Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2011
Comparative Study[Comparison of functional outcomes in angle-stable osteosynthesis of comminuted fractures of the proximal humerus with those in percutaneous Kirschner-wire fixation. A prospective study of mid-term results].
To evaluate the mid-term results in a group of patients with displaced comminuted (three- and four-fragment) fractures of the proximal humerus treated by angle-stable plate osteosynthesis and compare them with the results in the patients in whom the method of percutaneous Kirschner-wire (K-wire) fixation was used. ⋯ The analysis of functional outcomes showed that the therapeutic effect of K-wire transfixation was significantly worse than the effect of the angle-stable plate technique, and therefore the authors stopped using this method. At present intramedullary nailing is indicated in two- and three-fragment fractures and in some less displaced four-fragment fractures. An angle-stable plate is used in severely displaced four-fragment fractures. If the head is broken or dislocated, older patients are primarily indicated for hemiarthroplasty and younger ones for humeral head reconstruction.
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Acta Chir Orthop Traumatol Cech · Jan 2011
[Vertebral body augmentation using a vertebral body stent].
Osteoporotic vertebral fractures can be treated by minimally invasive percutaneous vertebral augmentation with bone cement using vertebroplasty or balloon kyphoplasty. Transcutaneous reduction and vertebral body stenting has been the most recent principle. In contrast to balloon placement in kyphoplasty, the stent remains in the vertebral body and supports both the vertebral body and cement filling. In this retrospective study we present the essential information on the method and our first results. ⋯ The novel method of vertebral body stenting with cement augmentation provides a rapid pain relief, gives stability to fracture reduction and has a low rate of cement leakage. However, care must be taken not to indicate cases with a damaged posterior corticalis of the vertebral body.
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Acta Chir Orthop Traumatol Cech · Jan 2011
[Single cannulated screws for stabilisation of pelvic ring and acetabular fractures].
Current trends in minimally invasive surgery together with advances in computed tomography and fluoroscopic guidance allow us to perform close reduction and percutaneous fixation also in non-displaced or minimally displaced fractures of the pelvic ring and acetabulum. Authors report the method of percutaneous screw fixation. ⋯ In specific localisations, the percutaneous fixation of pelvic ring and acetabular fractures using single screws presents a new surgical technique for which the indications have not been exactly defined yet. The procedure should be performed by an experienced surgeon ready to convert surgery from a minimally invasive procedure to an open one, if the navigation technique used does not provide a reliable guidance or when the fracture reduction or stabilisation fails.