Both Column Fractures of the Acetabulum: Epidemiology, Operative Management and Long-Term-ResultsOriginal papers

A. GÄNSSLEN, M. FRINK, F. HILDEBRAND, C. KRETTEK

Acta Chir Orthop Traumatol Cech. 2012; 79(2):107-113 | DOI: 10.55095/achot2012/015  

PURPOSE OF THE STUDYBoth column fractures, defined as an acetabular fracture with no articular fragment in connection with the axial skeleton account for approximately 20% of all acetabular fractures. The typical type of a both column acetabular fracture is the C1.2 fracture with a multifragmentary anterior column fracture extending to the iliac crest and a large posterior column fragment in more than half of the patients.MATERIAL AND METHODSThe analysis of 135 surgically treated patients with both column fractures showed that more than half of these patients had associated injuries. The mean age was 40 years, and two thirds of these patients...

Traumatic Epiphysiolysis of the Proximal FemurOriginal papers

A. EGKHER, I. SCHLENZ, H. SEITZ

Acta Chir Orthop Traumatol Cech. 2012; 79(2):114-118 | DOI: 10.55095/achot2012/016  

PURPOSE OF THE STUDYSeveral former studies show the treatment of slipped epiphysis of the femoral head (SEFH). Its reason is rather unknown. On the other hand the rare traumatic SEFH takes place due to a real accident. According to the literature these injuries are treated like chronic SEFHs. The aim of this study is to show the differences in pathology and treatment of an acute traumatic SEFH in relationship to the chronic SEFH.PATIENTS AND METHODSIn 8 patients dislocated traumatic SEFHs were reduced anatomically and stabilized by the means of 3 to 4 Kirschner-(K-) wires or two cancellous screws. Each patient got a plaster-cast fixation...

Surgical Treatment for Factures of the Neck and Body of the TalusOriginal papers

J. ZEMAN, J. MATĚJKA, T. PAVELKA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):119-123 | DOI: 10.55095/achot2012/017  

PURPOSE OF THE STUDYTo present a retrospective evaluation of the results of our method of open reduction and internal fixation.MATERIAL AND METHODSA total of 35 patients were surgically treated for talar fractures at our department between 2004 and 2008. There were 27 men and eight women, with an average age of 31 years (range, 21 to 65). Talar neck fractures were recorded in 21 and talar body fractures in 14 patients.The most frequent cause of injury was a fall from height (77%); motorcar accidents were less frequent (14%). Open fractures were found in 8.5% of the patients, and talar fractures as a single trauma were recorded in 80%...

MEDIN Implant of the First Metatarsophalangeal JointOriginal papers

R. HROMÁDKA, V. BARTÁK, A. SOSNA, S. POPELKA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):124-130 | DOI: 10.55095/achot2012/018  

PURPOSE OF THE STUDYHemiarthoplasty or total replacement of the first metatarsophalangeal (MTP) joint has been used in orthopaedic surgery for the last 60 year, but good post-operative outcomes have been achieved only in the last ten years. Joint replacement is mainly used in stage 3 and stage 4 hallux rigidus conditions for which arthrodesis is not indicated. The operation on the first MTP joint has its place in the present-day orthopaedics. This study describes anatomical measurements and the development of the first Czech implant (MEDIN Orthopaedics) to replace this joint.MATERIAL AND METHODSThirty cadaver specimens were used to develop...

Knee Arthroscopy in Children and Adolescents with Trauma HistoriesOriginal papers

J. JOCHYMEK, Š. ONDRUŠ, J. ŠKVAŘIL

Acta Chir Orthop Traumatol Cech. 2012; 79(2):131-134 | DOI: 10.55095/achot2012/019  

PURPOSE OF THE STUDYIn this retrospective study we analysed the major indications for knee arthroscopy and the diagnoses made using it in children and adolescents who had sustained knee joint injuries.MATERIAL AND METHODSA total of 731 knee joint artroscopies were performed and retrospectively evaluated in patients under 19 years of age. The group included patients with knee joint injuries treated at our department in the 2000-2010 period. There were 413 boys (58%) and 300 girls (42%) with an average age of 14 years and 2 months. The clinical diagnosis was compared with the arthroscopic diagnosis.RESULTSThe results of our comparative...

