Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2016
[Treatment for Periprosthetic Femoral Fractures after Total Hip Arthroplasty].
PURPOSE OF THE STUDY To give a description of the patient group, risk factors, classification, therapeutic procedures and treatment outcomes in periprosthetic femoral fractures after total hip arthroplasty treated in the Trauma Hospital in Brno. MATERIAL AND METHODS This retrospective study comprised of 51 patients treated for a periprosthetic femoral fracture between 2003 and 2013. This included 19 (37%) intra-operative and 32 (63%) post-operative fractures. ⋯ Osteosynthesis as a single procedure is indicated only if the femoral component is stable and well fixed. When the stem in B2 and B3 fractures is loose, revision surgery with stem replacement is necessary. Key words: periprosthetic fracture, total hip atrhroplasty, Vancouver classification.
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PURPOSE OF THE STUDY Perilunate dislocations and perilunate fractures are serious wrist injuries which are often overlooked at primary treatment. Their inadequate therapy results in severe wrist damage and patient disability. An early diagnosis and correct therapy can prevent such conditions. ⋯ CONCLUSIONS Good outcomes in perilunate injuries depend on an early and correct diagnosis, an appropriate therapeutic procedure and an orthopaedic surgeon who has experience with management of such injuries. A deep knowledge of wrist kinetics is necessary for this therapy as not all injuries happen according to textbook descriptions. Key words: perilunate dislocation, carpal instability, damage to carpal ligaments.
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Acta Chir Orthop Traumatol Cech · Jan 2016
Medial Spike and Obesity Associate with Open Reduction in Type III Supracondylar Humeral Fracture.
PURPOSE OF THE STUDY Although supracondylar humeral fractures represent a major part of the pediatric fractures, no classification system or radiological characteristics describes which supracondylar fractures require open reduction. We aim to evaluate the factors that lead us to perform open reduction during operation. MATERIAL AND METHODS We retrospectively evaluated 57 patients who underwent operation for type III supracondylar fracture, and divided them into two groups; those with open reduction and internal fixation, and those with closed reduction and percutaneous fixation. The two groups were compared based on age, gender, BMI by age, medial spike angle of the fracture, medial spike-skin distance and rotation angle between the fractured fragments. RESULTS Of all patients, 46 (81.71%) underwent closed reduction and percutaneous fixation (CRPF) and 11 (19.29%) were treated with open reduction and internal fixation (ORIF). BMI by age was remarkably higher in the ORIF group (p = 0.00). And medial spike angle was smaller in the ORIF group (p = 0.014). DISCUSSION Closed reduction and percutanous fixation is the main treatment of supracondylar humeral fractuers. Open reduction in supracondylar humeral fractures could be associate with complications and cosmetic lesions. Many studies indicates that obesity is high risk factor for complex fractures as well as preoperative and postoperative complications. A prominant medial spike could associate with muscle entrapment, and obliquity of the fracture line. It could be also an indirect finding of instablity of the fracture. CONCLUSION We suggest that a smaller medial spike angle and a higher BMI in children with Type III supracondylar humeral fractures may require open reduction, and it is unreasonable to avoid open reduction in cases where closed reduction is not achieved. ⋯ supracondylar humerus, open reduction, obesity, medial spike angle.
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Acta Chir Orthop Traumatol Cech · Jan 2016
[Intra-Articular Application of Tranexamic Acid Significantly Reduces Blood Loss and Transfusion Requirement in Primary Total Knee Arthroplasty].
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. ⋯ The economic benefit is also worth considering. In agreement with the recent literature, it is suggested to add topical TXA application to the recommended procedures for TKA surgery. Key words: tranexamic acid, Exacyl, topical application, intra-articular application, blood loss, hidden blood loss, total knee arthroplasty, complications.
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Acta Chir Orthop Traumatol Cech · Jan 2016
Comparative Study[Anterior Superior and Anterior Interior Iliac Spine Fractures. Comparison of the Results of Conservative and Surgical Treatment].
Avulsion fractures of the anterior superior iliac spine (ASIS) and anterior inferior iliac spine (AIIS) are rare injuries to the skeleton in children. They are most frequent in adolescent athletes, such as sprinters and long-distance runners, and football players. The authors present a group of patients treated at their department and compare the results of procedures used to manage different pelvic avulsion fractures. ⋯ Indications for surgical treatment are based on the degree of fragment displacement and the patient's demands for sports activities. Although long-term outcomes of both operative and conservative procedures are comparable, the patients treated surgically show faster recovery and need a shorter time of immobilisation. However, removal of osteosynthesis material may be associated with some risk of complications.