Orthopaedics, Traumatology, Surgery and Contemporary Concept of Trauma CareEditorial

M. KRBEC, O. ČECH

Acta Chir Orthop Traumatol Cech. 2010; 77(3):177-178

Results Covering 20 Years Use of the Cement-free Zweymüller Alloclassic Total Endoprosthesis of the Hip JointOriginal papers

M. WEISSINGER, C. HELMREICH, G. PÖLL

Acta Chir Orthop Traumatol Cech. 2010; 77(3):186-193 | DOI: 10.55095/achot2010/039  

PURPOSE OF THE STUDYFrom an initial group of 206 hips in 190 patients we carried out a retrospective clinical and radiological control of 74 hips in 72 patients covering a period of 20 years.MATERIAL AND METHODIndications in 74 operated hips evidenced 48 x (64,9 %) primary and 26 x (35,1 %) secondary coxarthrosis. The average age at the time of operation was 53 years (37 years - 68 years). All 72 patients with 74 hips received cement-free self-cutting Alloclassic screw cups of pure Titanium together with a cement-free square Alloclassic stem consisting of Titan-Aluminium-Niob alloy according to Zweymüller.Regarding the technique of...

Distal Femoral Periprosthetic Fractures: Classification and TherapyOriginal papers

T. TOMÁŠ, L. NACHTNEBL, P. OTIEPKA

Acta Chir Orthop Traumatol Cech. 2010; 77(3):194-202 | DOI: 10.55095/achot2010/040  

PURPOSE OF THE STUDYPeriprosthetic fracture is one of the most serious complication of total knee arthroplasty. In our retrospective clinical study we designed our classification with rules for treatment of those fractures.MATERIAL AND METHODSDuring the last thirty years we treated 53 distal femoral periprosthetic fractures in our orthopaedic department. In our clinical study we reviewed our group of distal femoral periprosthetic fractures with on the basis of X-ray findings, the treatment method used and treatment outcomes.RESULTSAccording to our findings we divided distal femoral periprosthetic fractures into six groups:Type...

Dynamic Neutralization Using the Dynesys System for Treatment of Degenerative Disc Disease of the Lumbar SpineOriginal papers

J. CIENCIALA, R. CHALOUPKA, M. REPKO, M. KRBEC

Acta Chir Orthop Traumatol Cech. 2010; 77(3):203-208 | DOI: 10.55095/achot2010/041  

PURPOSE OF THE STUDYDegenerative disc disease (DDD) is a spinal condition resulting from degeneration of the intervertebral discs. It is associated with symptoms of sciatica, back pain and leg weakness and also with degenerative instability of the spine. To arrest the degenerative cascade of disc disease, and taking into consideration stress placed on the adjacent discs managed by decompression and stabilisation by instrumented fusion, the lumbar spine was treated by dynamic posterior stabilisation of the segments affected. Based on the classification described by Dubois et al., the Dynesys system was used. The aim of this study was to evaluate...

Iliosacral Screw Fixation of the Unstable Pelvic Ring InjuriesOriginal papers

M. RYŠAVÝ, T. PAVELKA, M. KHAYARIN, V. DŽUPA

Acta Chir Orthop Traumatol Cech. 2010; 77(3):209-214 | DOI: 10.55095/achot2010/042  

PURPOSE OF THE STUDYTo report on the early results and possible complications of iliosacral screw fixation in the management of unstable pelvic ring injuries.MATERIAL AND METHODSOne hundred and two unstable pelvic ring injuries were treated using iliosacral screw fixation for posterior pelvic ring disruptions. Closed manipulative reductions of the posterior lesion were attempted for all patients. Open reductions were used in the minority of patients with unsatisfactory closed reductions as assessed fluoroscopically at the time of surgery. Anterior fixations were by means of open reduction in 62 patients and by external fixation in 14 patients,...

Latissimus Dorsi Transfer for the Treatment of Irreparable Craniodorsal Tears of the Rotator CuffOriginal papers

R. HART, R. BÁRTA, D. NÁHLÍK

Acta Chir Orthop Traumatol Cech. 2010; 77(3):215-221 | DOI: 10.55095/achot2010/043  

PURPOSE OF THE STUDYLatissimus dorsi transfer is a relatively complicated procedure subsequently requiring an active, long-term physical therapy. The surgeon's performance and a patient's effort are therefore of worth consideration. However, sutures of massive rotator cuff tears do not always produce good results. The aim of the study is to evaluate the role of latissimus dorsi transfer in the treatment of these shoulder pathologies.MATERIALA total of 21 patients were evaluated. Their age at the time of surgery ranged from 48 to 63 years, with an average of 54.8 years. A minimum follow-up was three years, the average was 47 months (70-36...

