Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2014
Randomized Controlled Trial[Metal staples versus conventional suture for wound closure in total knee arthroplasty].
Surgical incision closure, as well as total joint replacement itself, plays a key role in the overall outcome of an arthroplasty procedure. Uncomplicated wound healing is the essential condition of successful rehabilitation and the patient's return to normal activities. Although there are many innovative suturing techniques which offer advantages, their safety is still being discussed. The aim of this prospective non-blind randomised study was to evaluate wound healing and complications in relation to skin incision closure with either conventional suture or metal staples. ⋯ Correctly performed skin suturing by means of metal staples is not associated with a higher complication rate and is therefore a simple, rapid, efficient and economical alternative to the conventional suture technique.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Comparative Study Clinical Trial[The effect of central anatomical single-bundle versus anatomical double-bundle reconstruction of the anterior cruciate ligament on knee stability. a clinical study].
PURPOSE OF THE STUDY A comparison of the efficacy of central anatomical single-bundle (CASB) reconstruction with that of double-bundle (DB) repair of the anterior cruciate ligament (ACL) in relation to knee stability in anteroposterior translation (APT), internal rotation (IR) and external rotation (ER) of the joint. MATERIAL AND METHODS A total of 40 patients were evaluated; 20 had ACL reconstruction by the CASB technique using hamstrings and 20 underwent DB repair surgery. The average age was 31.3 years, and the group included 22 men and 18 women with 19 right and 21 left knees. ⋯ The latter has the same effect on knee stability as the presence of the AM bundle alone. When the PL bundle is added, knee stability, in both APT and internal/external rotation, is increased in comparison with central single-bundle ACL repair. Key words:anterior cruciate ligament, navigation, central anatomical single-bundle reconstruction, double-bundle reconstruction.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Is platelet-rich plasma injection an effective choice in cases of non-union?
By the expression of several growth factors from activated thrombocytes, the application of Platelet Rich Plasma (PRP) stimulates angiogenesis and regeneration thus stimulating recovery through cell differentiation. This study aimed to evaluate the effects of PRP injection on patients who had undergone surgery for fracture and in whom delayed union or nonunion had been determined. ⋯ Fracture healing is a process affected by many factors. Although PRP has been reported in literature to be a biological treatment which increases healing, adequate healing was not determined in the treatment of non-union with PRP injection. However, in selected patients determined with delayed union, PRP injection can be recommended in non-surgical treatment.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Case Reports[Middle-third clavicle fracture with ipsilateral acromioclavicular dislocation].
A rare case of a middle-third clavicle fracture concurrent with ipsilateral acromioclavicular dislocation in a 46-year-old women who had fallen off her bicycle is presented. The clavicular fracture was managed by locking plate osteosynthesis. ⋯ Both the radiographic and clinical outcomes were very good. The epidemiology, aetiology, diagnosis and therapy of this injury are discussed.
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Acta Chir Orthop Traumatol Cech · Jan 2014
ReviewFemoral shaft fractures in adults: treatment options and controversies.
Antegrade reamed femoral nailing via the piriformis entry point is the technique of choice in treating femoral shaft fractures, with retrograde nailing as an alternative. The supine position is favored to reduce complications, especially rotational malalignment. With navigation and robotic assistance fracture reduction can be supported and the rate of rotational, axis and length malalignement can potentially further reduced. ⋯ In multiply injured patients reamed nailing can be safely integrated in the DCO- or ETC-concept and can be performed in the majority of patients, even when additional severe chest and head injuries are present. Initial resuscitation should focus on general stabilization before definitive femur fixation. Plate osteosynthesis of the femur can be an option in selected patients.