Fractures of the Dens in Patients Older than 65 Years: Direct Osteosynthesis of the Dens Versus C1-C2 Posterior FixationOriginal papers

J. ŠTULÍK, P. ŠEBESTA, T. VYSKOČIL, J. KRYL

Acta Chir Orthop Traumatol Cech. 2008; 75(2):99-105 | DOI: 10.55095/achot2008/017  

PURPOSE OF THE STUDYSurgical treatment is preferred in our department in all patients with type II and type III dens fractures, regardless of their age, with the exception of non-displaced or completely reduced fractures in young patients. The aim of this study was to evaluate patients over 65 years of age treated by direct osteosynthesis of the dens or posterior atlanto-axial fixation and spondylodesis.MATERIALIn the years 2001 to 2005, 28 patients aged 65 years and older were surgically treated for dens fracture. This included 13 men and 15 women between 65 and 90 years of age, with an average of 77.4 years. According to the treatment,...

Efficacy of Antiseptics in the Prevention of Post-Operative Infections of the Proximal Femur, Hip and Pelvis Regions in Orthopedic Pediatric Patients. Analysis of the First ResultsOriginal papers

M. KOKAVEC, M. FRIŠTÁKOVÁ

Acta Chir Orthop Traumatol Cech. 2008; 75(2):106-109 | DOI: 10.55095/achot2008/018  

PURPOSE OF THE STUDYIn orthopedics an infected operative wound always presents a serious complication that, apart from many adverse effects on the patient, increases the costs of therapy. The aim of this study was to analyze the effectiveness of antiseptic agents in the prevention of postoperative complications associated with surgery on the proximal femur, hip and pelvis in children.MATERIALThis prospective randomized study included 162 patients with the following diagnoses: cerebral palsy, developmental hip dysplasia, Perthes' disease, epiphyseolysis of the femoral head, and tumors. A total of 182 surgical procedures were carried out...

Surgical Treatment of SpondylodiscitisOriginal papers

J. VČELÁK, L.TÓTH

Acta Chir Orthop Traumatol Cech. 2008; 75(2):110-116 | DOI: 10.55095/achot2008/019  

PURPOSE OF THE STUDYSurgical treatment of spondylodiscitis is associated with many complications and raises a number of issues for discussion. The aim of the study was to evaluate a group of patients who had undergone surgery for inflammation of the spine, and to discuss the optimal operative procedure.MATERIALBetween January 2000 and February 2005, a total of 81 patients were treated at our department for pyogenic or tuberculous spondylodiscitis. Of these, 31 (11 women and 20 men) underwent surgery. Patients treated by CT-guided abscess drainage puncture with antibiotic therapy were not included. Indications for surgery included neurological...

Neuromuscular Deformity of the Pelvis and Its Surgical TreatmentOriginal papers

M. REPKO, M. KRBEC, R. CHALOUPKA, V. TICHÝ, A. ŠPRLÁKOVÁ-PUKOVÁ

Acta Chir Orthop Traumatol Cech. 2008; 75(2):117-122 | DOI: 10.55095/achot2008/020  

PURPOSE OF THE STUDYTo evaluate the efficacy of surgical treatment in pelvic deformities associated with neuromuscular spine deformity, using radiographic parameters and clinical outcome analysis. In the lumbo-pelvic region, spinal deformity is most frequently combined with pelvic obliquity, lumbar hyperlordosis, hip deformity and leg-length discrepancy. Pelvic deformities include an excessive posterior or anterior pelvic tilt, obliquity or rotation and windblown hip syndrome.MATERIAL AND METHODSIn the period from 1994 to 2006, 42 paediatric patients (28 girls and 14 boys) underwent surgical correction of spine and pelvic deformities by...

Posterior Stabilization of L5 Burst Fractures without Reconstruction of the Anterior ColumnOriginal papers

P. ŠEBESTA, J. ŠTULÍK, T. VYSKOČIL, J. KRYL

Acta Chir Orthop Traumatol Cech. 2008; 75(2):123-128 | DOI: 10.55095/achot2008/021  

PURPOSE OF THE STUDYTo evaluate a group of 11 patients with L5 burst fractures treated by L4-S1 posterior instrumented spinal fusion without reconstruction of the anterior column.MATERIALThe group included seven men and four women aged between 14 and 66 years (average, 37.5 years), followed for 12 to 36 months (average, 18 months). Ten patients were treated by posterior instrumented spinal fusion at the L4-S1 level, and one with an associated injury to L3 underwent L2-L4-S1 posterior instrumented spinal fusion. The spinal column was inspected in eight patients in whom neurological symptoms or significant stenosis were present.METHODSOn...