TOEFIT-PLUS System for Replacement of the First Metatarsophalangeal JointOriginal papers

V. BARTÁK, S. POPELKA, R. HROMÁDKA, J. PECH, D. JAHODA, A. SOSNA

Acta Chir Orthop Traumatol Cech. 2010; 77(3):222-227 | DOI: 10.55095/achot2010/044  

PURPOSE OF THE STUDYHallux rigidus is a frequent disease of the first metatarsophalangeal (MTP) joint. It is a painful condition markedly reducing joint motion. For grade-3 and grade-4 disease, as classified by Coughlin, first MTP joint replacement is another option of surgical treatment, in addition to resection arthroplasty or arthrodesis.MATERIAL AND METHODSIn a group of 27 patients with symptomatic hallux rigidus, 28 MTP joint replacements using a TOEFIT-PLUS implant were carried out in the 2005-2009 period. There were 24 women and three men, with an average age of 56.3 years. The average follow-up was 24 months (range, 4 to 48). Indication...

Arthroscopic Repair of Subscapularis Tendon TearOriginal papers

D. MUSIL, P. SADOVSKÝ, J. STEHLÍK

Acta Chir Orthop Traumatol Cech. 2010; 77(3):228-234 | DOI: 10.55095/achot2010/045  

PURPOSE OF THE STUDYIn this study the arthroscopic reconstruction of a rupture of the subscapularis tendon is described and the results of the technique are evaluated, with the aim to show the advantages and effectiveness of this surgical procedure.MATERIALBetween 2006 and 2008, arthroscopic repair of the subscapularis tendon was carried out in 23 patients, 16 men and seven women, with an average age of 55 (range, 37-74) years. The dominant arm was treated more often (15x). All 23 patients treated by this diagnostic arthroscopic technique were included in the evaluation.METHODWith the patient in a lateral recumbent position, the...

Expert Tibial Nail (ETN) for Treatment of Diaphyseal Tibial Fractures in Current and Extended Indications: Technique and Clinical ResultsOriginal papers

J. TRLICA, T. DĚDEK, K. ŠMEJKAL, J. KOČÍ, P. LOCHMAN, M. FRANK

Acta Chir Orthop Traumatol Cech. 2010; 77(3):235-241 | DOI: 10.55095/achot2010/046  

PURPOSE OF THE STUDYTo present the authors' technical experience with the use of the Expert Tibial Nail (ETN) technique and its clinical results.MATERIAL AND METHODSBetween December 2005 and the end of 2007, the ETN technique was used in 41 patients to treat 41 diaphyseal tibial fractures. All patients were followed-up prospectively.RESULTSThe injury Severity Score (ISS) was in the range of 4 to 25 (average, 5.9). Eight patients suffered multiple trauma, 33 had isolated injuries. Of the 41 fractures, 31 were closed and 10 were open injuries. The fracture types according to the Tscherne classification were as follows: closed 0 type...

Evidence for the Best Treatment for Displaced Intra-articular Calcaneal FracturesCurrent concepts review

R. E. BUCKLEY

Acta Chir Orthop Traumatol Cech. 2010; 77(3):179-185 | DOI: 10.55095/achot2010/038  

In conclusion, this clinical scenario has proved to be a clinic conundrum. Unfortunately the surgical team may focus on the fracture and may overlook significant patient characteristics that could help in guiding optimal patient care. Operative management is the treatment of choice as long as complications can be minimized. Nonoperative care can lead to succesful results in select patients in a high percentage of cases. Percutaneous fixation and arthroscopic reduction are new areas for scientific study.

Diagnostic Options in Chronic Recurrent Multifocal Osteomyelitis: Case ReportsCase report

M. KOKAVEC, H. SAMEKOVÁ, E. KOŠKOVÁ, I. MAKAIOVÁ

Acta Chir Orthop Traumatol Cech. 2010; 77(3):242-246 | DOI: 10.55095/achot2010/047  

Chronic recurrent multifocal osteomyelitis (CRMO) is the most severe form of chronic non-bacterial osteomyelitis. In children and adolescents, the metaphyses of long bones are affected most frequently, but the lesions can be found at any site on the skeleton, as well as in other organs such as the skin, eyes, gastrointestinal tract or lungs. Since the clinical signs of CRMO and its course are not invariable and clear, it is often very difficult to make a clinical diagnosis.The authors present their experience with the CRMO diagnosis in three cases. In the first patient, CRMO was localised in the left proximal tibia, left proximal femur, left sacrum...

Successful Urgent Thoracotomy in a Patient with Penetrating Heart Injury - Case ReportCase report

K. ŠMEJKAL, R. PAŘÍZKOVÁ, P. LOCHMAN

Acta Chir Orthop Traumatol Cech. 2010; 77(3):247-249 | DOI: 10.55095/achot2010/048  

The case of a patient with a penetrating cardiac injury successfully treated by thoracotomy is reported. In a suicidal attempt, he suffered a self-inflicted thoracic stub wound penetrating the left ventricle. During transport to the hospital, he developed circulatory instability. He was admitted to the emergency department with no signs of life and bilateral non-responding mydriasis. Immediately, urgent anterolateral thoracotomy at the left 5th rib was performed. The pericardium was opened, cardiac tamponade was evacuated and the stab wound in the right ventricle was sutured. The subsequent ventricular fibrillation was treated using defibrillation...

Zápis ze zasedání výboru ČSOT konaného dne 9. 2. 2010 v hotelu IPVZ, Budějovická, Praha 4Reports from ČSOT

Acta Chir Orthop Traumatol Cech. 2010; 77(3):250