Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2015
[The effect of platelet-rich plasma on graft healing in reconstruction of the anterior cruciate ligament of the knee joint: prospective study].
PURPOSE OF THE STUDY Growth factors produced by platelets enhance tissue healing. The aim of this study was to confirm or disprove the hypothesis that, in anterior cruciate ligament (ACL) reconstruction, the application of platelet-rich plasma (PRP) into the tibial and femoral tunnels and in the graft enhances graft maturation and graft-bone interface healing and thus improves knee function at 3 and 12 months post-operatively in comparison with the control group. MATERIAL AND METHODS A total of 40 patient had the surgery; 20 underwent single-bundle hamstring reconstruction with PRP application (PRP group) and 20 had the same surgery without PRP addition (control group). ⋯ The function scoring results showed a statistically significant improvement in knee function between 3 and 12 months of followup within each group studied but revealed no difference between the groups. The hypothesis postulated above was disproved. Key words: anterior cruciate ligament, platelet-rich plasma, anatomic single-bundle reconstruction.
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Acta Chir Orthop Traumatol Cech · Jan 2015
[Surgical Stabilisation of Flail Chest Injury: Indications, Technique and Results].
Multiple rib fractures with segmental chest wall instability are caused by high-energy chest trauma and are associated with significant morbidity and mortality. Flail chest injuries are mostly combined with lung injury (contusion, rupture, laceration) and subsequent pneumothorax or haemothorax. Early mechanical ventilation with internal pneumatic splinting is a conservative treatment for flail chest in patients with respiratory insufficiency. The surgical stabilisation of a flail chest is an effective method of treatment and is beneficial for selected patients. It shortens the duration of mechanical ventilation and thus reduces morbidity associated with prolonged ventilatory support. In addition, it decreases long-term pain and the inability of a flail chest to heal due to malunion, non-union or progressive collapse of the flail segment. Surgical stabilisation of a flail chest is indicated when the clinical examination shows progressive respiratory dysfunction confirmed by the results of multiple detector computer tomography (MDCT) of the thorax. ⋯ Surgical stabilisation of the flail chest segment is considered an effective procedure in selected patients, leading to improvement of respiratory function. By allowing for a shorter period of time on mechanical ventilation, it reduces the occurrence of complications due to ventilatory support. The result of MDCT chest examination in patients with fail chest is an important indication criterion for surgical fixation.
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Acta Chir Orthop Traumatol Cech · Jan 2015
[Kirschner wire transfixation of unstable ankle fractures: indication, surgical technique and outcomes].
PURPOSE OF THE STUDY The aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODS Between 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. ⋯ The temporary transfixation provides good alignment of the ankle joint necessary for successful healing of soft tissues. A higher occurrence of post-traumatic ankle osteoarthritis, ossification and distal tibiotalar synostosis found in the patients treated by temporary transfixation is more related to serious types of ankle fractures the patient had suffered than to the method itself. Key words: unstable ankle fracture, soft tissue condition, indications for transfixation, treatment outcome.
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Acta Chir Orthop Traumatol Cech · Jan 2015
[Bone Remodelling in the Proximal Femur after Uncemented Total Hip Arthroplasty in Patients with Osteoporosis].
The aim of the study was to investigate the involvement of osteoporosis during remodelling of the proximal femur after uncemented total hip arthroplasty (THA) and the effect of bisphospohonate treatment on these changes. ⋯ The results of our study showed that the patients with untreated osteoporosis, who underwent uncemented THA, experienced a considerable decrease in the periprosthetic bone density of the proximal femur and were in worse clinical health. A bisphospohonate therapy was effective in eliminating this negative outcome. Both the clinical and densitometric findings in patients with treated osteoporosis were similar to those in patients with no osteoporosis.
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Acta Chir Orthop Traumatol Cech · Jan 2015
Measurement of compartment elasticity using pressure related ultrasound: a method to identify patients with potential compartment syndrome.
PURPOSE OF THE STUDY Decision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. ⋯ Further studies are required to prove whether this assessment is transferable to human muscle tissue. Determining the complete compartmental elasticity by ultrasound enhancement, this application may improve detection of early signs of potential compartment syndrome. Key words: compartment syndrome, intra-compartmental pressure, non-invasive diagnostic, elasticity measurement, elastography.