Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2001
Randomized Controlled Trial Clinical Trial[Aprotinin (Antilysin Spofa)--its effect on decreasing hemorrhage in the postoperative period in hip arthroplasty].
Aprotinin is a non-specific inhibitor of serine proteases with hemostyptic and hemostatic properties. The effect covers suppression of fibrinolysis and support of the role of thrombocytes in coagulation. In a prospective randomized study we verified whether the application of aprotinin (Antilysin Spofa, Czech Republic) in the dosage effective in cardiosurgical patients reduces blood loss and the need for blood transfusion for orthopaedic patients. ⋯ Infusion of aprotinin (Antilysin Spofa) in the dosage of the order of 106 KIU significantly reduces post-operative blood loss and frequency of transfusion in the peroperative period in patients undergoing THA.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Unreamed locking intramedullary nailing of humeral fractures--basic evaluation of a patient group].
The aim of the work is to provide an overview of the existing experience in Synthes unreamed humeral nail (UHN). ⋯ The main indication of UHN are comminuted or multi-level fractures of humerus in the central three fifths of its length. If possible we prefer the retrograde method of nailing, in the antegrade method we recommend distal locking from the anterior aspect of the arm. Transverse or short oblique fractures can be successfully treated by a simpler Hackethal technique. Long spiral fractures are ideally treated conservatively or by plate fixation.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Indications for emergency surgery in thoraco-abdominal injuries].
Under the conditions of an increasing number of car accidents and criminal injuries the thoracis and abdominal trauma is a source of a significant morbidity and mortality in blunt and penetrating mechanism of injury. On the basis of a group of patients operated on for blunt and penetrating injury of the chest and abdomen evaluation was made of the current indication and results of lifesaving surgery in case of these injuries. ⋯ Priority indication for a lifesaving surgery in thoracoabdominal injuries is significant intraabdominal bleeding diagnosed on the basis of the result of the clinical examination in hemodynamically unstable patients. In a stabilized patient the lifesaving surgery is performed on the basis of the result of visualization methods (spiral computer tomography, ultrasound, angiography, endoscopy) revealing apart from significant bleeding also severe injuries of intrathoracic and intraabdominal organs. Protracted hypovolemic shock with the development of multi-organ failure or the occurrence of simultaneous severe associated injuries in polytrauma are the most frequent causes of mortality in patients operated on for thoracoabdominal injury.
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Assessment of the authors' group of patients with a fracture of sternum and comparison with available literary findings. ⋯ The incidence of the fracture of sternum has recently increased. Isolated injuries of the chest do not pose any diagnostic or therapeutic problem. Of much greater severity are associated injuries of lungs and mediastinal organs which require a precise diagnosis and careful observation of the patient.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Case Reports[Complications with the acetabular cup in the CLS total hip joint endoprosthesis].
The aim of the study is to present complications of acetabular component of CLS total hip replacement and their solution. ⋯ Of the total number of 2231 implanted CLS cups in the period of 1986-1999 only 25 complications were recorded requiring a revision surgery, i.e. 1.1% of all cases. Complications relating to the cup were treated in case of acetabular defects by means of metal acetabular rings, cancellous bone grafting and cemented cups. In infections a two-step procedure was used with a repeated application of CLS cup, Prostalac technique or Girdlestone procedure.