[The development of early diagnosis and treatment of congenital hip dislocation in Czechoslovakia].

M Janovec

Acta Chir Orthop Traumatol Cech. 1989; 56(4):281-288

The author gives an account of the early diagnosis and treatment of congenital dislocation of the hip joint in Czechoslovakia since 1918. He pays more detailed attention to the period before the Second World War and the period immediately after the war when aids now used on a world-wide scale were introduced into practice such as Hanausek's apparatus, Frejka's cushion and Pavlik's stirrups. At the same time screening of neonates in some areas was started. The author mentions also methods of preventive examinations of the entire population introduced in the fifties. He also pays attention to efforts to reduce the radiation load in X-ray screening of...

[Experience with 3-stage screening for detection of congenital hip dysplasia].

J Komprda

Acta Chir Orthop Traumatol Cech. 1989; 56(4):289-293

We report an experience with a three-stage screening programme which has recently been recommended. It comprises the examination of children at three successive periods - at birth, at six weeks and at three months. In a prospective study we evaluated 789 children at all three periods. Pathological (unstable) hips were found at birth in about 20 per cent, the majority being lax hips and all underwent immediate treatment. At six weeks we were unable to detect any sign attributable to hip dysplasia except one instability persisting from birth. A limitation of abduction in one or another hip at six weeks or at three months was present in about 6 per cent;...

[Initial experience with the Steel triple osteotomy in the treatment of arthrosis of the hip joint as a result of congenital hip dysplasia].

M Rejholec, V Rybka, S Popelka, K Sadil

Acta Chir Orthop Traumatol Cech. 1989; 56(4):294-302

The age of the patients was 18 to 40 years (mean age 32 years), the interval after operation was 5 months to 3 years (mean 17 months). In all 8 patients proper covering of the head was achieved, CE angle 25-45 degrees, mean gain of CE angle 35 degrees. The X-ray picture revealed widening of the articular space and reabsorption of arthritic pseudocysts. As regards the clinical picture, marked regression of complaints was recorded. Osteotomy of the pelvis according to Steele prolongs the vitality of the hip joint: a) by increasing the contact surface in the hip joint, b) by shifting the till then minimally burdened and thus minimally usurated cartilage...

[Possibilities in modern spinal surgery].

O Vlach, P Slapnicka

Acta Chir Orthop Traumatol Cech. 1989; 56(4):303-327

Rapid development spine surgery brings about all over the world new surgical techniques and new instrumentation which in comparison to the previous ones achieve far better results. The authors present a survey of 1033 operations on the spine divided into 5 groups: 1. deformities (scoliosis, kyphosis and their combination, olisthesis, 2 injuries, 3. tumours, 4, inflammations and 5. other diseases (myelopathy, stenosis, failed back etc.). In comparison to previous years the year 1988 shows the increase in the number of operated injuries (from 15% to 23%), of tumours (from 3% to 5%) and other diseases (from 2% to 8%). A survey is presented of the surgical...

[Use of bone plates in external osteosynthesis].

J Král

Acta Chir Orthop Traumatol Cech. 1989; 56(4):328-337

The author applied the bone plate for external osteosynthesis in 6 patients. Three of them had open fractures of 2nd grade in the area of shin, one patient in the area of forearm. In 2 patients there occurred unstable pseudoarthrosis of shin with significantly trophically changed soft tissue covering. On the shin he always two broad bone plates on the anteromedial aspect of the shin, and namely in the V-configuration. For the increase of the stability of the assemblage he used the interconnection of two broad plates by one or two narrow moulded plates the subsequent modification of which allowed to apply the rubber traction for the training of the...

[Pediatric injuries in the lower extremities caused by insertion of the foot into the spokes of a bicycle].

M Kitka, V Blasko

Acta Chir Orthop Traumatol Cech. 1989; 56(4):338-342

The authors describe the injury of the lower extremity caused by putting the child's leg between the spokes of bicycle wheel during ride. The result is contusion of soft tissues of the leg and ankle or the fracture of the shin in a typical place. The injury requires a through treatment of soft tissues and sometimes also reduction of the fracture under total anaesthesia with subsequent fixation by plaster of Paris. On the basis of the group of 52 patients it has been proved that the mentioned injuries but for exceptional cases heal without sequelea. The authors emphasize the importance of the prevention of this injury by the installation of a plastic...

[The resection site in the treatment of giant cell bone tumors].

K Urban, O Fiala

Acta Chir Orthop Traumatol Cech. 1989; 56(4):343-349

The authors discuss surgical procedures (resections and amputations) in a group of 35 patients with giant-cell bone tumours who were treated at the Orthopaedic Clinic in Hradec Králové. The diagnosis was established in cooperation by the orthopaedist, pathologist and roentgenologist. Resections were made in 24 patients, i.e. in 13 patients as primary operations, in 11 patients as secondary operations. The group comprised three tumours classified as malignant. After primary resection a relapse developed once, after secondary resection there were two relapses. Twenty-one patients, i.e. 87.5%, had no relapse. On account of two extensive relapses in soft...

[The fate of patients after surgical revision of 3 intervertebral spaces in lumbo-ischiadic syndrome].

I Sulla, J Faguľa, G Vasko, M Santa, J Výrostko

Acta Chir Orthop Traumatol Cech. 1989; 56(4):350-357

The authors present a report on 9 patients (out of which five were female and four male patients) in the age group ranging from 34 to 55 years, who underwent in the period between 1 January 1982 and 31 December 1987 the revision of three intervertebral spades due to the unilateral lumbo-ischiadic syndrome. Operations of such an extent were performed only exceptionally, in case clinical symptoms and myelographic or CT examination proved the lesion of three intervertebral discs. Ensuing from the control examination performed in November 1988 two patients have been invalided and the rest of them working on a full load (five of them doing their original...

[Changes in pulmonary shunting and blood lactate during general anesthesia with controlled hypotension in patients with idiopathic scoliosis].

I Cundrle, O Vlach, M Dastych

Acta Chir Orthop Traumatol Cech. 1989; 56(4):358-364

In their work the authors observed the influence of controlled hypotension by means of sodium nitroprusside on the acidobasic balance, the oxygenation parameters, pulmonary shunt and lactatemia in patients with idiopathic scoliosis in the course of dorsal fusion by Harrington instrumentation. In comparison with the control group of patients there had not occurred significant - from the viewpoint of statistics - changes in ph, paCO2 and pvO2. However, the pulmonary shunt (Qva/Qt) doubled (p less than 0.002) which resulted in a significant decrease of paO2 (p less than 0.02) but in no case there occurred hypoxemia. The values of the lactate both in the...

[Technical orthopedic care of the diseased and deformed foot].

J Vosátka, B Vrbický

Acta Chir Orthop Traumatol Cech. 1989; 56(4):365-373

The authors present a brief survey of the essential possibilities of technical aids provided for patients with diseases and defects of feet. The work deals with fundamental indications for the application of various ways of technical solution and is supplemented with pictures.

[An innovative abduction diaper].

R Kubát

Acta Chir Orthop Traumatol Cech. 1989; 56(4):374-376