Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Treatment of anterior glenohumeral instability: personal experience with an arthroscopic stabilization technique, its indications and results].
Arthroscopic treatment of anterior post-traumatic instability of the glenohumeral joint is a recent surgical procedure. The aim of this study was to evaluate the outcomes of the method and define criteria on which indications for this treatment are based. ⋯ The arthroscopic treatment of anterior post-traumatic glenohumeral instability, using the Wolf method, resulted in a reduction of recurrent dislocations, supposing indication criteria were observed. Its outcomes were comparable with the results of conventional open surgery.
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Injuries of the lower cervical vertebrae--the monocortical stabilization technique].
In contrast to the thoracolumbal spine, the cervical spine bears a lower biomechanical load and, therefore, anterior stabilization of a fracture is a definitive procedure in the majority of cases. What remains the matter of choice is screw fixation in the body of the vertebra involved. This may be either monocortical or bicortical. In this study, we evaluate a group of patients in whom fractures of the lower cervical spine were treated using the CSLP monocortical system (Synthes). ⋯ Our experience and literature data suggest that the CSLP monocortical system is fully capable to stabilize the lower cervical spine after injury, supposing all procedures described above are completed. In more serious trauma and type B or C instability, the additional dorsal instrumented fusion is indicated.
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Acta Chir Orthop Traumatol Cech · Jan 2003
40-year experience in surgical treatment of congenital chest deformations--ethiopathogenesis, operative techniques and clinical results.
The aim of this study was to assess the results of surgical treatment of 58 patients with pectus excavatum and 11 with pectus carinatum and discuss the problems connected with ethiopathogenesis and operative techniques. ⋯ Ethipathogenesis of pectus excavatum and carinatum remains unsettled. Disturbances in endochondral ossification and growth of costal cartilage seem to be more probable cause of the deformities than diaphragm underdevelopment. Mild and severe forms of the two deformities result in circulatory-respiratory malfunctions, cosmetic defects and psychical problems. Due to possible circulatory-respiratory disorder, appropriate premedication as well as intra- and postoperative monitoring of RR, ECG, O2, CO2 are very important on the first day after the surgery. Ravistch-Garnier procedure for pectus excavatum and Chen procedure for pectus carinatum remain operations of choice. Transsternal traction can be replaced with internal stabilisation with a bar placed under the sternum what considerably reduces the time of hospitalisation but requires one more hospitalisation to remove the bar. Correction of pectus carinatum is permanent, correction of pectus excavatum turned out to be permanent in 90% cases providing that they were performed in patients aged 12-16. When patients were at the age 6-10, recurrence of the deformity occurred in 37% of cases. According to the clinical assessment, in both age groups, the proportion of very good or good scores equalled 70% and according to patient's evaluation--86.6%.
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Acta Chir Orthop Traumatol Cech · Jan 2003
[Treatment of deep chondral defects of the knee using autologous chondrocytes cultured on a support--results after one year].
The treatment of deep chondral defects is one of the key issues in current orthopedics and traumatology. We developed a new technique that greatly improved the outcome of treatment in young active patients. The method is based on transplantation of in vitro cultured autologous chondrocytes carried on the fibrin glue Tissucol. ⋯ The method described is effective for treating deep chondral knee injuries and can be recommended for use in clinical practice.
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We evaluated the outcomes of lumbar discectomies in relation to the presence or absence of degenerative spinal lesions and the surgical treatment used in order to determine the extent to which these factors influence the result of treatment. ⋯ The average 30.32% decrease in ODI score from 54.15% before the surgical tree of intervertebral discs herniation, as evaluated at an average of 3.22 years after surgery, is regarded as a good outcome. The Oswestry questionnaire generally permits a reliable assessment of patient complaints. In this study, a Czech translation of Version 2.0 of this questionnaire is presented and recommended for use. The presence of serious degenerative spinal lesions makes the outcomes of discectomy less satisfactory. Prospects for the approach that combines discectomy with fusion can be assessed in patients whose indications are well defined and complaints exactly evaluated.