Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Treatment of Extensive Chondral Defects of the Patella after Patellar Dislocation].
PURPOSE OF THE STUDY Patellar dislocation is a fairly frequent knee joint injury in young patients. In most cases, this injury can be treated conservatively or surgically. In many cases, patellar cartilage or lateral femoral condyle or both these parts of articular surface are injured, and in conservative treatment this chondral damage very often remains undiagnosed. ⋯ CONCLUSIONS Where a serious, extensive fragment of patellar cartilage is found, the fixation of cartilage with the use of transosseous PDS sutures brings very good and good results, without the necessity of another surgery, while the simultaneous treatment of medial patellar retinacula considerably decreases the risk of patellar re-dislocation, thus reducing the risk of further damage to cartilage of patelofemoral joint. The use of transosseous suture fixation is considered by the authors to be more appropriate than the use of screws, mostly because no further surgery to remove fixation screws is necessary. Key words: acute patellar dislocations, chondral lesions, chondral repair, arthroscopy.
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Acta Chir Orthop Traumatol Cech · Jan 2017
Randomized Controlled Trial Comparative Study[Comparison of Short-Therm Results of Conservative versus Operative Treatment of Distal Ulna Fractures Associated with Distal Radius Fracture Treated by Plate Osteosynthesis].
PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow-up period of 24 months (6-36). All the fractures of distal two thirds of ulnar styloid process were treated conservatively. ⋯ The operative treatment of subcapital ulna fracture had a very good early outcome as compared to conservative treatment of the fracture which healed in malunion, the change of axial position of the distal end of the bone resulted in a limited range of forearm mobility. CONCLUSIONS Based on the early functional and radiographic outcomes of RCT study it can be stated, in agreement with the other authors, that the operative treatment of distal ulna fractures associated with the distal radius fracture treated by ORIF should be indicated for base fractures of ulnar styloid process associated with DRUJ instability following the osteosynthesis of distal radius fracture and peripheral fragment dislocation ad axim or ad latus in radial direction by 2 mm and more, and also in case of displaced ulnar head fractures and instable and displaced subcapital fractures of the ulna. Key words: distal ulna fracture, plate osteosynthesis, LCP distal ulna plate.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Periprosthetic Femoral Fractures after Total Hip Replacement: Our Results and Treatment Complications].
PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). ⋯ Poor bone quality is a common feature, therefore a perfect mechanical fixation is necessary. The long-term results are affected primarily by the patient s age. Key words: periprosthetic femoral fractures, surgical treatment, results, complications.
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Acta Chir Orthop Traumatol Cech · Jan 2017
Comparative StudyThe Impact of Caregivers' Anxiety on Patients' Anxiety before Fast-Track Knee Arthroplasty.
PURPOSE OF THE STUDY Anxiety may have negative repercussions on the surgery including poorer outcomes. On the other hand, the majority of patients reporting preoperative anxiety fear not receiving enough attention from a caregiver. In patients undergoing fast-track knee arthroplasty, we determined the relationship between patients' preoperative anxiety and the anxiety the patient's caregiver. ⋯ The anxiety of unrelated caregivers is associated with low preoperative anxiety among patients. Preoperative interventions should focus on caregivers, especially male caregivers, and to related caregivers to help patients cope with anxiety before knee arthroplasty. Key words: knee arthroplasty. knee replacement. fast track, anxiety, caregiver, preoperative stress.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Four-Corner Arthrodesis of the Wrist with Dorsal Circular Plate - a Retrospective Monocentric Study].
PURPOSE OF THE STUDY Our study aimed to evaluate a group of patients who in the period from 2005 to 2014 underwent a four-corner arthrodesis of the wrist in our department. We also wanted to verify the hypothesis as to whether the use of conventional dorsal plate without the application of bone grafts leads to comparable results as the use of dorsal locking plates and routine application of bone grafts. MATERIAL AND METHODS Throughout the years 2005 to 2014 the four-corner arthrodesis of the wrist was performed in our department in a total of 62 patients, in two cases bilaterally. ⋯ In our group of patients, we confirmed the hypothesis that equally good results as with the use of locking plates can be achieved when using a non-locking plate system. Essential is the proper correction of DISI and primary good congruence between fused carpal bones instead of the use of bone grafts. Key words: SLAC wrist, SNAC wrist, four-corner arthrodesis, partial wrist fusion.