Acta Chir Orthop Traumatol Cech. 2012; 79(3)

Original papers

Release of the Lateral Structures of the First Metatarsophalangeal Joint during Hallux Valgus SurgeryOriginal papers

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

Acta Chir Orthop Traumatol Cech. 2012; 79(3):222-227 | DOI: 10.55095/achot2012/032  

PURPOSE OF THE STUDYOperations of hallux valgus deformity are very well known in orthopaedic surgery. The important part of these procedures is the release of soft tissue on the lateral side of the first metatarsophalangeal joint. Soft tissue procedures became routinely used in the 1920s and 1930s and several techniques of soft tissue release have been published in the past seventy years. We found several inaccuracies between the anatomy published and the routine clinical performance. The purpose of the study was to describe the anatomy of the first metatarsophalangeal joint's lateral part, especially the adductor hallucis muscle attachment, and...

Arthroscopically-Assisted Osteosynthesis of Calcaneal Fractures: Clinical and Radiographic Results of a Prospective StudyOriginal papers

L. KOPP, P. OBRUBA, R. MIŠIČKO, K. EDELMANN, V. DŽUPA

Acta Chir Orthop Traumatol Cech. 2012; 79(3):228-232 | DOI: 10.55095/achot2012/033  

PURPOSE OF THE STUDYThe aim of this prospective study was to evaluate the clinical and radiographic results in a group of patients with calcaneal fractures treated by means of minimally invasive, arthroscopically-assited osteosynthesis.MATERIAL AND METODSA total of 175 calcaneal fractures in 154 patients were treated surgically at the Trauma Centre of Masaryk Hospital between January 2006 and August 2010. Twenty-six patients were enrolled in this prospective study. They had a total of 30 calcaneal fractures, of which 28 were managed by minimally invasive, arthroscopically-assisted osteosynthesis. The patient's records included demographic...

Timing of Surgical Intervention in Acute Spinal Cord Injury and Post-Operative Neurological RecoveryOriginal papers

R. LUKÁŠ, P. BARSA, J. PAZOUR, J. ŠRÁM

Acta Chir Orthop Traumatol Cech. 2012; 79(3):233-237 | DOI: 10.55095/achot2012/034  

PURPOSE OF THE STUDYThe effect of an early surgical intervention in the traumatised spine on resolution of neurological deficit still remains a topic of professional discussions. The aim of this retrospective study was to find a correlation between the length of an injury-to-surgery interval and the development of a post-operative neurological deficit, and thus to answer the question of whether early surgical decompression and stabilization gives better chance of neurological recovery.MATERIAL AND METHODSMedical records of consecutive surgical patients admitted between 2007 and 2010 with traumatic spinal cord injury were reviewed and the...

Relationship of Acromial Morphology and Rotator Cuff TearsOriginal papers

D. MUSIL, P. SADOVSKÝ, M. ROST, J. STEHLÍK, L. FILIP

Acta Chir Orthop Traumatol Cech. 2012; 79(3):238-242 | DOI: 10.55095/achot2012/035  

PURPOSE OF THE STUDYTo evaluate the effect of acromial morphology, as assessed on radiographs, on rotator cuff tears.MATERIALA total of 200 patients surgically treated for shoulder disorders were enrolled. All were older than 40 years and had good quality shoulder radiographs. Two groups were composed: First, a clinical model group of 136 patients to be investigated for three parameters of rotator cuff injury that was divided into two subgroups. One included 68 patients, with an average age of 53.5 years, in whom surgery revealed no injury to the rotator cuff; the other subgroup of 68 patients, with an average age of 58 years, had a ruptured...

The Results of Ulnar Nerve Decompression in Guyon's Canal SyndromeOriginal papers

R. KAISER, L. HOUŠŤAVA, R. BRZEZNY, P. HANINEC

Acta Chir Orthop Traumatol Cech. 2012; 79(3):243-248 | DOI: 10.55095/achot2012/036  

PURPOSE OF THE STUDYThe aim of the study was to evaluate a group of patients treated for Guyon's canal syndrome with analysis of the cause for and outcome of surgery.MATERIAL AND METHODSThe group comprised 13 patients operated on for compressive neuropathies of the ulnar nerve in the canal of Guyon in the period from 2007 to 2010. The clinical parameters evaluated were the adduction strength of the fifth digit, degree of interosseous primus muscle hypotrophy and degree of hypoesthesia in the area innervated by the ulnar nerve. EMG parameters included motor and sensory nerve conduction through Guyon's canal. Patients' subjective evaluations...

