Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2018
[Suprapatellar Nailing of Tibial Fractures - Evaluation of Clinical and Radiological Results].
PURPOSE OF THE STUDY The locked nailing of diaphyseal fractures of the tibia currently represents a method of choice for treating the closed diaphyseal fractures, some of the tibial metaphyseal fractures and open tibial diaphyseal fractures classified as grade I and II according to Gustilo-Anderson (GA) classification. The suprapatellar (SP) approach is an alternative technique of insertion of the nail in semi-extension of the lower extremity with easier reduction, namely of multiple fractures and proximal diaphyseal fractures of the tibia in particular. This study aims to evaluate the group of patients in whom the suprapatellar approach was used and who were followed up for the period of at least 12 months. ⋯ The functional results of the knee joint are comparable to those achieved with the infrapatellar nailing technique. The final LS score correlates with the age of the patients. Key words:tibial fractures, suprapatellar approach, intramedullary nailing, knee pain.
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Acta Chir Orthop Traumatol Cech · Jan 2018
[Osteotomy after Distal Radius Fractures - Five-Year Clinical and Radiological Outcomes].
PURPOSE OF THE STUDY The purpose of our retrospective study is to evaluate 5-year functional and radiological outcomes in patients following corrective osteotomy of the distal radius and ulnar osteotomy for malposition after a distal radius fracture, to identify differences in the outcomes of corrective osteotomies depending on the type of the original fracture according to the AO classification, the grade of arthritis of radiocarpal (RC) joint, surgical approach and the way of stabilisation of the osteotomy. MATERIAL AND METHODS The followed-up group of 22 patients (8 men and 14 women) underwent osteotomy for malposition of distal radius in the period 2007-2011. The age of patients in the followed-up group ranged from 21 to 72 years, with the mean age of 51 years at the time of surgery. ⋯ Our results have proven better functional outcomes of deformity correction achieved by osteotomy in case of grade 1 and 2 arthritis than by the limited wrist arthrodesis. In patients showing arthritic changes, no progression was reported within five years after the osteotomy. Key words: distal radius fracture, distal radius deformity, osteotomy, functional results.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Comparative Study[Two-Stage Revision for Periprosthetic Infection of the Total Hip Arthroplasty: a Comparison of Two Methods].
PURPOSE OF THE STUDY The purpose of the study is a retrospective comparison of results of the two-stage revision total hip arthroplasty using a non-articulating and an articulating spacer to treat periprosthetic joint infection (PJI). Two basic hypotheses are evaluated: (1) the clinical outcomes of the patients treated with "hand made" articulating cement spacer are better than in non-articulating patient's group in two-stage revision for PJI of the total hip arthroplasty and (2) PJI recurrence is higher in the group of patients treated with an articulating spacer group. MATERIAL AND METHODS The evaluated group consists of a total of 57 patients (23 women, 34 men) with the mean age of 61.2 years. ⋯ CONCLUSIONS The results demonstrate the better clinical outcomes and the higher revision rate of patients with an articulating cement spacer in two stage revision. We didn't find any differences between the risk of PJI recurrence in both groups. Key words:periprosthetic infection, total hip replacement, cement spacer, two stage revision, articulating spacer, nonarticulating spacer.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Multicenter Study Clinical Trial[Comparison of Two Methods of Minimally Invasive Osteosynthesis for Proximal Radius Fractures in Paediatric Patients].
PURPOSE OF THE STUDY The presented study was construed as a retrospective multicentric clinical study focused on paediatric skeletal injuries of the proximal radius. As a general rule, the Type I displaced fractures (Judet classification) are treated conservatively, with no reduction. In the case of Type II-IV displacement, the fracture necessitates reduction or is also transfixed by a Kirschner wire (K-wire) or a Prevot nail (P-nail) where subsequent fragment instability occurs. ⋯ CONCLUSIONS The clinical results clearly show that when comparing the complications after the radial head fracture in children there is no statistically significant difference between the methods of osteosynthesis. This study shall serve as a starting point for the currently ongoing prospective multicentric study evaluating the modified ESIN technique using a pre-bent Kirschner wire. Key words:children, fracture, radius, proximal, osteosynthesis.
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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.