Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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PURPOSE OF THE STUDY The aim of our study is to show the pitfalls of performing skull X-rays in patients with head injuries and the lack of accuracy of this examination nowadays, and to clarify the current trend in the MTBI investigation algorithm. MATERIAL AND METHODS A retrospective study of 3,950 patients treated for acute head injury at the Department of Trauma Surgery (University Hospital Brno) in the period from 2015 to 2016. Inclusion criteria were the following: mild brain injury (GCS = 15), primary skull X-ray design in head injury diagnosis. ⋯ The purpose of MTBI diagnostics, however, should not be a rashly decision to perform a brain CT scan, but to put into practice the CT indication criteria in MTBI applying and respecting the validated guidelines known worldwide. CONCLUSIONS Our study, in which no X-ray examination revealed possible intracranial bleeding, clearly shows that nowadays the plain radiograph of the skull does not bring any benefit in the diagnosis of minor traumatic brain injury. Key words:skull X-ray, CT of the head, head injury, minor traumatic brain injury.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Evaluation of Efficacy of Systemic Administration of Tranexamic Acid (Exacyl) in Total Hip and Knee Arthroplasty - Prospective Cohort Study].
PURPOSE OF THE STUDY To evaluate the efficacy of the systemic administration of two doses of tranexamic acid (TXA) in total knee (TKA) and hip arthroplasty (THA). MATERIAL AND METHODS The study evaluated a total of 295 patients who underwent total knee and hip arthroplasty for osteoarthritis, prospectively followed up were the patients who had been administered the tranexamic acid (TXA), and this group was subsequently compared against the cohort - control group. Our evaluation was focused on perioperative and postoperative period. ⋯ A. S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Whole-Body CT Scan and Other Imaging Techniques in Examining Polytrauma Patients - Outcomes of a Questionnaire Survey of Trauma Centres in the Czech Republic].
PURPOSE OF THE STUDY The study aimed to map the use of imaging techniques and results reporting in polytrauma patients by the trauma centres in the Czech Republic. MATERIAL AND METHODS The representatives of radiology departments and units of all 12 trauma centres in the Czech Republic completed a questionnaire regarding the imaging in polytrauma patients. RESULTS The Focused Assessment with Sonography for Trauma (FAST) as an initial imaging is used by all the centres, the WholeBody CT scan (WBCT) is the dominant imaging technique everywhere and all the centres have standards in place for its performance. ⋯ A more careful consideration of indications for imaging examinations based on the clinical finding may reduce the radiation exposure of patients while maintaining the diagnostic accuracy. A structured report on WBCT in polytrauma is not used even though it is recommended by the European Society of Radiology. Key words:polytrauma, diagnostic imaging, Whole-Body Computed Tomography, structured report.
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PURPOSE OF THE STUDY Periprosthetic distal femoral fractures (PDFF) constitute an unpleasant complication in patients with a total knee replacement (TKR). The incidence reported in literature is 0.3-2.5 %. The number of periprosthetic knee fractures has been increasing due to the ageing of population, a growing number of implants, a longer life expectancy of patients, a more intensive physical activity of patients, and osteoporosis. ⋯ Very distal fractures classified as Su Type III with a loose femoral component require a revision surgery with a TKR with stems. The surgeon should be prepared for a revision surgery if the intraoperative finding is more complicated than anticipated based on the preoperative radiograph. Key words:total knee arthroplasty, periprosthetic fracture, osteosynthesis.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Treatment of Acute Periprosthetic Infections with DAIR (Debridement, Antibiotics and Implant Retention) - Success Rate and Risk Factors of Failure].
PURPOSE OF THE STUDY Revision surgery with implant retention and exchange of mobile prosthetic parts is considered to be the method of first choice in acute periprosthetic infections with a stable endoprosthesis and good condition of soft tissues, where the symptoms did not last longer than 3 weeks. The aim of the study was to evaluate the long-term outcomes and to identify the factors affecting the success rate of this procedure. MATERIAL AND METHODS This unicentric retrospective study evaluated the results of 18 surgeries with implant retention performed at the Department of Orthopaedics of České Budějovice Hospital in the period 2009-2016. ⋯ The results suggest that it is particularly appropriate in early postoperative infections of primary total joint replacements. Its indication in late periprosthetic infections, especially of repeatedly operated joints, shall be carefully considered. Key words:acute periprosthetic joint infections, PJI, DAIR, implant retention, risk factors, success rate.