Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2014
ReviewBiomechanical and biological aspects of defect treatment in fractures using helical plates.
The clinical case of figure 1 through figure 11 shows a series of impressive failures of plate fixation. The plates were repeatedly applied bridging a comminuted bone segment in a heavy patient. The biomechanical analysis elaborates why this happened and proposes an unconventional procedure to prevent this failure with a minimally invasive procedure. ⋯ A. D. Fernandez.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Axial lumbar interbody fusion: prospective monocentric study].
The aim of this prospective study was to evaluate clinical and radiographic results in the patients who underwent L5-S1 fixation using the technique of percutaneous lumbar interbody fusion (AxiaLIF). ⋯ The percutaneous axial pre-sacral approach to the L5-S1 interbody space with application of a double-treaded screw is another option for the management of this much strained segment. The technique is useful particularly when contraindications for conventional surgical procedures are present in patients with anatomical anomalies, in overweight patients or in those who have had repeated surgery in the region. Clinical outcomes and the success rate for L5-S1 bone fusion are comparable with conventional techniques. Complications are rare but their treatment is difficult.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Surgery for degenerative spondylolisthesis of the lumbar spine using intra-articular fusion. A prospective study].
The aim of the study is to present our surgical method of treating degenerative spondylolisthesis, which includes radical bilateral laminectomy to relieve compression on the spinal cord, transpedicular fixation of the segment and arthrodesis by bilateral intra-articular fusion. ⋯ At 1-year follow-up all patients showed better health conditions, with improvement in average scores for the ODI by 57%, for low back pain by 77% and for radicular and claudication pain by 82%. The technique of intra-articular fusion for treatment of degenerative spondylolisthesis resulted in solid bone fusion and spinal stability in all patients.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[The effect of anticoagulation and anti-aggregation treatment on the extent, development and prognosis of acute craniocerebral injury].
A retrospective analysis of the effect of anticoagulation and anti-aggregation treatments on the post-injury clinical status, frequency of necessary surgical interventions including re-operations, course of intracranial haemorrhage dynamics and treatment outcome in patients with acute traumatic intracranial haematoma. ⋯ The results did not confirm any statistically significant adverse effects of anticoagulation or anti-aggregation treatment on the severity of post-injury status and risk of intracranial bleeding progression. The incidence of poor outcomes is higher in anticoagulated patients than in anti-aggregated patients. Although not reaching the level of statistical significance, the results also indicate higher risk of significant haemorrhagic brain contusions in anti-aggregated patients.
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Fractures of the thoracic spine involve injury at the levels of Th2 to Th10. Because of pedicle morphology, pedicle screw fixation is a demanding procedure. However, evidence on the reliability and efficiency of this technique has recently been provided by several studies. The aim of this study was to analyse a group of patients with thoracic spine fractures treated by pedicle screw fixation and to evaluate treatment outcomes. ⋯ Pedicle screw fixation of thoracic spine fractures is a safe therapeutic method with a low risk of complications. It facilitates effective reduction and stable fixation with a low risk of secondary displacement and implant failure. Key words:transpedicular stabilisation, thoracic spine, fracture, pedicle screws.