Injury Patterns in Polytraumatized Children and Consequences for the Emergency Room ManagementOriginal papers

J. ZWINGMANN, H. SCHMAL, A. MEHLHORN, N. P. SÜDKAMP, P. C. STROHM

Acta Chir Orthop Traumatol Cech. 2010; 77(5):365-370 | DOI: 10.55095/achot2010/064  

INTRODUCTIONThe effective initial treatment in the emergency room of polytraumatized children requires a sound knowledge of common injury patterns, incidence, mortality, and consequences. The needed initial radiological imaging remains controversial and should be adapted to the expected injury pattern.PATIENTS AND METHODSIn this retrospective study, the injury patterns of 56 polytraumatized paediatric patients (age ≤ 16 years) in the period from December 2001 to May 2009 were evaluated. All children were initially diagnosed with a whole body CT scan. The cause of accident, the localization including the detailed diagnose, the lethality...

Efficiency of Conservative Treatment by Overhead Traction in Developmental Dysplasia of the HipOriginal papers

M. BURIAN, P. DUNGL, J. CHOMIAK, M. OŠŤÁDAL, M. FRYDRYCHOVÁ

Acta Chir Orthop Traumatol Cech. 2010; 77(5):371-377 | DOI: 10.55095/achot2010/065  

PURPOSE OF THE STUDYDevelopmental dysplasia of the hip (DDH) is a disorder affecting the development of the acetabulum, proximal femur and joint capsule. The objective of this study was to analyse the results of closed reduction by overhead traction in subluxated and dislocated hips.MATERIAL AND METHODSIn the period from 2002 to 2007, a total of 109 patients (124 hips) were treated by overhead traction. The indication criteria included adductor contracture and misalignment of the hip joint assessed as classes III A, III B or IV according to the Graf ultrasonographic classification. There were 96 (88 %) girls and 13 (12 %) boys. The left...

Ipsilateral Fractures of the Proximal Femur and the Femoral ShaftOriginal papers

P. DOUŠA, J. BARTONÍČEK, T. PAVELKA, L. LUŇÁČEK

Acta Chir Orthop Traumatol Cech. 2010; 77(5):378-388 | DOI: 10.55095/achot2010/066  

PURPOSE OF THE STUDYThe aim of the study was a retrospective evaluation of the surgical treatment of 171 fractures of the proximal femur and the femoral shaft.MATERIAL AND METHODSBetween the years 1994 and 2008, 171 ipsilateral fractures were operatively treated in 169 patients with an average age of 56 years (range, 21-97 years). The group comprised 108 men and 61 women.The fracture was fixed by the long Gamma nail (Howmedica) in 18 cases, by the long PFN (Synthes) in 147 cases and by the long PFH (Medin) in three cases. In two patients with a bilateral fracture, a reconstruction nail was used on one side and a combination of DHS and...

Early Complications Associated with Total Hip Arthroplasty due to Femoral Neck FractureOriginal papers

J. GALLO, I. ČECHOVÁ, J. ZAPLETALOVÁ

Acta Chir Orthop Traumatol Cech. 2010; 77(5):389-394 | DOI: 10.55095/achot2010/067  

PURPOSE OF THE STUDYFractures of the femoral neck have been serious health and social issues of the recent decades. Although up-to-date implants and perioperative care are now available, the treatment is still associated with an increased risk of postoperative complications. The aim of this study was to specify early postoperative complications and to ascertain which factors, if any, can predict them.MATERIAL AND METHODSBetween October 2005 and February 2007, a total of 155 patients were treated for femoral neck fractures in our department. The group of elderly patients (n=82) who underwent elective total hip arthroplasty for osteoarthritis...

Complications of Dynamic Hip Screw Treatment for Proximal Femoral FracturesOriginal papers

M. HRUBINA, M. SKOTÁK, J. BĚHOUNEK

Acta Chir Orthop Traumatol Cech. 2010; 77(5):395-401 | DOI: 10.55095/achot2010/068  

PURPOSE OF THE STUDYTo present the results of Dynamic Hip Screw (DHS) osteosynthesis for the treatment of proximal femoral fractures with a focus on specific complications of this method.MATERIALFrom 1997 till 2007, the authors performed 367 DHS osteosyntheses to treat 341 patients with fractures of the proximal femur. The average patient age was 81.8 years (21-101). Twenty-six patients had surgery for bilateral fractures.METHODSOsteosynthesis was always carried out using a 135° DHS (Medin, Nové Město na Moravě, Czech Republic) to manage fractures of the femoral neck (13 ); trochanteric and basicervical fractures (349 ) and subtrochanteric...

Transhumeral Head Plasty and Massive Osteocartilaginous Allograft Transplantation for the Management of Large Hill-Sachs LesionsOriginal papers

R. HART, F. OKÁL, M. KOMZÁK

Acta Chir Orthop Traumatol Cech. 2010; 77(5):402-410 | DOI: 10.55095/achot2010/069  

PURPOSE OF THE STUDYThe aim of this presentation is to inform the medical community about causal therapy (transhumeral head plasty or massive osteochondral allograft transplantation) for large Hill-Sachs lesions which frequently cause failure of anterior stabilisation following ventral shoulder dislocations.MATERIALSeven men with an average age of 26 years (19 to 33 years) undergoing surgery in 2006 and 2007 were evaluated. The minimum follow-up was 18 months (41 to 18 months).Impressions on more than 30 % of the articular surface, or those whose critical size was larger than one-eighth of the humeral diameter (on CT scan) were taken...

