Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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We describe the collection, storage and examination of allogenic bone grafts and their use in revision hip arthroplasty, indicated because of acetabular loosening, that involved either an uncemented cup or an augmentation device with a cemented cup according to the extent and nature of acetabular defects. ⋯ Our patients showed good allogenic bone ingrowth in relation to the acetabular bed and good bone restructuring and incorporation in relation to the implant. Neither mechanical failure of implants nor graft rejection were recorded. The risk of infection transfer was low and comparable with routine blood transfusion. The necessary prerequisite for revision hip arthroplasty is a well-operating bone tissue bank.
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Injuries of atlas account for 1-2% of all injures of the spine and for 7% of the injuries of the cervical spine. Fractures of atlas occur either as isolated fractures or in combination with the injury of the axis or occipital condyles. The aim of the work is to evaluate a group of patients with the injury of the atlas treated both conservatively and surgically. ⋯ Based on our own experience and the literary data we believe that suitable for the treatment of stable injuries of the atlas is conservative treatment, i.e. fixation in the Philadelphia collar for 12 weeks. In unstable injuries or intraarticular injures with dislocation we prefer surgical fixation of C1-C2 or C0-C2 in dependence on the type of injury. All associated injuries are indicated for surgical treatment.
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The authors present their 10-year experience with the computed tomography (CT) assisted insertion of implants in the sacroiliac (SI) region and acetabular region. Indications for these interventions and their detailed descriptions are reported. ⋯ The CT-guided surgical procedure allows us to assess both the shape and course of fracture lines or distance between the injured structures. It also enables us to choose the optimal direction, in relation to these structures, for an implant to be inserted and to respect important anatomical structures in the surroundings. It helps us to determine the exact length of implants to be used. During the procedure, repeated CT scans facilitate checking the direction and position of both instruments and implants. In the closing phase of the operation, it is possible to assess closeness of the bones screwed together, the definitive placement of the implants and their reliable fixation. This method also permits to check whether a screw did not penetrate through the opposite cortical bone.
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Acta Chir Orthop Traumatol Cech · Jan 2003
40-year experience in surgical treatment of congenital chest deformations--ethiopathogenesis, operative techniques and clinical results.
The aim of this study was to assess the results of surgical treatment of 58 patients with pectus excavatum and 11 with pectus carinatum and discuss the problems connected with ethiopathogenesis and operative techniques. ⋯ Ethipathogenesis of pectus excavatum and carinatum remains unsettled. Disturbances in endochondral ossification and growth of costal cartilage seem to be more probable cause of the deformities than diaphragm underdevelopment. Mild and severe forms of the two deformities result in circulatory-respiratory malfunctions, cosmetic defects and psychical problems. Due to possible circulatory-respiratory disorder, appropriate premedication as well as intra- and postoperative monitoring of RR, ECG, O2, CO2 are very important on the first day after the surgery. Ravistch-Garnier procedure for pectus excavatum and Chen procedure for pectus carinatum remain operations of choice. Transsternal traction can be replaced with internal stabilisation with a bar placed under the sternum what considerably reduces the time of hospitalisation but requires one more hospitalisation to remove the bar. Correction of pectus carinatum is permanent, correction of pectus excavatum turned out to be permanent in 90% cases providing that they were performed in patients aged 12-16. When patients were at the age 6-10, recurrence of the deformity occurred in 37% of cases. According to the clinical assessment, in both age groups, the proportion of very good or good scores equalled 70% and according to patient's evaluation--86.6%.
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Acta Chir Orthop Traumatol Cech · Jan 2003
Review Case Reports[Traumatic spondylolisthesis of L5-S1].
Pure traumatic bilateral lumbosacral dislocation is a rare injury with just eight cases reported in the literature. This condition occurred also in 36-year-old man, who was struck into the lower back by a falling tree, during a woodcutting, at the moment when he was kneeling and his spine was flexed. Neurological examination showed no signs of spinal nerves injury. ⋯ At a 24-month follow-up he was without any subjective complaints, neurologically asymptomatic and without restriction of mobility in the lumbosacral spine. He was able to resume his previous work. This rare case is discussed in a view of the relevant literature, biomechanics of trauma and the appropriate therapy with an emphasis on open reduction and internal fixation techniques.