Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Indications for emergency surgery in thoraco-abdominal injuries].
Under the conditions of an increasing number of car accidents and criminal injuries the thoracis and abdominal trauma is a source of a significant morbidity and mortality in blunt and penetrating mechanism of injury. On the basis of a group of patients operated on for blunt and penetrating injury of the chest and abdomen evaluation was made of the current indication and results of lifesaving surgery in case of these injuries. ⋯ Priority indication for a lifesaving surgery in thoracoabdominal injuries is significant intraabdominal bleeding diagnosed on the basis of the result of the clinical examination in hemodynamically unstable patients. In a stabilized patient the lifesaving surgery is performed on the basis of the result of visualization methods (spiral computer tomography, ultrasound, angiography, endoscopy) revealing apart from significant bleeding also severe injuries of intrathoracic and intraabdominal organs. Protracted hypovolemic shock with the development of multi-organ failure or the occurrence of simultaneous severe associated injuries in polytrauma are the most frequent causes of mortality in patients operated on for thoracoabdominal injury.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Triple osteotomy of the pelvis in children and adolescents.
To assess the results of Steel triple osteotomy on Developmental hip displacement (DDH) and Legg-Calvé-Perthes Disease (LCPD) cases utilising objective criteria based on measurements. All measurements were done by a co-author in a blind way. What concerns DDH, triple osteotomy was used in all cases in which authors felt to obtain a profit for a patient, so that hips with non-spherical head were operated on, too. On the other hand, as far as the experience with Steel osteotomy in LCPD is very limited, authors used this method presuming to obtain similar effect like with Salter osteotomy in younger patients. ⋯ The historical postulate of inaugurator of triple osteotomy, concerning the sphericity of the femoral head as a condition sine qua non, seems to be broken especially in Legg-Calvé-Perthes disease. Even sattle deformity of femoral head can be corrected. What concerns the DDH the greater degree of joint deformity, especially aspherical incongruency brings about the risk of failure of surgical procedure. Nevertheless, in this study five out from seven cases of that degree of distortion obtained at least partial correction.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Heterotopic bone formation in total hip arthroplasty: predisposing factors, classification and the significance for clinical outcome.
Heterotopic bone formation in the area around the femoral head is a recognised complication following total hip arthroplasty. The aim of the study was to determine the prevalence of heterotopic ossification and to select a method of classification. Also, we studied the potential association of heterotopic bone with the following variables: sex, age at operation, operative technique, type of prosthesis and previous surgery on the ipsilateral hip. ⋯ The study has identified male patients and female patients older than 65 years both with osteoarthrosis as risk factors for the formation of heterotopic bone. The prevalence did not depend on the operative approach or type of prosthesis used. Heterotopic ossification was not associated with previous operative treatment of the hip. Both classification systems used in this study have proved reliable.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[The uncemented cup of the CLS Spotorno joint endoprosthesis--5-years' results].
Authors report on five-year results in patients after THR operated on between 1994 and 1995 in which a cementless CLS Spotorno cup was used. ⋯ After five years the authors have a good experience with CLS Spotorno cup and recently they have started to indicate it more often in postdysplastic coxarthrosis in younger patients and in revision surgery for aseptic loosening of a cup. In young patients they recommend its matching with CLS Spotorno cementless femoral component and in middle-aged patients its matching with MS-30 (Morscher-Spotorno) cemented femoral component the centralizer of which allows an ideal anchoring of the stem in the cement mantle.