Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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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.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Randomized Controlled Trial[Long-Term Results of Computer-Navigated Total Knee Arthroplasties Performed by Low-Volume and Less Experienced Surgeon].
PURPOSE OF THE STUDY The study aims to evaluate the long-term results of computer-navigated total knee arthroplasties performed by less experienced surgeon performing a small number of procedures per year. MATERIAL AND METHODS In the prospective randomised study functional and radiological results, rate of revision and probability of clinical and radiological survival were compared in 30 computer-navigated (in 28 patients: 19 women, 9 men, with the mean age of 66.9 years) and 31 conventionally implanted (in 30 patients: 27 women, 3 men, with the mean age of 66.5 years) cemented total knee replacements without patellar resurfacing. The group was composed of patients who underwent surgery performed by the same surgeon who at the time of enrolment of patient in the study had no previous experience with the total knee replacement surgery and performed up to 30 such procedures annually. ⋯ However, the question remains unanswered if more accurate positioning of the implants achieved with computer navigation decrease the revision rate and extend the long-term survival of knee endoprostheses. CONCLUSIONS Kinematic computer navigation allowed a less experienced and low-volume orthopaedic surgeon to make the implantation of endoprostheses more accurate, to decrease the total revision rate, and thus to ensure a higher probability of long-term survival of total knee arthroplasties. Key words:computer navigation, total replacement, knee joint, long-term outcomes, low-volume surgeon, less experienced surgeon.
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Acta Chir Orthop Traumatol Cech · Jan 2017
Randomized Controlled Trial Comparative Study[Comparison of Short-Therm Results of Conservative versus Operative Treatment of Distal Ulna Fractures Associated with Distal Radius Fracture Treated by Plate Osteosynthesis].
PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow-up period of 24 months (6-36). All the fractures of distal two thirds of ulnar styloid process were treated conservatively. ⋯ The operative treatment of subcapital ulna fracture had a very good early outcome as compared to conservative treatment of the fracture which healed in malunion, the change of axial position of the distal end of the bone resulted in a limited range of forearm mobility. CONCLUSIONS Based on the early functional and radiographic outcomes of RCT study it can be stated, in agreement with the other authors, that the operative treatment of distal ulna fractures associated with the distal radius fracture treated by ORIF should be indicated for base fractures of ulnar styloid process associated with DRUJ instability following the osteosynthesis of distal radius fracture and peripheral fragment dislocation ad axim or ad latus in radial direction by 2 mm and more, and also in case of displaced ulnar head fractures and instable and displaced subcapital fractures of the ulna. Key words: distal ulna fracture, plate osteosynthesis, LCP distal ulna plate.
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Acta Chir Orthop Traumatol Cech · Jan 2017
Randomized Controlled Trial[Bacteriuria and Symptomatic Urinary Tract Infections during Antimicrobial Prophylaxis in Patients with Short-Term Urinary Catheters - Prospective Randomised Study in Patients after Joint Replacement Surgery].
PURPOSE OF THE STUDY A very serious complication following joint replacement surgery is periprosthetic joint infection that can be caused by a urinary tract infection. Insertion of an indwelling urinary catheter constitutes a risk factor that may result in urinary tract infections. The aim of this prospective randomised study was to compare the occurrence of significant bacteriuria and symptomatic urinary tract infections during antibiotic prophylaxis at the time of removal of an indwelling urinary catheter by cotrimoxazole in two doses and with no administration of antibiotics. ⋯ Therefore, we recommend asking the patients during the hospital admission process specifically about the urinary infection symptoms. The results of our study show that antibiotic prophylaxis during the removal of indwelling urinary catheters placed for a short-term is unnecessary. Key words: endoprosthesis, urinary catheter, bacteriuria, urinary tract infection.
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Acta Chir Orthop Traumatol Cech · Jan 2017
Randomized Controlled Trial[The Effect of Activation of the Shoulder Girdle Muscles on Functional Outcomes of Rehabilitation in Patients with Surgically Treated Distal Radius Fractures].
PURPOSE OF THE STUDY The aim of the study was to assess the functional outcomes of rehabilitation in patients with surgically treated distal radius fractures in the early postoperative period. We compared the functional outcomes of patients undergoing standard rehabilitation with the group of patients whose postoperative rehabilitation was extended with shoulder girdle exercises of the affected upper limb while the wrist was immobilized. Several indices and variables were used for the assessment of the functional therapeutic outcomes of the affected wrist. ⋯ CONCLUSIONS Shoulder girdle muscles exercises after a distal radius fracture, while wrist is immobilized, can evidently enhance functional capability and accelerate the hand-function restitution. Early functional outcomes of the injured wrist after the rehabilitation with shoulder girdle muscles exercises support the efficiency of this broadened rehabilitation protocol. Key words: distal radius frac,ture, hand, shoulder, functional treatment, rehabilitation.