Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2012
Review[Arthroplasty for intracapsular fractures of the femoral neck. Current concept review].
The authors discuss arguments concerning indications and selection of implants and operative techniques for arthroplasty in the treatment of femoral neck fractures. Their analysis is based on long-term experience with surgical treatment of patients with hip fractures and on the evaluation of a large number of publications by well-known specialists. The assessed group included 4795 patients treated at their institution between 1997 and 2010, of whom 1532 underwent hip replacement, with 1032 receiving hemiarthroplasty (HA) and 500 having total hip replacement (THR) indicated for femoral neck fractures. ⋯ Even if dislocation and loosening occur in these patients more often than in those with a THR procedure indicated for other reasons (primary or post-dysplastic arthritis), this therapy offers fewer complications and longer functioning in comparison with other methods of treating femoral neck fractures. A cemented prosthesis can be regarded as the standard implant; however, if the proximal femur shows good quality cortical bone, an uncemented implant can be used without a greater risk of future loosening. In the absence of hip arthritis which leads to the development of subchondral sclerosis required for the correct acetabular cup fixation, a hybrid THR with an expansion cup or a screw-in cup is recommended.
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Acta Chir Orthop Traumatol Cech · Jan 2012
Comparative Study[Comparison of patellar pain after total knee arthroplasty with conventional versus individual femoral rotational alignment].
The aim of the study was to find out whether the frequency and intensity of patellar pain can be affected by individual rotational alignment of the femoral component in total knee arthroplasty, as compared with the standard 3 degrees of external femoral rotation in conventional procedures. ⋯ An individual rotational alignment of the femoral component can significantly reduce the incidence of moderate to severe patellar pain or even need for revision surgery.
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Acta Chir Orthop Traumatol Cech · Jan 2012
ReviewManagement of hemodynamic unstable patients "in extremis" with pelvic ring fractures.
The hemodynamic status in patients with pelvic ring injuries is a major prognostic factor of an immediate mortality risk. Especially, patients "in extremis" are of high risk to die. This patient group is characterized by absent vital signs or being in severe shock with initial systolic blood pressure .70 mm Hg and/or requiring mechanical resuscitation or catecholamines despite >12 blood transfusions within the first two hours after admission. ⋯ Important parts of the initial treatment treatment concept include mechanical pelvic ring stabilization combined with hemorrhage control concepts. Mechanical stabilization is performed non-invasively by pelvic binder application or invasively by classical anterior pelvic fixation or posterior pelvic C-clamp, depending on the local available resources. In patients "in extremis" the concept of direct extraperitoneal pelvic packing is recommended, whereas in moderately unstable patients or in patients where persistant hemodynamic instability occurs despite shock therapy and mechanical stabilization and pelvic packing, arterial injury is ruled out by angiography followed by selected embolization of pelvic vessels.
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Acta Chir Orthop Traumatol Cech · Jan 2012
ReviewCurrent concepts review - fractures in the region of the elbow.
Elbow injuries continue to rise with increased athletic activity and life expectancy. Knowledge of anatomy and biomechanics of this sophisticated joint, various injury patterns, and the implication of injury to the static and dynamic stabilizers will result in improvement in specific diagnosis, and therapy. The surgical treatment of trauma to the adult elbow has evolved rapidly in recent years and many useful concepts and techniques have been established. This paper reviews the published scientific data and current opinion available to guide patient care.
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Acta Chir Orthop Traumatol Cech · Jan 2012
Comparative StudyComparison of the RTS and ISS scores on prediction of survival chances in multiple trauma patients.
Trauma represents the third cause of death after cardio vascular disease and tumors. Also in Iran, road accidents are one of the leading causes of death. Rapid evaluation of trauma severity and prediction of prognosis and mortality rate and probability of survival and rapid treatment of patients is necessary. One of the useful instruments for this is ISS and RTS scoring systems. This study evaluated 70 multi trauma patients in Fatemi trauma center affiliated to Ardabil University of medical science. ⋯ The ISS scoring system performed better than the RTS in predicting of mortality and probability of survival and the length of ICU stay and had high accuracy and can predict patients' outcome better by ISS measuring.