Ortopedia, traumatologia, rehabilitacja
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Ortop Traumatol Rehabil · May 2011
Management of displaced ankle fractures in elderly patients--is it worth performing osteosynthesis of osteoporotic bone?
Ankle fractures in the elderly with osteoporotic bones are often difficult to manage. It is debatable whether we should treat such fractures conservatively, surgically, or even plan primary arthrodesis. Furthermore, there is a risk of difficult or failed fixation. ⋯ Our results show that accurate reduction and internal fixation of ankle fractures in elderly patients is beneficial and associated with lower complication rates compared to MUA alone. The osteosynthesis failure rate was very low and patients spent less time in plaster and started physiotherapy earlier.
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Ortop Traumatol Rehabil · Sep 2010
Case ReportsUse of recombinant activated factor VII for reduction of perioperative blood loss during elective surgical correction of spine deformity in a Jehovah's Witness. Case report.
Planned surgical procedures at patients who refuse allogenic blood transfusion because of religious convictions are important problem, not only medical but also ethical and juristical. At the study authors report the successful use of activated recombinant factor VII (rFVIIa) for the reduction of perioperative blood loss in four years old child - Jehovah's Witness, who had planned Torode kyphectomy. Applied perioperative management together with preparing to surgery with erythropoietin allowed for reduction of blood loss and avoiding of blood transfusion. Authors state, that appropriate perioperative proceeding makes a possibility of safe surgical procedures also at patients who refuse the transfusion.
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Ortop Traumatol Rehabil · Sep 2010
ReviewClassical and modern classifications of luxations and fractures of thoracolumbar spine. Biomechanical and clinical aspects. Review of literature.
The authors present the advantages and disadvantages of the Denis and AO classifications based on a review of classical and recent literature concerning the evolution of classification of thoracolumbar spine conditions. The newest classification of fractures proposed by Vaccaro (TLICS - Thoracolumbar Injury Classification Severity Score) is discussed in detail. ⋯ The principles of modern operative treatment are briefly discussed. Short transpedicular segmental stabilization and immobilization is a commonly accepted approach in unstable fractures with neurological deficits.
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Ortop Traumatol Rehabil · Jul 2010
Radiographic evaluation of the results of total hip arthroplasty with the cementless Zweymüller endoprosthesis.
Cementless endoprostheses include the Zweymüller endoprosthesis. Extensive clinical and radiological investigations were carried out in the Department of Orthopaedics and Traumatology of the University of Medical Sciences in Poznań in 180 patients who had received this endoprosthesis between 1995 and 2004. ⋯ The Zweymüller Alloclassic endoprosthesis provides good stability of the acetabular component and the stem in the treatment of both primary and post-dysplastic degenerative changes. The Zweymüller stem provides good conditions for the integration of bone surface with the endoprosthesis, while the acetabular component facilitates the remodelling of the bone surrounding the implant.
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Ortop Traumatol Rehabil · May 2010
Cementless hip joint alloplasty complicated by intraoperative fracture of the femoral bone.
The aim of the study was to analyse the outcomes of hip replacement complicated by intraoperative femoral fractures and to analyse their effective management. ⋯ Unstable intraoperative femoral fractures during a hip replacement procedure are rare and occur mostly in patients with post-dysplastic hips with a narrow intramedullary canal. In cases of stable fractures of the trochanter and calcar region, 12 weeks of partial weight bearing without additional immobilization is a sufficient approach. The final results are satisfactory in most cases of intraoperative femoral fractures.