In Vitro Assessment of Vancomycin Released from Bone GraftsOriginal papers

P. MELICHERČÍK, D. JAHODA, V. BARTÁK, E. KLAPKOVÁ, O. NYČ, D. POKORNÝ, I. Landor, A. Sosna, T. Judl

Acta Chir Orthop Traumatol Cech. 2010; 77(5):411-415 | DOI: 10.55095/achot2010/070  

PURPOSE OF THE STUDYInfections of the musculoskeletal system present a serious problem in orthopaedic and trauma medicine because, typically, they are often recurrent and associated with the development of resistance to antibiotics. The aim of this study was to ascertain whether the local concentration of vancomycin released from cancellous bone grafts exceeded the minimum inhibitory concentration (MIC) for vancomycin-resistant Staphylococcus aureus (VRSA ≥16 mg/L) during a 16-day in vitro experiment.MATERIAL AND METHODSMorselised grafts of spongy bone were selected as ideal local carriers of antibiotic. They were impregnated...

Synovial Fluid from Aseptically Failed Total Hip or Knee Arthroplasty is Not Toxic to OsteoblastsOriginal papers

J. GALLO, A. ZDAŘILOVÁ, A. RAJNOCHOVÁ SVOBODOVÁ, J. ULRICHOVÁ, L. RADOVÁ, M. SMIŽANSKÝ

Acta Chir Orthop Traumatol Cech. 2010; 77(5):416-424 | DOI: 10.55095/achot2010/071  

PURPOSE OF THE STUDYA failure of total hip or knee artroplasty is associated with an increased production of joint fluid. This contains wear particles and host cells and proteins, and is assumed to be involved in the pathogenesis of aseptic loosening and periprosthetic osteolysis. This study investigated the effect of synovial fluid from patients with aseptically failed joint prostheses on osteoblast cultures.MATERIAL AND METHODSSynovial fluid samples were obtained from patients with failed total joint prostheses (TJP; n=36) and from control patient groups (n=16) involving cases without TJP and osteoarthritis, without TJP but with osteoarthritis,...

Comprehensive Diagnosis of Infection in Revision Total Replacements of Large JointsOriginal papers

K. KOUDELA Jr., L. GEIGEROVÁ, O. HES, K. KOUDELA Sr.

Acta Chir Orthop Traumatol Cech. 2010; 77(5):425-431 | DOI: 10.55095/achot2010/072  

PURPOSE OF THE STUDYTo make comprehensive diagnoses of the infections associated with revision total knee and hip arthroplasties in our group of patients.MATERIAL AND METHODSFrom September 2002 till November 2004, a group of 69 patients undergoing revision total joint replacement (65 hips and four knees) were evaluated. The period between primary and revision surgery ranged from 6 months to 25 years. The patients were examined for CRP, erythrocyte sedimentation rate (ESR) and white blood cell (WBC) counts. The samples of their periprosthetic tissue were assessed for biopsy and microbial findings. The removed prosthetic components were sonicated....

Our Results of the Brandes-Keller Procedure and Helal Metatarsal Osteotomy in Patients with Forefoot DeformityOriginal papers

A. ŠVARC, J. PILNÝ, J. KUBEŠ

Acta Chir Orthop Traumatol Cech. 2010; 77(5):432-435 | DOI: 10.55095/achot2010/073  

PURPOSE OF THE STUDYThe most frequent valgus deformity of the big toe is often associated with a collapse of the traverse arc of the foot. The purpose of the present study was to assess the results of forefoot reconstruction by the Brandes-Keller resection arthroplasty of the first metatarsophalangeal joint and the Helal metatarsal osteotomy when this deformity was present.MATERIALA retrospective study of 40 consecutive patients with severe forefoot deformities was performed. The patients were treated at our department in the period from 1997 to 2003. The average age at the time of surgery was 54.7 years. Twelve patients underwent bilateral...

Stable Fixation of Osteoporotic Fractures and Nonunions in the Upper Limb - Life Before the "Locking Plate"Current concepts review

J. B. JUPITER, H. WYSS

Acta Chir Orthop Traumatol Cech. 2010; 77(5):361-364 | DOI: 10.55095/achot2010/063  

I have had a wonderful opportunity over the past 30 years to surgically reconstruct many complex fractures and nonunions in the upper limb in the elderly patient with underlying osteoporosis and prior to the development of the "locked plate".This article will present a number of specific techniques using standard LC-DCP and screw in a variety of applications to provide stable internal fixation. These include the use of long plates; creating a "waved plate" initially described by Blatter and Weber; double plating; 3.5 mm intramedullary plate combined with a larger plate on the cortex; custom and machined blade plates as well as enhancement of screw...

Prof. MUDr. Milan Kovanda, CSc, oslavil 80. narozeninyReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2010; 77(5):436