Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Correction of kyphotic deformity of the cervical spine in ankylosing spondylitis using pedicle subtraction osteotomy of the seventh cervical vertebra].
The aim of the study is to present the technique of pedicle subtraction osteotomy (PSO) of the seventh cervical vertebra (C7) for correction of rigid kyphotic deformity of the cervicothoracic junction (C/Th) in patients with severe ankylosing spondylitis (AS).. ⋯ Corrective osteotomy of a rigid kyphotic deformity at the C/Th spine level in AS patients involves a complex reconstructive surgical procedure. The PSO technique reduces the risk of injury to the visceral structures ventral to the spine, and provides optimal conditions for bone healing at the site of vertebral body resection. If the patient heals well, a successful PSO procedure will markedly improve the quality of his/her life.
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Acta Chir Orthop Traumatol Cech · Jan 2014
The risk of neurovascular injury in minimally invasive plate osteosynthesis (MIPO) when using a distal tibia anterolateral plate: a cadaver study.
Percutaneous plating of the distal tibia via a limited incision is an accepted technique of osteosynthesis for extra-articular and simple intra-articular distal tibia fractures. The aim of this study was to analyze structures that are at risk during this approach. ⋯ Caution is advised when using anterolateral minimally invasive technique for plate insertion and screw placement in the distal tibia due to great variability in the neurovascular structures that course distally in the lower leg and cross the ankle.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Failure of the primary treatment of displaced supracondylar humerus fractures in children].
The aim of the study was to retrospectively evaluate the treatment outcomes of displaced supracondylar humerus fractures, including potential complications, in children treated at the Department of Paediatric General Surgery, Orthopaedics and Trauma Surgery of the Faculty of Medicine in Brno between 2000 and 2011. ⋯ Supracondylar humerus fracture is, regardless of advancements in therapy, an injury with an uncertain treatment outcome and a high percentage of complications. Since primary osteosynthesis failed in 20% of the patients treated by simple reduction under general anaesthesia and plaster cast immobilisation, for the patients requiring fracture reduction under general anaesthesia, the authors recommend one-stage primary treatment including K-wire transfixation. Re-displacement after primary osteosynthesis was always due to a technical error during the surgical procedure and can, therefore, be avoided by a precise operative technique.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Anatomy notes on minimally invasive plate osteosynthesis of the proximal humerus. A cadaver study].
The aim of the study was to assess the average length of a proximal and a distal incision, to verify the location of the axillary nerve and to identify risk factors for nerve injury during minimally invasive plate osteosynthesis. ⋯ The anterolateral approach is, when respecting the anatomical position of the axillary nerve, a safe alternative to the conventional deltoideopectoral approach.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Shape-memory osteosynthesis for trapeziometacarpal joint arthrodesis].
Arthrodesis of the trapeziometacarpal joint is the method of choice in the treatment of degenerative arthritis of this joint. This procedure was indicated most frequently in middle-age patients doing hard manual labor. Methods for achieving a solid fusion of the trapeziometacarpal joint are known and often reported in the literature. Frequently, they are associated with some failure rate, particularly as concerns bone union. Our study presents a simple and effective method verified in cadaver specimens and then currently used at our department. ⋯ An arthrodesis of the trapeziometacarpal joint based on careful assessment of indication criteria proved to be a simple, effective and low-cost method of stable osteosynthesis that provided good conditions for solid fusion of the trapezium with the base of the fist metacarpal. It allowed for sufficient abduction and opposition of the thumb, thus permitting satisfactory hand grip strength and full involvement in everyday life activities and occupations. It provided stability of the thumb, its painless movement and good cosmetic looks.