Acta Chir Orthop Traumatol Cech. 2004; 71(4)

[Possibilities of surgical treatment of upper cervical spine in patients with rheumatoid arthritis].

Z Klézl, M Olejárová, M Veselá, L Sedová, K Pavelka

Acta Chir Orthop Traumatol Cech. 2004; 71(4):201-209

PURPOSE OF THE STUDY: Patients with rheumatoid arthritis (RA) often suffer from instability of the upper cervical spine. The most common instability is anterior atlanto-axial subluxation (AAS). Instability may lead to neurologic deficits from spinal cord compression and intractable pain, decreasing quality of life and its length.MATERIAL AND METHODS: This prospective study analyzed different fixation methods and the influence of atlanto-axial and occipito-cervical fusion on clinical and radiological outcome. 41 patients with RA with instability of the upper cervical spine were treated surgically for progressive instability, pain and neurological...

[Incorporation of bone allografts with the use of Octopus revision system in total hip arthroplasty].

J Vojtassák, R Jány

Acta Chir Orthop Traumatol Cech. 2004; 71(4):210-213

PURPOSE OF THE STUDY: The study describes the revision arthroplasty of hip joints with grade III acetabular defects, as rated according to Paprosky, employing morsellized bone allografts and the Octopus revision acetabular system.MATERIAL: In the period from 1998 to 2002, a total of 8297 operations were performed in our Department; of these 1527 (18.4%) were total hip replacements. In this group, 267 (15.5%) revision arthroplasties were carried out, with the the Octopus revision system being used in 32 patients (age range, 30 to 79 years; average age, 60.3 years). The average period between the initial surgery and reimplantation was 6.5 (range,...

[Treatment of juvenile bone cysts by curettage and filling of the cavity with BAS-0 bioactive glass-ceramic material].

P Sponer, K Urban

Acta Chir Orthop Traumatol Cech. 2004; 71(4):214-219

PURPOSE OF THE STUDY: The aim of the study was to evaluate the long-term results of using the bioactive, glass-ceramic material BAS-0 for bone tissue replacement after removal of juvenile bone cysts by curettage.MATERIAL: Between 1990 and 2000, BAS-0 material was used to fill the cavity after removal of a juvenile bone cyst in 21 patients, 15 males and 6 females, with an average age of 15 years (range 4 to 44 years). Surgical treatment was indicated only in juvenile bone cysts meeting the following criteria: 1) subjective complaints, i. e., pain at activity; 2) X-ray findings of either a) thinning cortical layer with a potential for pathological...

[Ewing's sarcoma in children--current surgical treatment options, evaluation of our patients].

J Schovanec, J Mrácek, V Havlas, T Trc

Acta Chir Orthop Traumatol Cech. 2004; 71(4):220-227

PURPOSE OF THE STUDY: Neoplastic diseases continue to arouse much concern in the general population. This also applies to bone tumors. Until recently, these neoplasms, most frequently occurring in children and adolescents, were considered to have the worst possible prognosis with a minimal opportunity for a successful outcome of treatment. This is a likely reason for the still deeply rooted belief that amputation of the affected limb is necessary and disease prognosis is uncertain, which also applies to Ewing's sarcoma. Only lately could these patients be offered a hope of successful treatment including limb salvage.MATERIAL: In the period from...

[Fractures of the tibial pylon: treatment options and outcomes].

P Závitkovský, T Malkus

Acta Chir Orthop Traumatol Cech. 2004; 71(4):228-236

PURPOSE OF THE STUDY: Fractures of a tibial pylon are serious problems in traumatology. The methods of their therapy have not been unified yet and treatment outcomes are not satisfactory. This is often due to extensive comminution of the distal tibia, bone defects or a thin coverage of soft tissue. The objective of this study is to compare the literature data and, on the basis of this and our own experience, to present guidelines for the treatment of fractures of tibial pylons.MATERIAL: In the period from 1998 to June 2002, 60 patients (average age, 42 years) underwent surgery for a fracture of the tibial pylon in the Department of Orthopedics,...

[Complications and risks associated with an anticoagulation therapy combining low molecular weight heparin and Warfarin after total replacement of large joints--our experience].

P Míka, J Behounek, M Skoták, L Nevsímal

Acta Chir Orthop Traumatol Cech. 2004; 71(4):237-244

PURPOSE OF THE STUDY: This study deals with the efficacy and safety of anticoagulation therapy, using a combination of low molecular weight heparin (LMWH) and Warfarin, administered after total arthroplasty (TA) of large joints. Patients with a high rate of complications due to bleeding comprised the first evaluated group. After the causes had been analyzed and eliminated (or reduced), the second group of patients was evaluated. The aim of the study was to ascertain whether risks and complications did not overweight the benefits of Warfarin administration in the prophylaxis of deep venous thrombosis (DVT) and whether this combined anticoagulation therapy,...

[Results of Menon's arthroplasty in basal joint osteoarthritis].

M Lutonský, D Pellar

Acta Chir Orthop Traumatol Cech. 2004; 71(4):245-248

PURPOSE OF THE STUDY: Osteoarthritis of the basal joints is a frequent degenerative disease. The wide range of arthritic lesions of the first carpal metacarpal joint should be treated by targeted surgical techniques. These methods, including arthroplasty, arthrodesis and alloplasty, for use in relevant indications are available in the Department of Orthopedics at the Medical Faculty Teaching Hospital in Hradec Králové. In this study, the results of Menon's arthroplasty modified by the authors are evaluated.MATERIAL AND METHODS: The interpositional arthroplasty, first used and published by Menon in 1955, was introduced in January 2002 by the authors...