Development of Hip Joints Treated Non-operatively for Developmental Dysplasia of the Hip by Overhead Traction - Clinical and Radiographic Assessment after Reaching Skeletal MaturityOriginal papers

O. VALTR, P. ŠPONER, D. PELLAR, T. KUČERA

Acta Chir Orthop Traumatol Cech. 2020; 87(6):381-386 | DOI: 10.55095/achot2020/060  

PURPOSE OF THE STUDYThe purpose of the retrospective study was to analyse the success rate and safety of overhead traction in treating decentered hip joints. In patients treated strictly non-operatively, i.e. with no open reduction and no operative management of residual dysplasia performed, acetabular development was assessed once they have reached the skeletal maturity.MATERIAL AND METHODSThe restrospective study included a total of 40 patients treated by overhead traction in the period 1999-2002 for developmental dysplasia of the hip (ultrasound classes III.A, III.B, IV according to Graf classification). The study group consisted of...

Outcomes of Revisions of the Acetabular Component of THA with Paprosky Type 3a and 3b Defects Using Tantalum Trabecular Metal Implants 2-10 Years PostoperativelyOriginal papers

D. MUSIL, T. TRNKA, J. KLOUDA, J. PERTLÍČEK, M. HELD, J. STEHLÍK

Acta Chir Orthop Traumatol Cech. 2020; 87(6):387-395 | DOI: 10.55095/achot2020/061  

PURPOSE OF THE STUDYTantallum trabecular metal implants (Trabecular Metal Technology - TMT) considerably changed the acetabular reconstruction options in revision surgeries with extensive bone defects and distorted pelvic ring integrity. The purpose of this study is to ascertain the short-term to medium-term outcomes of acetabular reconstruction through TMT implants in patients with Paprosky type 3a and 3b acetabular defects and in case of pelvic discontinuity.MATERIAL AND METHODSThe prospective monocentric study included patients in whom the revision of acetabular components in total hip arthroplasty was performed, the acetabular defect...

Modern Treatment of Recurrent Patellofemoral Instability - Combined Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle TransferOriginal papers

K. SISÁK, C. GOMBÁR, G. FRIEBERT, Z. KOÓS

Acta Chir Orthop Traumatol Cech. 2020; 87(6):396-403 | DOI: 10.55095/achot2020/062  

PURPOSE OF THE STUDYThe treatment of recurrent patellofemoral instability has undergone a paradigm change during the last 15 years. Instead of non-anatomical operations, the current concept favors the reconstruction of injured structures and the normalization of the biomechanical environment. Our aim was to briefly summarize the etiology, diagnostic regimen, and therapeutic decision making of this varied patient group and to review our own patients who underwent combined medial patellofemoral ligament reconstrucion and tibial tubercle transfer.MATERIAL AND METHODSBetween 2015-2017 we performed combined ligament reconstruction and tubercle...

Derotational Intertrochanteric Osteotomy in Habitual Dislocation of the PatellaOriginal papers

R. HART, D. NÁHLÍK, L. PAŠA

Acta Chir Orthop Traumatol Cech. 2020; 87(6):404-408 | DOI: 10.55095/achot2020/063  

PURPOSE OF THE STUDYThe preoperative planning in habitual dislocation of the patella should take into account all pathologies and the procedure should address all abnormalities. One of them might be also the rotational deformity of the femur. The purpose of this prospective study was to confirm the hypothesis that the only correction of pathological femoral anteversion by derotational intertrochanteric osteotomy (in the absence of another pathology) or the correction of femoral anteversion with simultaneous reconstruction of the patellofemoral joint provide adequate stability for the patellofemoral joint, with respect to the elimination of the...

Occult Injuries to Posterior Pelvic Segment in Elderly Patients with Pubic Rami FracturesOriginal papers

J. BIELÁK, R. HART

Acta Chir Orthop Traumatol Cech. 2020; 87(6):409-413 | DOI: 10.55095/achot2020/064  

PURPOSE OF THE STUDYThe incidence of pelvic fractures in geriatric population has been increasing. The diagnostic method of first choice is plain pelvic anteroposterior X-ray which, however, mostly reveals merely the pubic rami fractures. The pain caused by undiagnosed lesion of the posterior pelvic segment may substantially reduce the patient s mobility, thus also their self-sufficiency which is crucial in elderly patients. The purpose of this prospective study was to evaluate the incidence of an occult injury to the posterior pelvic ring in patients with an X-ray finding of pubic rami fractures only.MATERIAL AND METHODSThroughout a three-year...

