Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2021
Comparison of Clinical Features and Serum Parameters of Culture-Positive Children with Culture-Negative Children in Septic Arthritis and Acute Osteomyelitis.
PURPOSE OF THE STUDY The aim of this study was to investigate the culture results of children undergoing debridement for suspected septic arthritis or acute osteomyelitis and to compare the laboratory parameters and clinical characteristics of culture-positive and culture-negative patients. MATERIAL AND METHODS Patients who underwent surgery in our hospital for septic arthritis and acute osteomyelitis between 2011 and 2019 were retrospectively analyzed. Seventy-two of 96 patients were included in the study. ⋯ Empirical antibiotic therapy with a wide postoperative spectrum is important for joint health in these patients. Preoperative serum parameters cannot predict the agent needed for treatment. Key words: septic arthritis, osteomyelitis, pediatric septic arthritis, pediatric joint infection, pediatric infection.
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Acta Chir Orthop Traumatol Cech · Jan 2021
Does It Matter the Fixation Method of The Posterior Malleolar Fragment in Trimalleolar Fractures?
PURPOSE OF THE STUDY The purpose of this study was to evaluate if the fixation method of a posterior fragment in trimalleolar ankle fractures affects the surgical outcomes. MATERIAL AND METHODS A retrospective evaluation was made of all the cases of trimalleolar fractures over a 9-year period in a trauma center. Patients aged 18 - 70 years were enrolled in the study. ⋯ CONCLUSIONS The study results demonstrated that better functional and radiological outcomes was observed with direct open reduction and fixation of the posterior fragment than indirect reduction and percutaneous fixation in the patients with trimalleolar fracture. The arthritis risk and patient satisfaction were seen to be correlated with the anatomic reduction of the articular surface. Key words: trimalleolar fracture, posterior malleolar fracture, percutaneous screw, open reduction and fixation, ankle fracture.
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Acta Chir Orthop Traumatol Cech · Jan 2021
Direct Radiography Following Fracture Reduction Improves the Reliability of Pauwels Classification.
PURPOSE OF THE STUDY Pauwels classification system is widely used to classify the femoral neck fractures. Even its widely usage there are severals debates about its reliability. After the femoral neck fracture occured the lower extremity rotates externally and this external rotation deformity could lead to misevaluation of Pauwels angle at the initial radiographs. ⋯ We hypothized that the reliability of this classification system could be improved after reduction of the fracture. CONCLUSIONS Our study showed that classifying the femoral neck fracture according to Pauwels classification system is more confidential after the reduction, however we can not state that it's reliability is adequate. Key words: femoral neck fracture, Pauwels classification, reliability, inter-observer, intra-observer.
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Acta Chir Orthop Traumatol Cech · Jan 2021
The Effect of Plaster of Paris on Reliabilities of RUST and mRUST Scoring Systems.
PURPOSE OF THE STUDY The aim of our study is to investigate the reliabilities of the radiographic union score for tibial fracture (RUST) and modified RUST scoring systems in the evaluation of fracture healing in adult tibia fractures treated with intramedullary nailing and pediatric tibia fractures treated with closed reduction and cast immobilization and to compare the reliabilities between two groups. MATERIAL AND METHODS Between January 2016 and January 2020, the informations of patients (ages of 4-10) with tibia fractures treated with closed reduction and casting and patients (aged 18-65 years) with tibia fractures treated with intramedullary nailing were analyzed retrospectively. Forty-seven good quality AP and lateral radiographs (represent different healing stages) each for pediatric and adult fracture groups were selected and were included in two PPTs separately. ⋯ CONCLUSIONS Our study showed that both RUST and mRUST scoring systems are useful tools that can be used safely assessing fracture healing in both pediatric and adult tibia fractures. The presence of a plaster of Paris on the extremity did not adversely affect the inter-observer and intra-observer agreement of the RUST and mRUST scoring systems. Key words: pediatric tibia fracture, radiographic union score for tibial fracture (RUST), modified RUST, radiographic union, reliability.
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Acta Chir Orthop Traumatol Cech · Jan 2021
Causes for Delay to Surgery in Hip Fractures and How It Impacts on Mortality: a Single Level 1 Trauma Center Experience.
PURPOSE OF THE STUDY The increasing number of hip fractures puts enormous demand on our level 1 trauma centre. Because we have to synchronize hip fracture treatment with all other injuries delays to surgery can occur. In this study, we analysed the reasons for delay to surgery and how it impacts on mortality of hip fracture patients in our institution. ⋯ Mortality is influenced by the patients' characteristics, but not by delay to surgery. A multidisciplinary approach and skilled surgical teams are, besides early operation, the most important assurance of a good outcome. Key words: trochanteric fracture, femoral neck fracture, timing, mortality.