Tibiotalocalcaneal Arthrodesis Using a Retrograde Nail Locked in the Sagittal PlaneOriginal papers

R. VESELÝ, V. PROCHÁZKA, P. VIŠŇA, J. VALENTOVÁ, J. ŠAVOLT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):129-133 | DOI: 10.55095/achot2008/022  

PURPOSE OF THE STUDYTo evaluate our experience with the use of a retrograde nail locked in the sagittal plane for tibiotalocalcaneal arthrodesis indicated in severe post-traumatic arthritis of the ankle.MATERIALTwenty patients, 16 men and four women at an average age of 58.7 years (range, 23 to 72) were evaluated. All patients had severe post-traumatic changes in the talocrural and talocalcaneal joints. Five patients also had an equinus deformity. In two patients arthrodesis followed the treatment of purulent arthritis of the talocrural joint. A local fasciocutaneous flap was used for soft tissue reconstruction in three patients. All patients...

Extending the Indications of Intramedullary Nailing with the Expert Tibial Nail®Current concepts review

S. KUHN, M. HANSEN, P. M. ROMMENS

Acta Chir Orthop Traumatol Cech. 2008; 75(2):77-87 | DOI: 10.55095/achot2008/014  

Numerous modifications in nail and screw design have led to the development of the Expert Tibial Nail®. It enables the surgeon to further extend the spectrum of fractures eligible for intramedullary nailing. In the proximal metaphysis spongious bone screws achieve an optimized purchase in the cancellous bone. Multidirectional interlocking screws ensure that alignment can be well maintained and stability preserved in short proximal or distal tibial segments. The end cap achieves angular stability between the proximal oblique screw and the nail. These changes in implant design enhance the stability of the bone-nail construct and reduce the risk for...

Late Hematogenous Infection of Prosthetic JointCurrent concepts review

D. JAHODA, O. NYČ, J. ŠIMŠA, E. KUČERA, P. HANEK, P. CHRZ, D. POKORNÝ, N. TAWA, I. LANDOR, A. SOSNA

Acta Chir Orthop Traumatol Cech. 2008; 75(2):88-92 | DOI: 10.55095/achot2008/015  

The importance of prevention in late hematogenous infection is well understood but, because responsibility lies with general practicioners and other specialists, the orthopedic surgeon is usually not much interested. In both our and other countries, discussions are taking place on whether and to what extent antibiotic prevention should be carried out.Antibiotic prophylaxis of hematogenous infection is not indicated for all patients with joint arthroplasty, but only for a limited, defined group of patients at high risk. In these, however, the present state of knowledge suggests that prevention is necessary.A preventive treatment of late hematogenous...

Pelvic Fractures: Role of Imaging Methods in the Diagnosis of Isolated Pelvic Fractures and Multi-TraumaCurrent concepts review

J. CHMELOVÁ, V. DŽUPA, L. PLEVA

Acta Chir Orthop Traumatol Cech. 2008; 75(2):93-98 | DOI: 10.55095/achot2008/016  

The authors evaluate the role of imaging methods used in the diagnostics of pelvic fractures with the aim to suggest the most effective way of their use. The exact diagnosis of an injury is achieved most quickly if, in hemodynamically stable patients, CT scan is the initial examination and, based on the findings, conservative, invasive (laparotomy) or miniinvasive (angiography with bleeding artery embolization) procedures are used. In hemodynamically unstable patients, the diagnostic procedure always begins with plain X-ray and FAST (ultrasound) examination of the pelvis. When large hemoperitoneum is diagnosed, laparotomy is indicated. When only a...

Congenital Pseudoarthrosis of the Clavicle in a Boy with Prader-Willi's SyndromeCase report

P. ŠPONER, D. NEUMANN, K. KARPAŠ

Acta Chir Orthop Traumatol Cech. 2008; 75(2):134-136 | DOI: 10.55095/achot2008/023  

The authors present the case of a boy with congenital pseudoarthrosis of the right clavicle who met all clinical and auxologic criteria of Prader-Willi's syndrome. Poor cooperation due to mental retardation was the reason for the primary conservative treatment. During this, deformity of the middle clavicle progressed, but without development of subjective complaints and functional deficit. At his 16 years, this cosmetic defect became unacceptable for his parents and, later than it is usually recommended, resection of pseudoarthrosis with plate osteosynthesis and autologous spongioplasty was indicated. The sufficient skeletal maturation and size of...

Zemřel profesor MUDr. Václav Tošovský, Dr.Sc.Reports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):137

Významné životní jubileum prof. MU Dr. Jaromíra Emra, CSc.Reports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):138

Zpráva z AGA Shoulder Fellowship 2007 ve Spojených státech (4. - 29. 4. 2007)Reports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):139-140

Zpráva z XIII. vánočního vinohradského sympoziaReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):141

Zpráva ze 4. ortopedického sympozia v LitoměřicíchReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):141-142

AO Masters Course - Davos 2007Reports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):143

Zápis ze zasedání výboru ČSOT konaného dne 12. 2. 2008 v hotelu IPVZ Praha 4, BudějovickáReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2008; 75(2):144