Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2014
Is platelet-rich plasma injection an effective choice in cases of non-union?
By the expression of several growth factors from activated thrombocytes, the application of Platelet Rich Plasma (PRP) stimulates angiogenesis and regeneration thus stimulating recovery through cell differentiation. This study aimed to evaluate the effects of PRP injection on patients who had undergone surgery for fracture and in whom delayed union or nonunion had been determined. ⋯ Fracture healing is a process affected by many factors. Although PRP has been reported in literature to be a biological treatment which increases healing, adequate healing was not determined in the treatment of non-union with PRP injection. However, in selected patients determined with delayed union, PRP injection can be recommended in non-surgical treatment.
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Acta Chir Orthop Traumatol Cech · Jan 2014
[Scaphoid excision and four-corner fusion using the variable angle locking intercarpal fusion plate for treatment of post-traumatic degenerative changes of the wrist].
The aim of this study is to compare functional and X-ray results before and after four-corner arthrodesis using an angular stable dorsal circular plate in patients with post-traumatic degenerative changes of the wrist. ⋯ Four-corner arthrodesis of the wrist using angular stable dorsal circular plate fixation provides pain relief with acceptable preservation of the range of motion and no consolidation problems. Long-term follow-up and a larger group of patients would be necessary to confirm these hopeful results.
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Acta Chir Orthop Traumatol Cech · Jan 2014
ReviewBiomechanical and biological aspects of defect treatment in fractures using helical plates.
The clinical case of figure 1 through figure 11 shows a series of impressive failures of plate fixation. The plates were repeatedly applied bridging a comminuted bone segment in a heavy patient. The biomechanical analysis elaborates why this happened and proposes an unconventional procedure to prevent this failure with a minimally invasive procedure. ⋯ A. D. Fernandez.
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Acta Chir Orthop Traumatol Cech · Jan 2014
ReviewFracture healing: fracture healing understood as the result of a fascinating cascade of physical and biological interactions. Part I. An Attempt to Integrate Observations from 30 Years AO Research.
The choice of best procedure in fracture treatment relies on a proper understanding of tissue reactions to the prevailing mechanical and biological conditions. Investing time and effort is rewarding as it opens up access to a fascinating world and improves fracture treatment based on logical decision making. An intact bony skeleton enables mechanical functions of the human body such as locomotion. ⋯ The following paper addresses a fascinating interplay between physical and biological processes that enable fractured bone to bridge solidly and remodel to regain its "pre-fracture" function and structure. no one of the different treatment modalities or healing patterns is best on its own. for a given situation the goal is to recover the function of the bone, limb and patient early and permanently by choosing the optimal procedure and implant. Understanding bone reactions permits a rational choice and replaces subjective predilection and monomania. The stability of the fiation and the blood supply are priority considerations, which must often be weighed against each other.
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Acta Chir Orthop Traumatol Cech · Jan 2014
Randomized Controlled Trial[Metal staples versus conventional suture for wound closure in total knee arthroplasty].
Surgical incision closure, as well as total joint replacement itself, plays a key role in the overall outcome of an arthroplasty procedure. Uncomplicated wound healing is the essential condition of successful rehabilitation and the patient's return to normal activities. Although there are many innovative suturing techniques which offer advantages, their safety is still being discussed. The aim of this prospective non-blind randomised study was to evaluate wound healing and complications in relation to skin incision closure with either conventional suture or metal staples. ⋯ Correctly performed skin suturing by means of metal staples is not associated with a higher complication rate and is therefore a simple, rapid, efficient and economical alternative to the conventional suture technique.