Magnetic Resonance Imaging in the Diagnosis of Intra-Articular Lesions of the KneeOriginal papers

R. ČELLÁR, D. SOKOL, M. LACKO, Š. ŠTOLFA, A. GHARAIBEH, G. VAŠKO

Acta Chir Orthop Traumatol Cech. 2012; 79(3):249-254 | DOI: 10.55095/achot2012/037  

PURPOSE OF THE STUDYMagnetic resonance imaging (MRI) has the highest sensitivity of all methods for the diagnosis of intra-articular knee injuries. In spite of this, its benefit for the decision-making algorithm is questionable. The aim of this study was to evaluate the real situation in our regional conditions.MATERIAL AND METHODSThe medical records of the patients who underwent knee arthroscopy in 2008 and 2009, and had pre-operative MRI examination, were retrospectively reviewed. The group included 92 patients (46 women and 46 men; average age, 41.7 years) of whom 49 had knee injury in their medical history.RESULTSIn medial meniscus...

Validation of the DTP-3 System for Noninvasive Spinal Shape Measurement by Comparison with X-Ray ExaminationOriginal papers

J. KREJČÍ, J. GALLO, J. SALINGER, P. ŠTĚPANÍK

Acta Chir Orthop Traumatol Cech. 2012; 79(3):255-262 | DOI: 10.55095/achot2012/038  

PURPOSE OF THE STUDYRepeated measurements of the spine are absolutely necessary in children and adolescents affected by spinal deformities especially during their growing-up periods. To avoid risks of tissue damage from x-ray exposure, several methods for non-invasive measurement of the spinal curvature have been developed. One of them is the DTP-3 position system allowing for a three-dimensional measurement of anatomical landmarks (spinous processes) and the calculation of curvature angles in both the frontal and sagittal planes. We were interested to know whether the DTP-3 was precise enough to determine the true spinal curvature.MATERIAL...

Micturition, Sexual and Defecation Disorders in Middle-Aged Women after Pelvic Fractures. A Comparative StudyOriginal papers

V. DŽUPA, M. OTČENÁŠEK, J. VRÁNOVÁ, V. DUCHÁČ, R. GRILL, V. BÁČA

Acta Chir Orthop Traumatol Cech. 2012; 79(3):263-268 | DOI: 10.55095/achot2012/039  

PURPOSE OF THE STUDYTo present the results of a three-year study on micturition, defecation, gynecological and sexual disorders in middle-aged women who sustained pelvic fractures.MATERIAL AND METHODSA group of 33 female patients who were treated for unstable pelvic fractures (AO types B or C) in the 2004-2009 period were evaluated (treated group) and compared with 31 women who had given vaginal birth at least once and went to see a urologist because of urinary problems in the period from 2009 to 2010 (control group).The questionnaires used in the study included ICIQ, UIQ, UDI and PISQ12 instruments. Urodynamic tests included flow cystometry,...

Epidemiological, Morphological and Clinical Aspects of Ankle FracturesOriginal papers

J. MARVAN, H. BĚLEHRÁDKOVÁ, V. DŽUPA, V. BÁČA, M. KRBEC

Acta Chir Orthop Traumatol Cech. 2012; 79(3):269-274 | DOI: 10.55095/achot2012/040  

PURPOSE OF THE STUDYThe study presents the evaluation and comparison of two groups of patients surgically treated for ankle fractures at our department in 2007 and in 2010, respectively. Our analysis included patients' age, the mechanism of injury, fracture morphology and the method of osteosynthesis. The aim of the comparison was to ascertain recent trends in the development of the selected characteristics.MATERIAL AND METHODSThe 2007 group comprised 62 patients, 31 men and 32 women, the 2010 group had 123 patients, 55 men and 68 women. The ankle fractures were classified according to the Weber and Lauge-Hansen systems. The selected characteristics...

