Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
-
Acta Chir Orthop Traumatol Cech · Jan 2020
[Treatment of Subtrochanteric Fractures, Our Experience, Complications].
PURPOSE OF THE STUDY The study gives a retrospective assessment of the outcomes of surgical treatment in patients who sustained a subtrochanteric fracture. MATERIAL AND METHODS In the period 2010-2018, a total of 118 patients with a subtrochanteric fracture, namely 75 males and 43 females, the mean age 61 years, were treated at our department. The study group included the patients who met the following inclusion criteria: age 18+, fracture treated by intramedullary nailing, follow-up for at least 12 months, in case of impaired healing and need for revision surgery follow-up until complete healing was achieved. ⋯ Displacement to varosity, flexion displacement or a combination of both cause impaired healing with non-union and failed osteosynthesis. Treatment of non-union is extremely challenging and always consists in the correction of anatomical relationships. Key words: subtrochanteric fractures, surgical treatment, outcomes, complications.
-
Acta Chir Orthop Traumatol Cech · Jan 2020
Randomized Controlled Trial Comparative Study[Surgical Treatment of Clavicle Midshaft Fractures - Prospective Randomized Trial].
PURPOSE OF THE STUDY Comparison of the outcomes of clavicle midshaft fractures using two different surgical techniques, namely intramedullar osteosynthesis using elastic stable intramedullary nailing (ESIN) with medial cap and extramedullar plate osteosynthesis. MATERIAL AND METHODS The prospective randomized trial was conducted at the Department of Trauma Surgery of the Department of Surgery of the University Hospital Hradec Králové in the Czech Republic at the Level I Trauma Center between 2014 and 2018 and compared two types of osteosynthesis of clavicle midshaft fractures. 60 patients were enrolled in the study and were randomly assigned to one of the two groups. In Group 1, the participants were treated by ESIN and in Group 2 by plate osteosynthesis. ⋯ There is a statistically significant difference in shorter X-ray exposure and lower received radiation dose in plate fixation and reduction. The complication rate is comparable in both the methods. Key words: elastic stable intramedullary nailing, midshaft clavicle fracture, ESIN, TEN, titan elastic nail, clavicle plate osteosynthesis, 3.5 LCP clavicular plate, indication for midshaft fracture treatment.
-
Acta Chir Orthop Traumatol Cech · Jan 2020
[Evaluation of a Combination of Waveform Amplitude Latency and Decrease of Waveform Amplitude Magnitude during Spinal Surgery in Intraoperative Neurophysiological Monitoring of Transcranial Motor Evoked Potentials and Its Incidence on Postoperative Neurological Deficit].
PURPOSE OF THE STUDY This retrospective study investigated the significance of a combination of peak latency of waveform amplitude and waveform amplitude in association with spinal deformities. The correlation with postoperative neurologic deficit was evaluated too. MATERIAL AND METHODS Between January 2007 and January 2018, a group of 113 patients was evaluated in the study who underwent spine surgery using intraoperative neurophysiological monitoring (IONM) focusing on transcranial motor evoked potential (tc-MEP) monitoring. ⋯ Further studies should set the alarm criteria more precisely for the waveform amplitude latency peak delay to achieve more effective spinal cord tc-MEP monitoring. Our concept of findings supports the neurophysiological monitoring findings in other studies. Key words: monitoring, IONM, intraoperative neurophysiological monitoring, tc-MEP, motor evoked potential, transcranial, amplitude, latency, peak.
-
Acta Chir Orthop Traumatol Cech · Jan 2020
[Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index].
PURPOSE OF THE STUDY This thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents. MATERIAL AND METHODS The key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. ⋯ DISCUSSION The following discussions and evaluations, together with personal experience and thorough knowledge of real-life solutions, became the basis for recommendations of triage procedures, organization of surgery and traumatology departments and material equipment of medical facilities in the Czech Republic. CONCLUSIONS By applying the results of the habilitation thesis it is possible to achieve an optimal solution and increase the reliability in the preparedness of hospitals in dealing with crisis situations, especially to eliminate the discrepancy between theory and practice. Key words: mass casualty incidents, triage, hospital preparedness, disaster management response.
-
Acta Chir Orthop Traumatol Cech · Jan 2020
[Treatment of Fractures of the Distal Third of Tibia Diaphysis by MIPO Technique].
PURPOSE OF THE STUDY MIPO (Minimally Invasive Plate Osteosynthesis) technique is currently a commonly used method to treat fractures of the distal third of tibia diaphysis. At the same time, it is just like other methods accompanied by a relatively high complication rate. The purpose of this study was to determine whether the use of this technique at our department is effective and whether the complication rate does not differ considerably from values reported by literature. ⋯ CONCLUSIONS The treatment of fractures of the distal third of tibia diaphysis remains an unsolved issue despite the development of stateof-the art materials, implants and surgical techniques. The MIPO technique can be considered an effective method of treatment of these types of fractures, achieving a high success rate of healing and acceptable rate of complications. Key words: minimally invasive plate osteosynthesis (MIPO), distal third of tibia diaphysis, locking compression plate (LCP).