Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Evaluation of Efficacy of Systemic Administration of Tranexamic Acid (Exacyl) in Total Hip and Knee Arthroplasty - Prospective Cohort Study].
PURPOSE OF THE STUDY To evaluate the efficacy of the systemic administration of two doses of tranexamic acid (TXA) in total knee (TKA) and hip arthroplasty (THA). MATERIAL AND METHODS The study evaluated a total of 295 patients who underwent total knee and hip arthroplasty for osteoarthritis, prospectively followed up were the patients who had been administered the tranexamic acid (TXA), and this group was subsequently compared against the cohort - control group. Our evaluation was focused on perioperative and postoperative period. ⋯ A. S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications.
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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.
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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
[Mid-Term Outcomes of Reconstruction of Charcot Foot Neuroarthropathy in Diabetic Patients].
PURPOSE OF THE STUDY The aim of this study was to evaluate the mid-term outcomes of the surgical reconstruction of Charcot Foot Neuroarthropathy in diabetic patients with failed conservative treatment and indicated for a below-knee amputation. MATERIAL AND METHODS In the period from 2010 to 2015 the surgical reconstruction of inactive, chronic Charcot Foot Neuroarthropathy classified as type II and III by Sanders and Frykbeg was performed in 16 patients with failed conservative treatment. All these patients were by the diabetes centres initially indicated for a below-knee amputation. ⋯ Positive mid-term outcomes of surgical reconstruction justify further development of this method, bearing in mind the necessity of careful indication and preoperative preparation of the patient in cooperation with diabetologists. Precise and accurate surgical technique and relevant postoperative care are essential to minimise the potential complications. Key words:Charcot arthropathy, diabetic neuropathy, rocker - bottom foot deformity, foot reconstruction.
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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.