

Unlabelled: The diagnosis of osteochondral fractures and medial patellar retinaculum injuries that originate as a result of Traumatic Patellar Dislocation (TPD) appears to be crucial for establishing the treatment strategy. Those injuries may be efficiently recognized by means of ultrasonography (USG)., Material and Methods: The analysis of the USG patterns in 22 knees after TPD in 21 patients treated between 2004 and 2007 was proceeded. In all children knee USG examination followed its clinical examination and X ray imaging. The standard USG knee assessment was supplemented by patellar articular cartilage assessment according to the author's technique and dynamic examination of the functional efficiency of the Medial Patello-Femoral Ligament (MPFL). 15 patients were treated surgically and 7 conservatively., Results: The following USG patterns of TPD--concomitant injuries were observed: avulsion fracture of the patellar insertion of MPFL (16), injury of MPFL fibres (17), injury of MPFL femoral insertion (4), intramuscular hematoma of the quadriceps muscle (3), osteochondral fracture with presence of the intraarticular loose body and corresponding fracture-site leasion of the articular surface of the lateral femoral condyle or patella (12), and non-full thickness articular cartilage injury (8). The sonographic diagnoses were confirmed in 20 out of 22 knees (91%), including 13 out of 15 patients operated., Conclusions: TPD may result in numerous injuries of the knee extensor apparatus and articular cartilage. The authors' experiences displayed usefulness of the USG in diagnosis of these damages. Using dynamic assessment the patellar articular cartilage as well as a function of the MPFL can be examined.

We present a rewiev of orthopaedic literature, our clinical experience, and examples on pediatric ankle fractures. The rules of anatomic physeal and articular surface reduction in intraarticular injuries are emphasised. We present complications, specially ankle axial deformities caused by bony bars and its reasons, specially periosteal interposition or jatrogenic physeal damage by an inapropriate stabilisation.

We present results of treatment in 36 cases of distal tibial epiphyseolysis in 34 patients treated between 1999 and 2005 with a minimal follow up of 12 months (average 28,5, range 13-84 months). The mean age at injury was 12 years (range from 7 to 16). There were 22 cases of type II injury according to the Salter-Harris classification, 5 cases of type VII, 3 of type IV, 2 of type I and two cases of triplane fracture, one case of retrospectively recognised type V and one of type III. 12 children required open reduction and K-wire fixation, the rest of 22 children underwent closed reduction followed by percutaneus fixation in 12 cases. Concomitant fibular fracture occured in 30 cases and required open reduction and fixation in 4. There were 18 good, 14 fair and 3 bad results according to Gleizes. The mean AOFAS scale result was 92.7. One child underwent 2 weeks of intravenous antybiotic therapy to recover from superficial skin infection around percutaneus K-wires. Four cases of physeal bar formation were noted. In two of them distal tibial osteotomy to correct ankle varus was necessary and one underwent bony bridge removal followed by fatty tissue interposition. The remaining physeal bar resulted in 10 degree of ankle valgus without functional dispairement.

We present Ignatio Ponseti's approach to idiopathic clubfoot management and its biological basis. The key principles of the Ponseti method of treatment are 1. All deformity components are corrected simultaneously except equinus, which is corrected last, usually by percutaneous Achilles tenotomy. 2. The correction is maintained by external foot rotation around the head of the talus. 3. The excavatus is corrected by supination of the first ray of the foot. 4. The corrections are performed weekly and after 4-5 weeks of treatment a percutaneous Achilles tenotomy is performed in local or general anaesthesia. 5. After another 3 weeks of plaster cast immobilisation, a Dennis Brown brace is used to keep the correction until 4-5 years of life.

We present a rare case of an aggressive form of chondroblastoma arising from proximal radius. Because of an initial histopathologic diagnosis of paraosteal osteosarcoma, the patient was treated with preoperative chemotherapy and afterwards a local tumor resection with one half of proximal radius was performed. A final histopathologic examination revealed typical benign chondroblastoma. We discuss the rare localisation of chondroblastoma and its differential diagnosis with surface osteosarcoma.

