Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Treatment of anterior glenohumeral instability: personal experience with an arthroscopic stabilization technique, its indications and results].
Arthroscopic treatment of anterior post-traumatic instability of the glenohumeral joint is a recent surgical procedure. The aim of this study was to evaluate the outcomes of the method and define criteria on which indications for this treatment are based. ⋯ The arthroscopic treatment of anterior post-traumatic glenohumeral instability, using the Wolf method, resulted in a reduction of recurrent dislocations, supposing indication criteria were observed. Its outcomes were comparable with the results of conventional open surgery.
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Current diagnostic and therapeutic approaches in liver injuries].
The recent improvements in hospital care system (centralized specialized care) and the use of new imaging methods and modern technologies in surgical treatment have greatly enhanced successful outcomes of therapy in liver injury. The aim of the study was to evaluate the contribution of procedures included in the diagnostic-therapeutic algorithms to the treatment of blunt injury to the liver in our patient population. ⋯ 1. The treatment strategy in a patient with blunt liver trauma is determined by the patient's hemodynamic status; in a stable patient, spinal CT examination of the thorax and abdomen is mandatory. 2. Urgent laparotomy is indicated when the patient with blunt liver trauma is hemodynamically unstable due to diagnosed hemoperitoneum or suspected intraperitoneal bleeding. 3. Conservative therapy is applied when the criteria for non-surgical treatment are fulfilled. 4. Surgical strategy for blunt liver trauma is based on the extent and localization of the injury, the patient's overall status and severity of associated injuries. Resection of the injured parenchyma is indicated when laceration of a liver lobe occurs. 5. The prognosis of blunt liver injury is influenced, apart from hemorrhagic shock reversibility, by the severity of associated injuries in multiple trauma.
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Acta Chir Orthop Traumatol Cech · Jan 2003
Less invasive stabilization system (LISS) in the treatment of distal femoral fractures.
The treatment of distal femoral fractures has been associated with a high rate of complications for a long time. Although implants and surgical techniques have improved, plate osteosynthesis and intramedullary nailing have been accompanied by a high occurrence of infection, non-union and malalignment. The treatment of soft tissue envelopes using "biological" osteosynthesis and minimally invasive approaches has resulted in a decrease in complication rates and ultimately led to the concept of the less invasive stabilization system (LISS). ⋯ Infection, delayed union and non-union rates are low, as shown by yet unpublished data from our clinic. Primary bone grafting, which is rarely necessary with this system, is carried out only when there is a great bone loss. Implant failure, such as screw loosening or secondary malalignment, is not seen.
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Treatment of deep chondral defects of the knee using autologous chondrocytes cultured on a support--results after one year].
The treatment of deep chondral defects is one of the key issues in current orthopedics and traumatology. We developed a new technique that greatly improved the outcome of treatment in young active patients. The method is based on transplantation of in vitro cultured autologous chondrocytes carried on the fibrin glue Tissucol. ⋯ The method described is effective for treating deep chondral knee injuries and can be recommended for use in clinical practice.
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Acta Chir Orthop Traumatol Cech · Jan 2003
Case Reports[Vertebral osteoid osteoma--peroperative detection of its nidus using a surgical gamma probe].
The case of a vertebral osteoid osteoma localized in the arch and pedicle of the fourth lumbar vertebra in a young girl is described. The condition was manifested by the development of scoliosis, which was also the initial diagnosis. Because of painful muscle contractions and persistent pain at night, osteoid osteoma was suspected and then confirmed by scintigraphy. ⋯ One year later she was without any complaints, fusion was healed and she had no relapse. The aim of this study was to draw attention to this less known and therefore less frequently employed method that may enable the surgeon to detect conditions otherwise difficult to localize. This method can also be used for other body sites if the lesion treated accumulates radionuclides.