Arthroscopically-Assisted Procedures on the Hip JointOriginal papers

P. NEPRAŠ, J. MATĚJKA, P. ZEMAN, J. KUDELA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):135-139 | DOI: 10.55095/achot2012/020  

PURPOSE OF THE STUDYSince 2000 arthroscopically-assisted surgery on hip joints has become more widely used. The technique is relatively demanding and should be used only after arthroscopic procedures on other large joints are mastered to perfection. A thorough study on cadaverous specimens should be a prerequisite for adopting it as a routine method. The aim of this study was to evaluate indications for hip arthroscopy as, from the year 2006, this was gradually introduced and more widely used at our department.MATERIAL AND METHODSForty-two hip joints were assessed out of the 83 hips which had been treated by arthroscopic surgery before...

Incidence of Proximal Femur Fractures in Relation to Seasons of the Year and WeatherOriginal papers

F. BURGET, L. PLEVA, K. KUDRNA, Z. KUDRNOVÁ

Acta Chir Orthop Traumatol Cech. 2012; 79(2):140-143 | DOI: 10.55095/achot2012/021  

PURPOSE OF THE STUDYThe opinion that proximal femur fractures occur mainly in the winter season and are related to slippery surfaces prevails in both the lay and medical communities. The elucidation of this relationship would lead to a better understanding of the aetiology of these fractures and may help to prevent them in the elderly population.MATERIAL AND METHODSIn a retrospective study conducted at two departments, the occurrence of proximal femur fractures in patients 60+ years old in relation to weather conditions (air temperature and its humidity, atmospheric pressure, rain and mist) between January 1, 2001 and December 31, 2005...

Percutaneous Dynamic Interspinous Stabilisation for the Treatment of Juxtafacet Cysts of the Lumbar Spine: Prospective StudyOriginal papers

L. HRABÁLEK, T. WANEK, M. ADAMUS

Acta Chir Orthop Traumatol Cech. 2012; 79(2):144-149 | DOI: 10.55095/achot2012/022  

PURPOSE OF THE STUDYTo present the authors' philosophy on the surgical treatment of juxtafacet cysts of the lumbosacral (LS) spine, with its primary aim of dynamic lumbar stabilisation with an interspinous implant, inserted by a minimally invasive approach, without concurrent exploration of the spinal canal and cyst removal.MATERIAL AND METHODSDuring a 20-month period, ten patients aged between 25 and 70 years (average age, 53.2 years) were indicated for surgical treatment of a juxtafacet cyst by percutaneous insertion of an In-Space interspinous spacer without surgical exploration of the spinal canal. The group comprised six men and four...

Spinal Cord Concussion: A Retrospective Study of Twenty-Four PatientsOriginal papers

P. NESNÍDAL, J. ŠTULÍK, M. BARNA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):150-155 | DOI: 10.55095/achot2012/023  

PURPOSE OF THE STUDYSpinal cord concussion is characterised as fully reversible, temporary inhibition of conductive function due to trauma, without signs of structural changes. Although neurological deficit is usually related to the severity of spinal injury, this is different in spinal cord concussion. The aim of this retrospective study was to evaluate a group of 24 patients with spinal cord concussion, to design a diagnostic algorithm and propose an effective therapy with a good prognosis for the patients.MATERIALWe reviewed clinical records of 9 768 patients hospitalised at the Department of Spinal Surgery, University Hospital in Motol,...

