Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Oct 2007
[Treatment of intra-articular proximal tibial evaluation of two- to seven-year follow-up].
Intra-articular fractures of the proximal tibia always present a complicated therapeutic problem. In this retrospective study, the results of both conservative and surgical treatment of these fractures are evaluated. ⋯ In intra-articular fractures of the proximal tibia, treatment outcomes depend on the type of fracture as well as correct reduction and use of appropriate fixation. When accurate alignment, joint stability and well reduced articular surfaces are achieved, outcomes are very good. At mid-term follow-up, reduction under arthroscopic control gives better results than stabilization performed by arthrotomy.
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Acta Chir Orthop Traumatol Cech · Oct 2007
Comparative Study[Massive tears of the rotator cuff--comparison of mini-open and arthroscopic techniques. Part 2. Arthroscopic repair].
In this study the results of arthroscopic repair of massive rotator cuff tears are evaluated and compared with those of mini-open surgery published in Part 1. ⋯ Arthroscopic rotator cuff repair can be recommended as the procedure fully comparable with the open technique. Because of the possibility to diagnose and treat all shoulder pathologies at one stage, all rotator cuff repairs at present carried out at our department are arthroscopic procedures.
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The aim of the study was to ascertain what proportion of patients undergoing total knee arthroplasty (TKA) complain of restricted knee joint motion, and to investigate options for improvement of this situation. ⋯ Restricted motion of the knee joint after TKA is difficult to treat and, therefore, prevention is recommended. This should include thorough conservative treatment of gonarthrosis, early indication for surgery, prevention of elevation in the joint line and consistent rehabilitation with appropriate analgesia. For severe stiffness of the knee joint, as evaluated by the criteria of Kim et al., revision arthroplasty can be recommended.
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Although great advances have been made in both radiological diagnosis and antibiotic therapy of microbial infections, the treatment of spinal infections remains a major clinical challenge. Many of the patients affected are referred to spinal units with long delays. The general population is ageing and the number of immunocompromised patients, as well as the number of operative procedures for spinal disorders are increasing. The aim of our study was to evaluate the clinical presentations of spinal infections, options for their diagnosis, indications for treatment and their risk factors and the results of surgery. ⋯ Early diagnosis is a prerequisite for good treatment outcomes. Clinical examination, results of laboratory tests, and scintigraphy and MRI findings play the key role. When progressing osteolysis is suspected, a CT scan is necessary. Debridement should be as radical as possible, but always in compliance with the patient's health state. At an advanced stage of disease, spinal stabilization is important because it allows us to remove infected tissue. Intravenous and then oral antibiotic therapy at 2 to 4 and 6 to 12 weeks of follow-up is mandatory. The management of spinal infections is a complex process requiring good multidisciplinary cooperation.