We present 6 children with Ehlers-Danlos syndrome (EDS) with concomitant joint contractures. In 3 of them bilateral clubfeet together with hip, and (or) knee, or wrist flexion contractures were observed. In all of them, after initial soft tissue surgery for clubfeet, reccurences were noted requiring another surgery. Clubfeet were the only manifestation of joint contractures in another 2 children. In one of them soft tissue surgery was succesful, in the second a hypercorrection was noted. One child with EDS had a recurvatum knee deformity which was succesfully treated conservatively. We speculate on two different forms of EDS with joint contractures: a mild one, in which clubfeet are the only joint contractures, and in which a soft tissue surgery may lead to overcorrection, and a severe one, with multiple joint contractures like in arthrogryposis multpiplex congenita, in which soft tissue surgery for clubfeet and joint contractures may lead to reccurences.

Nine wrists in eight patients were treated surgically between 1988 and 2003 for symptomatic Madelung's deformity. The pain of involved wrist followed by forearm deformation fulfilled criteria for surgery. Closing wedge osteotomy of the distal radius were carried out eight times accompanied by shortening of the ulna (four patients), excision of the distal ulna (one patient), and no ulnar surgery (three patients). Pain relieved after surgery. The follow up period ranged from 1 to 9.5 years. No pour results were stated in subjective patient's estimation during final check up. Wrist appearance were stated to be satisfactory. Limitation of the range of motion concerning supination and pronation of the forearm were stated invariably. X-ray retrospective assessment of the inclination angle, lunate coverage and presence of arthritic changes were conducted. Time and method of surgical treatment for Madelung's deformity should be considered individually.

We present a strategy of a complex rehabilitation in children with pffd before and after Van Nes rotationplasty. The rehabilitation proces is divided into tree stages: preoperative, in which general exercises, swimming etc. are used to improve patient's general phisical condition with special care to improve ankle range of motion and to strenghten the muscles: gastrocnemius, quadriceps femoris and glutei on the afected side. Second stage begines whith the cast removal. Gentle ankle manipulations, passive and in about a 0 days after the cast removal, active ankle movements are excercised. The last stage begins when individual prosthesis is made and the patient begins to learn how to stand and to walk with proper active "knee" flexion and extension and with proper foot progression angle, initialy with cruthes on flat surface, and finnally, about 3 months after the surgery without cruthes, also on stairs. A good cooperation with the child's parents and with the child itself is necessary to have a success in the rehabilitation process.

We present 33 children with 34 elbow dislocations. In 22 cases concomittant fractures around the elbowe were noted: 13 displaced medial epicondyle fractures, 5 radial neck fractures, 2 radial head fractures, 2 coronoid process fractures, 1 olecranon fracture, 1 lateral condyle fracture, 1 medial condyle fracture. In 5 children more than one concomittant fracture were noted. The mean age during dislocation was 11 years (from 4 to 15), the mean follow up period was 3.5 years (from 2 to 5). On follow up a clinical examination of the elbow was performed including axis assesment and elbow ROM. X-ray were taken in all children in AP and lateral view. All children had a satisfying function of the extremity and no pain was noted. No difference in ROM was noted in children with isolated elbow dislocation or with concomittant medial epicondyle fractures however in 3 of those children a persistent flexion contracture was observed. Among children with other fractures poorer results occured in 3 patients, specially after displaced radial neck fractures. In one of them there was slight supination and pronation restriction, in second a complete ankylosis of proximal radioulnar joint occured in neutral forearm position. In one child after elbow dislocation and medial condyle fracture a late radial dislocation occured. We think that concomitant medial epicondyle fracture does not impare good results of elbow dislocation treatment if well recognised and treated. Other fractures, specially radial neck fractures, increase the risk of complications.

