Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Surgical management of talus fractures: mid-term functional and radiographic outcomes].
The aim of this prospective study was to present injury characteristics and to evaluate therapeutic procedures and midterm functional and radiographic results of the surgical management of talus fractures. ⋯ Our results confirmed that the management of talar fractures by means of osteosynthesis is indicated even in nondisplaced Hawkins type 1 fractures, staged treatment is effective in dislocated and open fractures, delayed surgery is a safe procedure for less dislocated fractures and injuries requiring complex care should be referred to foot surgery centres.
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Acta Chir Orthop Traumatol Cech · Jan 2013
Supraacetabular external fixation for pain control in geriatric type B pelvic injuries.
PURPOUSE OF THE STUDY: Pelvic ring fractures in the geriatric population are of increasing frequency. Often insufficiency fractures or occult fractures are described. With a classical injury mechanism the majority of these injuries are the result of a low energy trauma, typically a fall from standing or during walking.Clinically, many patients report immediate anterior groin pain but detailed clinical examination often shows significant posterior pelvic pain. CT evaluation often reveals posterior pelvic ring injury, in the majority of cases a sacral compression fracture. Despite adequate diagnostics, many of these patients suffer from persistent pain, which can be observed up to 8 weeks after injury. To asses the role of external fixator in pain relief and early mobilisation in this group of patients the study was performed. ⋯ This simple operative procedure, therefore, can be used for pain control and sufficient mobilization to avoid secondary medical complications.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Use of the Omega plate for stabilisation of acetabular fractures: first experience].
The aim of our study is to solve the problem of insufficient fixation of comminuted fractures of the quadrilateral plane and the iliopectineal line. These fixation problems occur while using the standard narrow 3.5 mm fixation plate applied from a modified Stoppa approach. A new plate developed by the authors--the Omega plate--fulfils the requirements. ⋯ The Omega plate enables us to fix fractures of the superior pubic ramus, fractures of the anterior acetabular column, fractures of the quadrilateral acetabular plate, fractures in the iliopectineal line and simple fractures of the posterior column. A CT-defined projection of the pelvic inlet based on pre-operative CT scans allows us to choose the appropriate plate size and to shape the plate pre-operatively. After a technically well performed Stoppa approach and good fragment reduction, the application of an Omega plate is easy if our recommendations are followed. Fixation of all fragments of the anterior column and the quadrilateral plate is very stable and the Omega plate is highly resistant to secondary loss of reduction. A potential total hip arthroplasty does not require Omega plate removal.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Scapular fracture related to polytrauma severity in patients with serious brachial plexus palsy].
Brachial plexus palsy is often accompanied by other injuries. Scapular fracture is thought to be a marker of polytrauma severity. The aim of this study was to evaluate associated injuries in patients with serious brachial plexus involvement and to determine whether there is a relationship between scapular fracture and severity of polytrauma in such patients. ⋯ Both scapular fracture and serious brachial plexus injury are usually associated with other severe injuries. They occur due to high-energy trauma. Generally, patients who sustain scapular fractures and upper limb impairment in motorcycle and car crashes are at high risk of other associated injuries and more severe polytrauma.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Complications associated with surgical treatment of pelvic ring fractures].
A retrospective analysis of complications associated with surgical treatment of pelvic ring fractures. ⋯ The characterisation and evaluation of complications associated with the management of pelvic ring fractures is problematic because it is difficult to distinguish which of them have been caused by pelvic ring fracture and associated injuries and which are due to surgical treatment. Although most complications arise from injury, the increasing role of surgery in their treatment leads to a higher rate of iatrogenic complications most frequently resulting from an improper surgical technique, including fracture reduction and/or fixation.