Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2015
[Augmentation of the Anterior Cruciate Ligament in Patients with Symptomatic Isolated Tear of Anteromedial or Posterolateral Bundle: Evaluation of Two-Year Clinical Results].
We present the results of a prospective study of patients with symptomatic partial ACL tears comparing the pre-operative findings with the clinical results at two years after anterior cruciate ligament (ACL) augmentation. ⋯ Our results show that ACL augmentation using isolated replacement of either the AM or the PL bundle brings about statistically significant improvement of all subjective and most of the objective criteria by two years after surgery.
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The aim of the study was to analyse causes of impaired bone healing in femoral fractures and to present options of their management. ⋯ A successful outcome of femoral fracture repair is based on an understanding of the biomechanical principle, i.e., correct fracture reduction and stable osteosynthesis fitting the morphology of the fracture. Comminuted femoral fractures heal well with the use of a narrow long nail whose working length allows for even distribution of movement at a fracture line amongst the fragments and thus fracture motion load does not exceed 20%. On the other hand, short oblique and transverse fractures are examples of problematic fractures which require maximum possible stability provided by a thick nail with a short working length; this is achieved by reaming the medullary cavity or adding lag screws. In our group of patients these fractures were also the most problematic ones. Generally, nailing remains the golden standard in the management of femoral fractures.
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Acta Chir Orthop Traumatol Cech · Jan 2015
[Validity of the Morawietz classification for evaluation of periprosthetic tissue].
PURPOSE OF THE STUDY A consensual classification of the periprosthetic interface membrane obtained at revision total joint arthroplasty was published by Morawietz et al. in 2006. Based on histomorphological criteria, four types of periprosthetic membrane were proposed: type I, aseptic failure; type II, septic failure; type III, combined type (carrying signs of both type I and II); and type IV, indeterminate type. The aim of this study was to find out whether and to what extent the Morawietz system would be suitable for use at an independent institution involved in the evaluation of periprosthetic membranes for a long time. ⋯ An increased sensitivity for infectious membrane detection can be achieved by using supplementary immunohistochemical staining effective particularly in chronic and low-grade infections. 4. Painless and stable THAs typically have very low expression levels of CD4, CD20 and Hsp-60 proteins, and interferon- -gamma (IFN-γ) as well. Key words: total hip arthroplasty, total knee arthroplasty, aseptic loosening, prosthetic joint infection, tissue analysis, membranes, CD receptors, Hsp-60 protein, IFN-γ.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Randomized Controlled Trial[Surgical treatment of humeral diaphyseal fractures].
The aim of the study was to compare two surgical methods of treating diaphyseal fractures of the humerus. ⋯ Intramedullary nailing has not yet shown such good outcomes in humeral as in tibial fractures. The results of metaanalysis have indicated that humeral fractures treated by plate osteosynthesis have fewer complications and require repeat surgery less frequently. However, as shown by most recent studies, this difference is getting smaller. The MIPO technique was adopted at our department several years ago and the aim was to compare our results with those of other centres. The studies so far published have show that MIPO and conventional open plate osteosynthesis give comparable outcomes. CONCLUSIONS The statistical evaluation using the unpaired t-test did not show any significant differences in either the functional results or the number of complications between the two methods. Both achieved about 90% of excellent and good results and had 26% of complications. The only significant difference was found in the length of operative time (136 min in MIPO versus 117 min in EHN). With use of the Chi-Square test, a significant correlation between AO fracture type and treatment outcome in the MIPO group was found, i.e., no poor result was recorded for type A fractures, as assessed by the CM/LES score. No such correlation between the fracture type and the functional outcome was seen in the EHN group.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Functional results following titanium elastic-stable intramedullary nailing (ESIN) of mid-shaft clavicle fractures.
INTRODUCTION While plate fixation remains the gold standard for surgical treatment for displaced mid-shaft clavicle fractures (DMCF), intramedullary fixation has emerged as a promising alternative. However, due to its more demanding technique and depending on the fracture's nature, an open reduction can be necessary. Aim of this study was to compare the outcome of open reduction versus closed reduction of DMCF using ESIN. ⋯ CONCLUSION There was no significant difference comparing patients who were treated with an open versus a closed technique. If appropriately indicated we believe that using ESIN is an adequate and successful operative technique for DMCF. There were no significant differences in shoulder function after either procedure.