Talus Fractures: A Current Concepts Review of Diagnoses, Treatments, and OutcomesCurrent concepts review

J. M. LAMOTHE, R. E. BUCKLEY

Acta Chir Orthop Traumatol Cech. 2012; 79(2):97-106 | DOI: 10.55095/achot2012/014  

The talus is the key articular segment linking the leg and foot, and as such, is subject to complex loads and may occasionally fracture. Fracture patterns provide clues to the underlying pathomechanics and energy of the injury, both of which can help guide treatment and suggest prognosis. Talus fractures have a wide variety of presentation from low-energy avulsion fractures of the lateral or posterior processes, to high-energy comminuted talar body fractures. Appropriate, expedient treatment provides the patient the best chance of obtaining a good functional outcome. Treatment relies on appropriate diagnosis, which hinges on clinical suspicion provided...

Primary Pyomyositis of the Muscles around the Hip. Case Reports and Literature ReviewCase report

K. KOUDELA Jr., J. KOUDELOVÁ, T. SKALICKÝ

Acta Chir Orthop Traumatol Cech. 2012; 79(2):156-161 | DOI: 10.55095/achot2012/024  

The authors present three case reports of primary pyomyositis, a severe but rare disorder involving the muscles around the hip. In three boys, with an average age of 16 years, the disease developed suddenly in association with strenuous sporting activities. The boys had fever, pain and restricted motion at hip joints, haemoculture tests positive for Staphylococcus aureus and the presence of inflammatory markers. Magnetic resonance findings showed infiltrates and abscesses in the muscles around the hip. X-ray and computed tomography (CT) examination of the pelvis revealed bone irregularities near the pubic symphysis due to repeated avulsion injury to...

Urgent Pedal Bypass as Part of the Treatment of an Extensive Lower-Leg InjuryCase report

Z. KŘÍŽ, R. STAFFA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):162-164 | DOI: 10.55095/achot2012/025  

The authors present the case of a subadventitial rupture of the popliteal artery and devastating injury to the crural arteries due to a crush injury to the proximal shank. The arterial injury was treated by urgent popliteo-pedal bypass grafting. Besides the surgical procedure, the authors also discuss revascularisation syndrome. The subadventitial rupture of the popliteal artery is a serious condition associated with a risk of high amputation.

Fracture-Separation of the Distal Humeral Epiphysis in a Four-Month-Old Infant. Case ReportCase report

Ľ. SÝKORA, J. TRNKA

Acta Chir Orthop Traumatol Cech. 2012; 79(2):165-168 | DOI: 10.55095/achot2012/026  

We report the case of a 4-month-old infant with fracture-separation of the distal humeral epiphysis diagnosed on the basis of X-ray examination. Closed reduction was performed under ultrasound guidance. The effect of reduction was checked by computer tomography and magnetic resonance imaging and, under general anaesthesia, the arm was immobilised using a collar-and-cuff. Subsequently, percutaneous osteosynthesis with two 1.2-mm Kirschner wires through the radial condyle was carried out. The fracture was allowed to heal in a normal elbow position with plaster cast for 5 weeks. The duration of immobilisation had to be prolonged and removal of the wires...

Metatropic Dysplasia as the Cause of Atlantoaxial Instability, Spinal Stenosis and Myelopathy. Case Report and Literature ReviewCase report

M. BARNA, J. ŠTULÍK, F. FENCL

Acta Chir Orthop Traumatol Cech. 2012; 79(2):169-174 | DOI: 10.55095/achot2012/027  

We present the case of a patient, aged 4 years and 10 months, with metatropic dysplasia. The baby had repeated apnoeic episodes, bradycardia and cardiac arrests and was diagnosed with foramen magnum stenosis and atlantodental dislocation. The episodes were markedly associated with neck movements. Considering this clinical presentation, we performed laminectomy of the atlas, foramen magnum enlargement and decompression followed by dorsal C0-C2 stabilisation with allogeneic bone chips. After the operation, apnoeic episodes did not recur.

Profesor MUDr. Otto Vlach, DrSc, 80 letReports from ČSOT

Richard Chaloupka, Martin Řepko

Acta Chir Orthop Traumatol Cech. 2012; 79(2):175