Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Rotational acetabular osteotomy in the treatment of Legg-Calve-Perthes disease].
The material of prospective study involving 57 surgically treated hips in 55 patients suffering with a severe form of Legg-Calvé-Perthes disease (LCPD) was analysed by the use of statistical methods to depict the influence of age, of sex, of the amount of head involvement on the outcomes of surgical treatment by rotational acetabular osteotomy (Salter or Steel osteotomy from 9 years of age). ⋯ Submitted study was prepared to be matched nextly with the conservative group, which will be published in another publication. Internal analysis of the presented cohort disclosed that presented surgical treatment (Salter or Steel osteotomy respectively) assured, that irrespective of higher age, the important parameters like epiphyseal quotient and acetabulum-head index did not become worse than in younger groups. Even in the group over 9 years of age, 87.5% were categorised like excellent and fair results in Stulberg classification.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Personal experience with injuries of the flexor tendons of the hand].
The study presents a retrospective evaluation of a group of 198 patients with 242 acute injuries of tendons of flexors of the hand in the period between 1995-1999. Evaluation covers the outcomes of the primary treatment as compared to the secondary reconstruction surgery--mainly in zone II after Kleinert. ⋯ Treatment of the flexor tendons of the hand should be performed as soon as possible with a full comfort for the patient (operating theatre, total or local anesthesia) as well as for the surgeon (assistance, perfect suture material). Reconstruction surgery is considerably less successful. In all zones after the primary surgery excellent or good results are at least by 10%, in zone II even by 16%, more frequent than in the secondary surgery.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Randomized Controlled Trial Clinical Trial[Aprotinin (Antilysin Spofa)--its effect on decreasing hemorrhage in the postoperative period in hip arthroplasty].
Aprotinin is a non-specific inhibitor of serine proteases with hemostyptic and hemostatic properties. The effect covers suppression of fibrinolysis and support of the role of thrombocytes in coagulation. In a prospective randomized study we verified whether the application of aprotinin (Antilysin Spofa, Czech Republic) in the dosage effective in cardiosurgical patients reduces blood loss and the need for blood transfusion for orthopaedic patients. ⋯ Infusion of aprotinin (Antilysin Spofa) in the dosage of the order of 106 KIU significantly reduces post-operative blood loss and frequency of transfusion in the peroperative period in patients undergoing THA.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Unreamed locking intramedullary nailing of humeral fractures--basic evaluation of a patient group].
The aim of the work is to provide an overview of the existing experience in Synthes unreamed humeral nail (UHN). ⋯ The main indication of UHN are comminuted or multi-level fractures of humerus in the central three fifths of its length. If possible we prefer the retrograde method of nailing, in the antegrade method we recommend distal locking from the anterior aspect of the arm. Transverse or short oblique fractures can be successfully treated by a simpler Hackethal technique. Long spiral fractures are ideally treated conservatively or by plate fixation.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Case Reports[The Bosworth ankle fracture (case report)].
The authors describe an atypical case of the so called Bosworth fracture of ankle. A woman, 26 years suffered a fracture of fibula in the proximal third of the shaft, the distal fibular fragment was displaced from the fibular insicure of distal tibia posteromedially where it remained locked behind posterior tibial tubercle, and a fracture of medial malleolus and fracture of the posterolateral fragment of distal tibia. Thus it was a fracture-dislocation of ankle of Weber C type. ⋯ In children or young adults fibula does not break, it only dislocates and in adolescents there may simultaneously occur epiphysiolysis of distal tibia. On the medial side there usually occurs a fracture of medial malleolus or rupture of deltoid ligament or there is no lesion on the medial side. Conservative reduction is successful only exceptionally, i.e. only in case of intact fibula or its high fracture (Weber C), the method of choice is open reduction and internal fixation.