Propriocepcja jest jedną z podstawowych składowych motorycznej części układu nerwowego człowieka. Do jej głównych zadań należy przede wszystkim odbieranie bodźców ze środowiska zewnętrznego i kontrolowanie odpowiedzi motorycznej w postaci wzbudzenia ruchu lub napięcia odpowiednich struktur tkankowych. Jej sprawne funkcjonowanie stanowi fundament prawidłowo funkcjonującego organizmu. W ciągu ostatnich kilkudziesięciu lat istota propriocepcji została doceniona przez szerokie grono naukowców, lekarzy specjalistów oraz fizjoterapeutów, którzy zgodnie podkreślają, iż jest ona kluczowym elementem zakończenia procesu rehabilitacji oraz pełnego powrotu do zdrowia pacjentów. Historia tego ciekawego zjawiska sięga połowy XVI wieku, jednakże swój prawdziwy rozkwit osiągnęła na przełomie XIX i XX wieku dzięki pracy Sir Charlesa Scotta Sherringtona.
EN
Proprioception is one of the basic components of the motor unit of human nervous system. It is mainly responsible for the external stimulus perception and motor response control in the form of movement or tissue contraction. It’s efficient function is the base of proper function of human organism. In last few years the issue of proprioception was appreciated by many scientists, specialists and physical therapists which declare that it is one of the most important elements in the ending of the rehabilitation process and patients full recovery. History of this interesting phenomenon is reaching the middle of the XVI century but the full achievement is dated in XIX century thanks to works of Sir Charles Scott Sherrington.
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A permanent on-call service for hand amputation (Replantation Service) was established in 2010 as the initiative of the Council of Polish Society for Surgery of the Hand. It is run by three qualified hand centres in Trzebnica, Poznań and Szczecin. The aim of the study was to present a summary of the almost three-year activity of this service. Material and methods. Over this period, a total of 435 cases of total amputations, subtotal amputations and other severe injuries to the hand were referred. Of these, 290 referrals (67%) were accepted and 141 (33%) rejected. Among accepted, there were 100 total (34%) and 113 subtotal (39%) amputations; 81 patients had other, severe hand injuries, such as crush, degloving and extensive wounds involving all tissues. Results. Young and middle-age males constituted the majority of patients with the mean age of 42 years (range 2-82). The most common injury was amputation of several digits (including thumbs) in one patient - 141 cases (48%), followed by amputations from the metacarpal- to the proximal forearm level -115 (39%) and elbow/arm level - 9 cases (3%). Niniteen patients (6%) had multi-level amputation or injury of the involved extremity. Replantation of the completely amputated extremity was performed in 83 patients (28%), revascularization in 95 (32%) and in 59 (20%) primary repair of the complex injuries. In 23 cases, the repair of tissue defects was performed with flaps, mostly with greater omentum. Survival rate was of 84% for replantations and 88% for revascularizations. Conclusion. Establishing of the Replantation Service constituted a significant progress in organization of the management of the most severest upper limb injuries.
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