Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2018
[Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis].
PURPOSE OF THE STUDY The triplane fracture of the distal tibial epiphysis is characterised by the fracture line in typical three planes which can, however, differ case by case. The authors use the CT imaging as the perfect examination method to determine the nature of the fracture to plan the osteosynthesis. MATERIAL AND METHODS In the five-year retrospective study of a group of patients treated at their own department in the period 2011-2015 the authors assess a total of 55 patients with a triplane fracture. ⋯ CONCLUSIONS An X-ray obtained from 4 views is a standard examination in diagnosing a triplane fracture. A CT scan than makes it possible to precisely locate the fracture line, to determine the size of fragments and to plan the optimal placement of osteosynthetic material. Key words: tibial fractures, distal tibia fractures, paediatric fractures, triplane fracture, physeal fracture, CT imaging, minimally invasive osteosynthesis, treatment of distal tibia, osteosynthesis planning.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Randomized Controlled Trial[Long-Term Results of Computer-Navigated Total Knee Arthroplasties Performed by Low-Volume and Less Experienced Surgeon].
PURPOSE OF THE STUDY The study aims to evaluate the long-term results of computer-navigated total knee arthroplasties performed by less experienced surgeon performing a small number of procedures per year. MATERIAL AND METHODS In the prospective randomised study functional and radiological results, rate of revision and probability of clinical and radiological survival were compared in 30 computer-navigated (in 28 patients: 19 women, 9 men, with the mean age of 66.9 years) and 31 conventionally implanted (in 30 patients: 27 women, 3 men, with the mean age of 66.5 years) cemented total knee replacements without patellar resurfacing. The group was composed of patients who underwent surgery performed by the same surgeon who at the time of enrolment of patient in the study had no previous experience with the total knee replacement surgery and performed up to 30 such procedures annually. ⋯ However, the question remains unanswered if more accurate positioning of the implants achieved with computer navigation decrease the revision rate and extend the long-term survival of knee endoprostheses. CONCLUSIONS Kinematic computer navigation allowed a less experienced and low-volume orthopaedic surgeon to make the implantation of endoprostheses more accurate, to decrease the total revision rate, and thus to ensure a higher probability of long-term survival of total knee arthroplasties. Key words:computer navigation, total replacement, knee joint, long-term outcomes, low-volume surgeon, less experienced surgeon.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Establishing an Interdisciplinary Compulsory Elective Subject 'Spine' in the Curriculum of the University Study Course of Human Medicine.
PURPOSE OF THE STUDY Back pain and pathologies of the spine are among the main reasons why people consult a doctor, both general practitioners and paediatricians, as well as, specifically, orthopaedists, surgeons, and neurosurgeons. This involvement of different faculties calls for a high degree of interdisciplinary co-operation. In order to mediate these aspects of spine-specific diagnostics, therapy, and research to students during their studies and to promote up-and-coming specialists, the compulsory elective subject 'Spine' was established. ⋯ The compulsory elective course continues to be offered in the curriculum with a slightly altered schedule. CONCLUSIONS In view of the high prevalence of patients with back pain and its associated importance in terms of healthcare policy and social relevance, our experience leads us to recommend the general integration of such a compulsory elective subject in the study of human medicine. Key words:elective subject, spine, students, spinal disorders.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Observational Study[Changes in Cognitive Functions after Total Hip Arthroplasty].
PURPOSE OF THE STUDY The postoperative delirium is a frequent, oftentimes underestimated complication of total hip arthroplasty. Its occurrence is reported to be between 10% and 50%. The postoperative delirium increases mortality, the length of hospital stay and leads to worse functional results. ⋯ CONCLUSIONS Our study clearly showed that a highly sensitive test to detect the current changes in cognition in a short-term horizon is the Abbreviated Mental Test Score. Based on the statistically significant factors determining the onset of the change in cognition that we had revealed, we elaborated a clearly arranged scheme of identified risk factors and interventions for the prevention and early identification of the onset of changes in cognitive functions and potential delirium. Key words:total hip arthroplasty, cognitive impairment, delirium.
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PURPOSE OF THE STUDY The aim of our study was to determine the indications for radial head resection at the present day. MATERIAL AND METHODS The radial head resection was performed in the period from 2008 to 2015 in 63 patients divided into three groups. The first group marked "CR" consisted of 33 patients with the Mason type III fracture. ⋯ Serious complications occurred only in cases when the fracture was accompanied by a concomitant injury, i.e. in the Mason-Johnson type IV fractures and in concomitant proximal ulna fracture. When an indication for radial head resection is made, it is essential to correctly diagnose the injury which is clearly a contraindication to this method, i.e. the Essex-Lopresti and the "terrible triad" injuries. Key words: fracture, radial head, resection.