Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Combined fractures of the atlas and epistropheus account for 3 % of all acute injuries to the cervical spine. In relation to all C1 and C2 injuries this is 43 % and 16 %, respectively. The aim of this study is to evaluate a group of patients with combined C1-C2 fractures and to suggest an effective therapeutic procedure. ⋯ Combined atlantoaxial fractures are serious, life-threatening injuries which, because of their diversity, require an individual approach to each patient. Early surgery is recommended with increasing frequency, particularly in the cases with persisting dislocation or instability. At the same time it is necessary to ensure that motion restriction of the cervical spine be minimal.
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Acta Chir Orthop Traumatol Cech · Jan 2005
[Complications of internal fixation by a short proximal femoral nail].
The article presents analysis of complications of the treatment of unstable fractures of the proximal femur by the proximal femoral nail (PFN Synthes). ⋯ The most frequent mistake is reduction with the persisting varus position or distraction in the fracture line, incorrect placement of the screw in the femoral neck or the nail in the femoral shaft, wrong choice of the length of the screws, unnecessary hesitation in solving the defect in the course of the treatment. Forced insertion of the implant may cause additional damages to the skeleton. PFN is a quality implant for the treatment of unstable pertrochanteric and subtrochanteric fractures of the femur. The number and severity of complications may be reduced by the observance of proper principles of reduction and exact surgical technique.
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Acta Chir Orthop Traumatol Cech · Jan 2005
[Arthroscopic stabilization of the fractured intercondylar eminence].
The authors present the results of arthroscopic reduction of a displaced fracture of the intercondylar eminence and stabilization of the fracture with a tension band wire and absorbable, double PDS sutures. ⋯ Arthroscopic stabilization of a fractured eminence by means of PDS sutures is a gentle surgical procedure that provides good mechanical support, facilitates early rehabilitation and achieves good outcomes. The use of absorbable sutures allows us to avoid further surgery in order to remove fixation material.
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Acta Chir Orthop Traumatol Cech · Jan 2005
[Use of a hybrid external fixator for treatment of tibial fractures].
The study deals with treatment of the articular ends of the tibia, using a hybrid external fixator. A group of patients treated in the years 2001-2003 is retrospectively evaluated. ⋯ The method described here is, in addition to other options of fracture osteosynthesis, suitable for treatment of fractured ends of the tibia. External fixator application can be used with advantage for treatment of supra or infra-articular fractures of the tibia and fractures associated with marked swelling of soft tissues, for which internal osteosynthesis is not indicated, and in open fractures as well.
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Acta Chir Orthop Traumatol Cech · Jan 2005
[Harms technique of C1-C2 fixation with polyaxial screws and rods].
The Harms technique of stabilizing C1-C2 by fixation with polyaxial screws and rods is a further option for atlantoaxial fixation from the dorsal approach. Harms and Melcher published this method in 2001, but the operation had first been performed by Harms in August 1997. The aim of this study is to evaluate the first results and try to assign the Harms C1-C2 fixation an appropriate standing in the in broad range of options for stabilization of the atlantoaxial complex. ⋯ The Harms fixation of C1-C2 is a very effective technique for stabilizing the atlantoaxial complex. It enables us to provide temporary fixation without damage to atlantoaxial joints and to reduce the vertebrae after the screws and rods had been inserted, which is unique. These advantages compensate for a higher cost of the implant.