This article describes our clinical experience with the so-called biological methods of reconstruction after limb salvage bone tumor resections. Depending on the localization and resection type (transarticular, extraarticular) we have used various types of auto- and allogenic bone grafts, arthrodesis, arthrodesis with elongation, and Van Nes rotationplasty. The advantages and disadvantages of these methods are discussed.

We present the significancy of the hip USG examination in the diagnosis of the clinically silent developmental hip dysplasia (DDH). The clinical and ultrasonographic hip assessment were performed in 972 children and sonographic abnormalities silent in clinical examination were stated in 155 of them (15.9%). Physiological immaturity was stated in 87% of this group. An orthopedic treatment was nessesery in 34 children (3.5% of cohort). Children with pathological hip dysplasia (type II D or above according to the Graf classification) with no pathological signs in clinical assessment constituted 0.25% of the cohort. We claim the USG examination of the infant hip is a method of choice in the early diagnosis of the DDH and the only method to detect clinically silent DDH.

The authors present early results of conservative treatment in congenital clubfeet connected with the percutaneous tendon Achilles tenotomy in 10 children (16 feet). 9 feet were of type III and 7 of type IV according to the Dimeglio scale. Minimum follow up was 6 months, with an average follow up period of 10 months. All cut Achilles tendons regenerated completely. On follow up 9 feet were completely corrected, 5 presented with mild forefoot adduction and 2 feet required surgery because of recurrent equinovarus deformity. The authors claim that the percutaneous tendon Achilles tenotomy is a safe and valuable procedure which allows to avoid early surgery in 88% of clubfeet.

We resected eight calcaneus-navicular bars in six children. The average age at the surgery was fifteen years, and the average follow up period was four years. In all cases the extensor digitorum brevis was interposed into the gap created by an excision of the bar. On the follow up three feet were painfree and four were occasionally painful. In one case a coalition recurred, and the pain did not improve. The ankle range of motion was normal in all cases, whereas the subtalar motion was limited in three feet, and normal in the remaining five.

The authors present a review of literature of the past 40 years, relevant to the pathological anatomy of congenital clubfoot and their own views--based on intra-operative observations. Performing Goldner's procedure the authors noted the talar bone was rotated internally, as a whole and externally in relation to the forefoot. The head and neck of the talar bone were deviated medially in relation to the trochlear axis. These deformities lead to pronation and supination movements instead of the normal flexion and extension of the foot. The authors believe a wide capsulotomy with resection of the ligaments is necessary to achieve proper clubfoot correction.

Between 1996 and 2000 the authors followed-up 6 children with congenital hypertrophy of 7 feet. Surgical treatment was performed in 4 children (4 feet). The average age at the time of surgery was 9 years, and the average follow-up period was 3 years. 2 cases of macrodactyly of the I and II rays of the foot and 1 case of macrodactyly of the II ray of the foot were observed. Amputations of phalanges or toes in all 3 cases were performed with amputations of distal parts of adjacenet metatarsals in 2 cases. Soft tissue debulking was routinely done. Operative treatment of 1 case of the foot gigantism connected a resection of the IV and V metatarsals, a removal of the III metatarsal, an epiphysiodesis of II metatarsal and an amputation of all toes at the MIP joint level. A good cosmetic result was achieved in all children with macrodactyly and all of them were normal shoes. The treatment in the case of foot gigantism yielded good functional result and satisfactory cosmetic result. The patient required orthopaedic foot-wear. In the authors' opinion the resection of the lateral rays of the foot is superior the central ray resection.

The authors present the results of surgical treatment of resistant idiopathic and recurrent clubfoot (type IV according to Dimeglio classification). In the group who underwent a primary procedure, results were noted according to the Magone classification: 35.7% very good results, 11.9% good results, 9.52% satisfactory and 42.5% bad results (recurrent clubfeet accounts for 37.5%). The authors noted that the Goldner technique yields results comparable to the peri-talar release technique.