Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2015
Comparative StudyBiomechanical comparison of dynamic hip screw, proximal femoral nail, cannulated screw, and monoaxial external fixation in the treatment of basicervical femoral neck fractures.
PURPOSE OF THE STUDY The objective of this study was to establish relative fixation strengths of proximal femoral nail (PFN), dynamic hip screw (DHS), monolateral external fixator (EF), and cannulated screw (CS) in basicervical hip fracture model. MATERIAL AND METHODS The study involved four groups of implanted composite proximal femoral synthetic bones of eight specimens per group; nailing with PFN, DHS, fixation with three cannulated screws, and EF. 70˚ osteotomy was performed to simulate a Pauwels Type 3 basicervical fracture. Minimum preload of 100 N was applied before loading to failure. ⋯ CONCLUSION Our findings suggest that PFN, DHS and EF achieved higher fixation strengths than CS in basicervical fracture. PFN has higher failure loads and possesses biomechanical benefits for fixation of unstable basicervical fractures compared with DHS and EF. Key words: basicervical fracture, internal fixation, biomechanics.
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Acta Chir Orthop Traumatol Cech · Jan 2015
Randomized Controlled Trial[The Effect of Tranexamic Acid on Blood Loss after Primary Unilateral Total Knee Arthroplasty. Prospective Single-Centre Study].
Tranexamic acid is an antifibrinolytic agent which blocks plasmin-mediated fibrin degradation. It is used in surgery to reduce intra-operative and post-operative blood loss. The aim of our study was to assess the effect of tranexamic acid administration on blood loss after elective primary unilateral total knee arthroplasty. ⋯ Our study confirmed the efficacy and safety of tranexamic acid administration in relation to blood loss after total knee arthroplasty. In this indication, the administration is in accordance with the literature data.
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Due to the aging population, there is an increasing number of fragility fractures of the pelvis (FFP). They are the result of low energy trauma. The bone breaks but the ligaments remain intact. ⋯ Lumbopelvic fixation is restricted to highly unstable lumbopelvic dissociations. More studies are needed to find the optimal treatment for each type of instability. Key words: pelvis, fragility fracture, diagnosis, classification, treatment.
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Acta Chir Orthop Traumatol Cech · Jan 2015
[The effect of platelet-rich plasma on graft healing in reconstruction of the anterior cruciate ligament of the knee joint: prospective study].
PURPOSE OF THE STUDY Growth factors produced by platelets enhance tissue healing. The aim of this study was to confirm or disprove the hypothesis that, in anterior cruciate ligament (ACL) reconstruction, the application of platelet-rich plasma (PRP) into the tibial and femoral tunnels and in the graft enhances graft maturation and graft-bone interface healing and thus improves knee function at 3 and 12 months post-operatively in comparison with the control group. MATERIAL AND METHODS A total of 40 patient had the surgery; 20 underwent single-bundle hamstring reconstruction with PRP application (PRP group) and 20 had the same surgery without PRP addition (control group). ⋯ The function scoring results showed a statistically significant improvement in knee function between 3 and 12 months of followup within each group studied but revealed no difference between the groups. The hypothesis postulated above was disproved. Key words: anterior cruciate ligament, platelet-rich plasma, anatomic single-bundle reconstruction.
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Acta Chir Orthop Traumatol Cech · Jan 2015
Case ReportsSequential subtrochanteric femoral fracture after atypical diaphyseal fracture in a long-term bisphosphonate user: a case report.
Recent reports have found a relationship between long-term bisphosphonate therapy and the occurrence of low-energy subtrochanteric or diaphyseal atypical femoral fractures. These fractures usually occur at only one site in the same bone. We report a rare case of a patient with sequential atypical femoral fractures (first, a diaphyseal fracture, and second, an ipsilateral subtrochanteric fracture) after low-energy trauma. ⋯ This case indicates that an atypical subtrochanteric femoral fracture can occur after an atypical diaphyseal fracture in a long-term bisphosphonate user. Doctors should be aware of the possibility of a second fracture and explain the risk to the patient. Key words: bisphosphonate, atypical femoral fracture, low-energy trauma, subtrochanteric and diaphyseal femoral fractures.