Current concepts review

Management of Hemodynamic Unstable Patients "in extremis" with Pelvic Ring FracturesCurrent concepts review

A. GÄNSSLEN, F. HILDEBRAND, T. POHLEMANN

Acta Chir Orthop Traumatol Cech. 2012; 79(3):193-202 | DOI: 10.55095/achot2012/029  

The hemodynamic status in patients with pelvic ring injuries is a major prognostic factor of an immediate mortality risk.Especially, patients "in extremis" are of high risk to die. This patient group is characterized by absent vital signs or being in severe shock with initial systolic blood pressure ≤70 mm Hg and/or requiring mechanical resuscitation or catecholamines despite >12 blood transfusions within the first two hours after admission.The sources of pelvic bleeding is in approximately 80-90% of venous origin and relevant arterial bleeding accounts for 10-20%.Important parts of the initial treatment treatment concept include...

Current Concepts Review - Fractures in the Region of the ElbowCurrent concepts review

G. GRADL, J. B. JUPITER

Acta Chir Orthop Traumatol Cech. 2012; 79(3):203-212 | DOI: 10.55095/achot2012/030  

Elbow injuries continue to rise with increased athletic activity and life expectancy.Knowledge of anatomy and biomechanics of this sophisticated joint, various injury patterns, and the implication of injury to the static and dynamic stabilizers will result in improvement in specific diagnosis, and therapy. The surgical treatment of trauma to the adult elbow has evolved rapidly in recent years and many useful concepts and techniques have been established.This paper reviews the published scientific data and current opinion available to guide patient care.

Current Knowledge on the Effect of Technology and Sterilization on the Structure, Properties and Longevity of UHMWPE in Total Joint ReplacementCurrent concepts review

D. POKORNÝ, M. ŠLOUF, P. FULÍN

Acta Chir Orthop Traumatol Cech. 2012; 79(3):213-221 | DOI: 10.55095/achot2012/031  

Ultrahigh molecular weight polyethylene (UHMWPE) is the most frequently used bearing surface in currently used total joint replacements (TJR). According to the literature available, UHMWPE is the best polymer material, in terms of biocompatibility, mechanical properties and wear resistance, for this application. In spite of this fact, UHMWPE wear (i.e., release of microscopic particles from the polymer surface) remains one of the main reasons of TJR failures. Consequently, the wear of UHMWPE is a subject of intensive study by both materials scientists and orthopaedic surgeons.The structure and properties of UHMWPE strongly depend on the way of...

Case report

Osteoid Osteoma of the Femoral Neck Mimicking Monarthritis and Causing Femoroacetabular ImpingementCase report

G. W. HERGET, N. P. SÜDKAMP, J. BÖHM, P. HELWIG

Acta Chir Orthop Traumatol Cech. 2012; 79(3):275-278 | DOI: 10.55095/achot2012/041  

Different aetiologies including the femoroacetabular impingement (FAI) may cause a painful hip, especially in young patients. Two general types of femoroacetabular impingement have been described, the pincer- and the cam type impingement. The latter is characterized by a femoral deformity, usually a bump on the head-and-neck junction that impinges on the acetabular rim. The authors describe the case of a 21-year-old male, bodybuilder, suffering from progressive hip pain with impairment of exercise tolerance, gait and other daily activities. Besides limitation of hip internal rotation physical examination was normal. He had a transitory response to...

Inveterate Dislocation Fracture of the Sternoclavicular JointCase report

K. KOUDELA, J. KOUDELOVÁ, V. ŠIMÁNEK

Acta Chir Orthop Traumatol Cech. 2012; 79(3):279-283 | DOI: 10.55095/achot2012/042  

We present the case report of a 21-year-old man with a late diagnosis of retrosternal dislocation of the sternoclavicular joint with a fractured sternal end of the clavicle. The first symptom leading to the diagnosis was dysphagia associated with physical activity. The diagnosis was based on computed tomography examination. In the first place, the fragment of the medial clavicular end was fixed with two screws. During surgery the sternoclavicular joint was wrongly identified; this fact was revealed by the following radiographic examination. On revision surgery, the sternoclaviculr ligament was reconstructed using a semitendinosus tendon graft. The...