Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Evolution of Opinions on Chest Wall Stabilisation and Our Experience].
PURPOSE OF THE STUDY Rib fractures represent one of the most common fractures sustained by 10-40% of all patients with blunt chest trauma, their incidence increases with age. In the current literature, however, new indication criteria continue to emerge. The purpose of this study is to assess the indication criteria, the timing of surgery and the use of individual plates in dependence on fracture location in our patients after the chest wall stabilisation in a retrospective analysis. ⋯ Nonetheless, correctly and early indicated stabilisation of the chest wall based on accurate indication criteria is of a great benefit to the patients. The aim of each and every trauma centre should be to develop a standardised protocol for the management of blunt chest trauma (the so-called "rib fracture protocol"), which comprises precisely defined criteria for patient admission, multimodal analgesia, indications for surgery, comprehensive perioperative and postoperative care and a subsequent rehabilitation of patients. Key words: rib fracture protocol, chest wall stabilisation, flail chest.
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Acta Chir Orthop Traumatol Cech · Jan 2020
Randomized Controlled Trial Comparative Study[Surgical Treatment of Clavicle Midshaft Fractures - Prospective Randomized Trial].
PURPOSE OF THE STUDY Comparison of the outcomes of clavicle midshaft fractures using two different surgical techniques, namely intramedullar osteosynthesis using elastic stable intramedullary nailing (ESIN) with medial cap and extramedullar plate osteosynthesis. MATERIAL AND METHODS The prospective randomized trial was conducted at the Department of Trauma Surgery of the Department of Surgery of the University Hospital Hradec Králové in the Czech Republic at the Level I Trauma Center between 2014 and 2018 and compared two types of osteosynthesis of clavicle midshaft fractures. 60 patients were enrolled in the study and were randomly assigned to one of the two groups. In Group 1, the participants were treated by ESIN and in Group 2 by plate osteosynthesis. ⋯ There is a statistically significant difference in shorter X-ray exposure and lower received radiation dose in plate fixation and reduction. The complication rate is comparable in both the methods. Key words: elastic stable intramedullary nailing, midshaft clavicle fracture, ESIN, TEN, titan elastic nail, clavicle plate osteosynthesis, 3.5 LCP clavicular plate, indication for midshaft fracture treatment.
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Treatment of Fractures of the Distal Third of Tibia Diaphysis by MIPO Technique].
PURPOSE OF THE STUDY MIPO (Minimally Invasive Plate Osteosynthesis) technique is currently a commonly used method to treat fractures of the distal third of tibia diaphysis. At the same time, it is just like other methods accompanied by a relatively high complication rate. The purpose of this study was to determine whether the use of this technique at our department is effective and whether the complication rate does not differ considerably from values reported by literature. ⋯ CONCLUSIONS The treatment of fractures of the distal third of tibia diaphysis remains an unsolved issue despite the development of stateof-the art materials, implants and surgical techniques. The MIPO technique can be considered an effective method of treatment of these types of fractures, achieving a high success rate of healing and acceptable rate of complications. Key words: minimally invasive plate osteosynthesis (MIPO), distal third of tibia diaphysis, locking compression plate (LCP).
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Treatment of Subtrochanteric Fractures, Our Experience, Complications].
PURPOSE OF THE STUDY The study gives a retrospective assessment of the outcomes of surgical treatment in patients who sustained a subtrochanteric fracture. MATERIAL AND METHODS In the period 2010-2018, a total of 118 patients with a subtrochanteric fracture, namely 75 males and 43 females, the mean age 61 years, were treated at our department. The study group included the patients who met the following inclusion criteria: age 18+, fracture treated by intramedullary nailing, follow-up for at least 12 months, in case of impaired healing and need for revision surgery follow-up until complete healing was achieved. ⋯ Displacement to varosity, flexion displacement or a combination of both cause impaired healing with non-union and failed osteosynthesis. Treatment of non-union is extremely challenging and always consists in the correction of anatomical relationships. Key words: subtrochanteric fractures, surgical treatment, outcomes, complications.
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Comparison of 2-Screw Implant and Antirotational Blade Implant in Treatment of Trochanteric Fractures].
PURPOSE OF THE STUDY Surgical treatment of trochanteric fractures with intramedullary nailing still remains controversial as to which nail design is the best with no postoperative complications. The purpose of this study was to provide a comparative evaluation of complications in the treatment of trochanteric fractures using 2-screw proximal femoral nail versus proximal femoral anti-rotational blade nail. MATERIAL AND METHODS A retrospective review was conducted between March 2013 and March 2019. ⋯ CONCLUSIONS In our study no statistically significant difference in postoperative mechanical and infectious complications was confirmed between the 2-screw proximal femoral nail and the proximal femoral nail with antirotational blade. We have arrived at the conclusion that both types of nails are equivalent in treating trochanteric fractures. Key words: intramedullary nail, screw, blade, trochanteric fracture, complication.