Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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PURPOSE OF THE STUDY Periprosthetic distal femoral fractures (PDFF) constitute an unpleasant complication in patients with a total knee replacement (TKR). The incidence reported in literature is 0.3-2.5 %. The number of periprosthetic knee fractures has been increasing due to the ageing of population, a growing number of implants, a longer life expectancy of patients, a more intensive physical activity of patients, and osteoporosis. ⋯ Very distal fractures classified as Su Type III with a loose femoral component require a revision surgery with a TKR with stems. The surgeon should be prepared for a revision surgery if the intraoperative finding is more complicated than anticipated based on the preoperative radiograph. Key words:total knee arthroplasty, periprosthetic fracture, osteosynthesis.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Avascular Necrosis of Femoral Head and Coxarthrosis Progression after Acetabular Fractures].
PURPOSE OF THE STUDY Non-operative and operative treatment of acetabular fractures is associated with a risk of development of posttraumatic avascular necrosis of femoral head or with the development of posttraumatic coxarthrosis. The purpose of the study was to identify the occurrence of these two complications in patients in our group and to determine the risk factors for the development of these complications. MATERIAL AND METHODS The retrospective study was conducted in two Level I trauma centres in the period from 2009 to 2014. ⋯ Conversely, sex and instability of osteosynthesis detected on the radiograph within 3 months postoperatively were not confirmed as the risk factors for the development of aforementioned complications. To verify the results of this retrospective study other multicentric and prospective studies should be conducted. Key words: complications of treatment of acetabular fractures, risk factors for avascular necrosis of femoral head, risk factors for coxarthrosis.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Economic Analysis of the Costs of Hospital Stay of Patients with Infection as a Complication of Total Replacements - Part 1: Total Knee Arthroplasty].
PURPOSE OF THE STUDY The study aims to quantify the costs of a hospital stay of patients with total knee periprosthetic joint infection throughout the period of treatment. MATERIAL AND METHODS The group included patients who have been treated at our department for infection as a complication of total knee replacement since 1 January 2011, who have been provided with treatment (including complications) exclusively at the departments of Nemocnice České Budějovice, a.s. and whose treatment can be considered completed in 2018. The patients were included in the study regardless of the type of infection and method of treatment. ⋯ High costs of therapy together with the requirement of expert care would justify the introduction of care provided by specialised centres. In this case, centralisation could result in a more efficient use of funds and improvement of the quality of provided care. Key words:total knee arthroplasty, PJI - periprostetic joint infection, economic analysis. ÚVOD.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Current Concepts in the Treatment of Intra-Articular Calcaneal Fractures].
PURPOSE OF THE STUDY The aim of this study was to evaluate and present the current concepts in the treatment of intra-articular calcaneal fractures. MATERIAL AND METHODS During the period of ten years (1/2007-12/2016) 162 dislocated intra-articular calcaneal fractures in 145 patients were treated and evaluated at the Trauma Department of University Hospital in Bratislava. The study group included 97 male (67%) and 48 (33%) female patients. ⋯ CONCLUSSIONS At our department we prefer percutaneous reduction and osteosynthesis as a method of choice in tongue-type fractures, and the Palmer s modified approach is the preferred method in Sanders type IIA and IIB fractures. In Sanders type III fractures we advise to use the plate osteosynthesis and for Sanders type IV fractures an external fixator is recommended. Key words:individual treatment concept.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Outcomes and Complications of Surgical Treatment for LSS at 1-Year Follow-up - Prospective Study].
PURPOSE OF THE STUDY Lumbar spinal stenosis (LSS) is a serious and fairly frequent disorder with prevalence increasing with age which often results in a disability. The surgical procedures are often very risky due to the greater age of patients with severe stenosis and their comorbidities. The study aimed to assess the functional outcomes and complications in patients who underwent surgical treatment for LSS at one year postoperatively and to identify the differences in the functional outcomes, if any, in dependence on the number of operated segments. ⋯ A significant improvement of all the followed-up parameters was reported. The authors did not confirm the correlation between the postoperative improvement and the number of treated segments. Key words:lumbar spinal stenosis, quality of life, post-operative outcomes, complications.