Advantages and Pitfalls of Stabilisation of Supracondylar Humerus Fractures in Children by Lateral Approach OnlyOriginal papers

J. HENDRYCH, P. HAVRÁNEK, M. ČEPELÍK, T. PEŠL

Acta Chir Orthop Traumatol Cech. 2020; 87(6):414-420 | DOI: 10.55095/achot2020/065  

PURPOSE OF THE STUDYSupracondylar humerus fracture (SCF) with dislocation is indicated for closed reduction and osteosynthesis. The method achieving the best stability is CRCPP (closed reduction and crossed percutaneous pinning), even though there is a risk of iatrogenic ulnar nerve injury. The CRLPP (closed reduction and lateral percutaneous pinning) method eliminates this risk at the cost of less stable osteosynthesis.The purpose of this study is to compare the SCF stabilisation by CRLPP with the stabilisation by CRCPP in rotationally stable fractures and to identify the risk of iatrogenic ulnar nerve injury, or the failure of osteosynthesis...

Open Incisional Biopsy and Ultrasound-Guided Core Needle Biopsy of Extremity-Localized Musculoskeletal TumorsOriginal papers

L. PAZOUREK, I. STANICZKOVÁ ZAMBO, T. TOMÁŠ, M. MAHDAL

Acta Chir Orthop Traumatol Cech. 2020; 87(6):421-428 | DOI: 10.55095/achot2020/066  

PURPOSE OF THE STUDYTo evaluate the results of incisional open biopsies and ultrasound-guided core needle biopsies for musculoskeletal lesions in extremity and limb girdle locations.MATERIAL AND METHODSIn 2019, 176 open incisional biopsies were performed at our department, 113 from bone lesions and 63 from soft tissue lesions. In the period of September 2019 to February 2020, we started performing also ultrasound-guided core needle biopsies from soft tissue lesions in limited indications, namely in 23 cases. The diagnostic accuracy, complications and pain associated with the procedure were evaluated.RESULTSOf 113 open incisional...

Optimal Route for Tranexamic Acid in Diabetics and Obese Patients Undergoing Primary Total Knee Arthroplasty - a Data from Randomized StudyOriginal papers

J. LOŠŤÁK, J. GALLO, Ľ. BALÁŽ, J. ZAPLETALOVÁ

Acta Chir Orthop Traumatol Cech. 2020; 87(6):429-437 | DOI: 10.55095/achot2020/067  

PURPOSE OF THE STUDYTo determine the optimal strategy for tranexamic acid (TXA) administration in diabetic patients, smokers and obese patients (BMI > 30 kg/m2) undergoing primary total knee arthroplasty (TKA).MATERIAL AND METHODSThe total of 400 consecutive patients indicated for primary TKA were randomised into 4 basic groups with different TXA administration regimens. Group 1 (IV1) had a single intravenous dose (15 mg TXA/kg) applied prior to skin incision. Group 2 (IV2) got two intravenous doses (15 mg TXA/kg): one prior to skin incision and one subsequently 6 hours after the first dose. Group 3 (TOP) had 2 g TXA in 50 ml of saline...

Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development IndexOriginal papers

F. BURGET, P. DOUŠA, M. KLOUB, T. KOZÁK, L. PLEVA, V. ROGALEWICZ

Acta Chir Orthop Traumatol Cech. 2020; 87(6):438-446 | DOI: 10.55095/achot2020/068  

PURPOSE OF THE STUDYThis thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents.MATERIAL AND METHODSThe key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. Another sub-group consists of hospitals in areas with a higher frequency of terrorist attacks and a separate group is formed by 5 hospitals in...

Metal Debris with Cobalt Intoxication and Heart Damage as a THA ComplicationCase report

J. HACH, M. KUBÁNEK, D. PELCLOVÁ, K. LACH, P. FULÍN

Acta Chir Orthop Traumatol Cech. 2020; 87(6):447-451 | DOI: 10.55095/achot2020/069  

Total hip replacement is currently a standard orthopaedic procedure. A number of complications caused by wear of the articulating parts of the endoprosthesis were described in the past. In recent years, there have been reports of systemic manifestations of metal components wear, leading to the development of chronic metal poisoning and organ damage. Our case report documents two cases of heart damage, resulting in heart failure with the need for heart transplantation, caused by metal poisoning originating from a failed THA.

Rare Vascular Complication after ACL ReconstructionCase report

M. HANUS, R. HUDÁK

Acta Chir Orthop Traumatol Cech. 2020; 87(6):452-455 | DOI: 10.55095/achot2020/070  

The anterior cruciate ligament reconstruction is currently one of the most commonly performed arthroscopic procedures of knee joint. Overall, it is a reliable and sophisticated procedure associated with a relatively low complication rate. In the available literature, less severe complications are reported in 3-7% of cases. The most frequent complications are intractable pain not manageable using analgesic therapy (6.7%), hemarthrosis requiring puncture (4.4%), fever (3.2%) and other complications related in particular to immobilisation (1.2%). The percentage of severe complications is very low (less than 1%). These include deep vein thrombosis (0.6%),...

XXIV. Národní kongres ČSOT, Brno 2020Reports from ČSOT

M. REPKO

Acta Chir Orthop Traumatol Cech. 2020; 87(6):456