Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2003
Less invasive stabilization system (LISS) in the treatment of distal femoral fractures.
The treatment of distal femoral fractures has been associated with a high rate of complications for a long time. Although implants and surgical techniques have improved, plate osteosynthesis and intramedullary nailing have been accompanied by a high occurrence of infection, non-union and malalignment. The treatment of soft tissue envelopes using "biological" osteosynthesis and minimally invasive approaches has resulted in a decrease in complication rates and ultimately led to the concept of the less invasive stabilization system (LISS). ⋯ Infection, delayed union and non-union rates are low, as shown by yet unpublished data from our clinic. Primary bone grafting, which is rarely necessary with this system, is carried out only when there is a great bone loss. Implant failure, such as screw loosening or secondary malalignment, is not seen.
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Acta Chir Orthop Traumatol Cech · Jan 2003
Case Reports[Vertebral osteoid osteoma--peroperative detection of its nidus using a surgical gamma probe].
The case of a vertebral osteoid osteoma localized in the arch and pedicle of the fourth lumbar vertebra in a young girl is described. The condition was manifested by the development of scoliosis, which was also the initial diagnosis. Because of painful muscle contractions and persistent pain at night, osteoid osteoma was suspected and then confirmed by scintigraphy. ⋯ One year later she was without any complaints, fusion was healed and she had no relapse. The aim of this study was to draw attention to this less known and therefore less frequently employed method that may enable the surgeon to detect conditions otherwise difficult to localize. This method can also be used for other body sites if the lesion treated accumulates radionuclides.
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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
[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.