Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2017
Cemented Hemiarthroplasties Are Associated with a Higher Mortality Rate after Femoral Neck Fractures in Elderly Patients.
PURPOSE OF THE STUDY The postoperative outcomes of total hip replacement and hemiarthroplasty after femoral neck fractures in elderly patients were analysed to determine general and local complications as well as morbidity and mortality rates in order to detect risk profiles and assess the best individual treatment option. MATERIALS AND METHODS One hundred sixty-one femoral neck fractures among patients aged ≥ 65 years treated with cemented hemiarthroplasty (HA) or uncemented total hip arthroplasty (THA) between January 2005 and October 2013 were evaluated. In the presence of articular pathologies as well as a fracture type Garden III or IV, the indication for joint replacement was given. ⋯ After cemented HA, our study reveals a high mortality rate due to thromboembolic events. For patients with multimorbidity in particular, these findings therefore suggest that uncemented THA should be considered to prevent lethal complications. Key words: femoral neck fracture; total hip arthroplasty; hemiarthroplasty; complications.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Mid-Term to Long-Term Results of Revision Total Hip Arthroplasty Using the Oval-Shaped Acetabular Cup - TC Type].
INTRODUCTION The purpose of our paper is to evaluate the mid-term to long-term results and to confirm the basic criteria of a high-quality revision implant: safe bridging of bone defects, achievement of reliable primary fixation of revision acetabular cup, achievement of good secondary stability with documentable osteointegration of cup and demonstration of remodelling of transplanted bone tissue in the area of defects and in spaces between the implant ribs. MATERIAL AND METHODS Altogether 36 patients (38 cups) were evaluated who had undergone revision hip arthroplasty in the period from 2004 to 2010. The mean follow-up was 8.2 years (5.1-11.6 years after the reimplantation, more than 10 years in 16 patients who underwent surgery). ⋯ CONCLUSIONS The oval-shaped uncemented cup - type TC meets the requirements placed on a state-of the art revision implant, moreover its specific construction helps improve the conditions where another re-operation of acetabulum is necessary. By evaluating mid-term to long-term results of non-homogenous group of 36 patients (38 cups) we have obtained data on joint function comparable to similar groups with revision uncemented implants presented in our and foreign literature. Key words: revision oval-shaped cup, bone remodelling, pull-out tests, angular stable screws, computed tomography.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Four-Corner Arthrodesis of the Wrist with Dorsal Circular Plate - a Retrospective Monocentric Study].
PURPOSE OF THE STUDY Our study aimed to evaluate a group of patients who in the period from 2005 to 2014 underwent a four-corner arthrodesis of the wrist in our department. We also wanted to verify the hypothesis as to whether the use of conventional dorsal plate without the application of bone grafts leads to comparable results as the use of dorsal locking plates and routine application of bone grafts. MATERIAL AND METHODS Throughout the years 2005 to 2014 the four-corner arthrodesis of the wrist was performed in our department in a total of 62 patients, in two cases bilaterally. ⋯ In our group of patients, we confirmed the hypothesis that equally good results as with the use of locking plates can be achieved when using a non-locking plate system. Essential is the proper correction of DISI and primary good congruence between fused carpal bones instead of the use of bone grafts. Key words: SLAC wrist, SNAC wrist, four-corner arthrodesis, partial wrist fusion.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Treatment of Displaced Patellar Fractures with Multiple Circular Cerclage].
PURPOSE OF THE STUDY The study aims to conduct a mid-term evaluation of results of the treatment of patellar fractures with multiple circular cerclage. MATERIAL AND METHODS The retrospective clinical study with its own group of patients who underwent surgery in our centre in the period from 2008 to 2014. The study included a total of 29 patients with displaced patellar fractures treated with multiple circular cerclage. ⋯ It can be used for majority of types of fracture, including comminuted fractures, in which, however, there is a slightly higher risk of loss of reposition. The functional outcomes and the number of complications are comparable to other surgical techniques used. Key words: displaced patellar fracture, multiple circular cerclage, functional outcomes.
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Acta Chir Orthop Traumatol Cech · Jan 2017
[Results of Surgically Treated Patients for Hip Fracture - Complications, Mortality].
PURPOSE OF THE STUDY Our main objective was to evaluate the mortality and complications of patients following surgical treatment of hip fractures and to identify the associated risk factors for postoperative mortality. MATERIAL AND METHODS We retrospectively reviewed all patients over the age of 50 who underwent surgical treatment for femoral neck and peritrochanteric fractures at our institution in 2003 and 2013. Mortality was compared between subgroups classified by age, gender, fracture type, method of treatment. ⋯ That means that a complicated operation such as hip arthroplasty could be postponed and operated in more comfortable conditions (in superaseptic OR) by orthopedic surgeons. Although we haven't identified any modifiable risk factor, we believe that the reasons for better survival are multifactorial as discussed. Key words: hip fracture, proximal femoral fracture, mortality, complications, time to surgery.