Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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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.
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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).
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Comparison of 2-Screw Implant and Antirotational Blade Implant in Treatment of Trochanteric Fractures].
PURPOSE OF THE STUDY Surgical treatment of trochanteric fractures with intramedullary nailing still remains controversial as to which nail design is the best with no postoperative complications. The purpose of this study was to provide a comparative evaluation of complications in the treatment of trochanteric fractures using 2-screw proximal femoral nail versus proximal femoral anti-rotational blade nail. MATERIAL AND METHODS A retrospective review was conducted between March 2013 and March 2019. ⋯ CONCLUSIONS In our study no statistically significant difference in postoperative mechanical and infectious complications was confirmed between the 2-screw proximal femoral nail and the proximal femoral nail with antirotational blade. We have arrived at the conclusion that both types of nails are equivalent in treating trochanteric fractures. Key words: intramedullary nail, screw, blade, trochanteric fracture, complication.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Treatment of Acute Periprosthetic Infections with DAIR (Debridement, Antibiotics and Implant Retention) - Success Rate and Risk Factors of Failure].
PURPOSE OF THE STUDY Revision surgery with implant retention and exchange of mobile prosthetic parts is considered to be the method of first choice in acute periprosthetic infections with a stable endoprosthesis and good condition of soft tissues, where the symptoms did not last longer than 3 weeks. The aim of the study was to evaluate the long-term outcomes and to identify the factors affecting the success rate of this procedure. MATERIAL AND METHODS This unicentric retrospective study evaluated the results of 18 surgeries with implant retention performed at the Department of Orthopaedics of České Budějovice Hospital in the period 2009-2016. ⋯ The results suggest that it is particularly appropriate in early postoperative infections of primary total joint replacements. Its indication in late periprosthetic infections, especially of repeatedly operated joints, shall be carefully considered. Key words:acute periprosthetic joint infections, PJI, DAIR, implant retention, risk factors, success rate.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Outcomes of Treatment of Calcaneal Fractures Using Locking Compression Plate with or without Augmentation].
PURPOSE OF THE STUDY The retrospective study aims to compare the outcomes of augmentation of neutral triangle formed after the calcaneal fracture reduction with osteosynthesis using the locking compression plate with the outcomes of osteosynthesis without augmentation. MATERIAL AND METHODS In the period from 2005 to January 2011, 98 patients with 114 calcaneal fractures were treated by open reduction and internal fixation (ORIF) method with the use of calcaneal plate. The group included 15 women (15.3%) and 83 men (84.7%), with the mean age of 39.2 years (12-62 years). ⋯ CONCLUSIONS The operative treatment of displaced intra-articular fractures consisting of open reduction from extended lateral approach and internal calcaneal LCP fixation brings good results. We concluded that there is no statistically significant difference in the results of osteosynthesis with a locking plate alone and combined with augmentation of diaphyseal defect of the calcaneus. Filling of the diaphyseal defect in the calcaneus is not necessary, it neither accelerates the healing, nor brings better treatment outcomes Key words: calcaneal fracture, cement augmentation of defect, locking plate, extended lateral approach.