Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2013
Comparative Study[Pelvic injuries and acetabular fractures: differences in their severity].
The aim of the study was to assess differences in the number and severity of associated injuries between patients with pelvic injury and those with acetabular fracture. ⋯ The study comparing the patients with pelvic injury with those having acetabular fracture showed a significantly higher proportion of men in the group with acetabular fractures. A fall from height significantly more often caused a pelvic injury than an acetabular fracture. In traffic accidents, drivers usually suffered acetabular fractures while pedestrians and cyclists had pelvic injuries. However, a significantly higher number of associated injuries and multiple trauma with an ISS > 16 recorded in the patients with pelvic injury in comparison with those with acetabular fractures was the most important difference between these two groups.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Scapular fracture related to polytrauma severity in patients with serious brachial plexus palsy].
Brachial plexus palsy is often accompanied by other injuries. Scapular fracture is thought to be a marker of polytrauma severity. The aim of this study was to evaluate associated injuries in patients with serious brachial plexus involvement and to determine whether there is a relationship between scapular fracture and severity of polytrauma in such patients. ⋯ Both scapular fracture and serious brachial plexus injury are usually associated with other severe injuries. They occur due to high-energy trauma. Generally, patients who sustain scapular fractures and upper limb impairment in motorcycle and car crashes are at high risk of other associated injuries and more severe polytrauma.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Evaluation of the clinical results in patients with symptomatic partial tears of the anterior cruciate ligament diagnosed arthroscopically].
The study presents a retrospective evaluation of clinical data and arthroscopic findings in a group of our patients with symptomatic knee instability due to a partial tear of the anterior cruciate ligament (ACL). ⋯ To make the definite diagnosis of partial ACL tears, patient medical history, clinical knee examination including instability type and degree assessment under general anaesthesia and, most importantly, arthroscopic findings on both ACL bundles are necessary.
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At the present time proximal femoral fractures account for 30% of all fractures referred to hospitals for treatment. Our population is ageing, the proportion of patients with post-menopausal or senile osteoporosis is increasing and therefore the number of proximal femoral fractures requiring urgent treatment is growing too. In the age category of 50 years and older, the incidence of these fractures has increased exponentially. ⋯ Pseudoarthrosis or varus malalignment in a healed hip should be managed by valgus osteotomy. When the femoral head or the acetabulum is damaged, total hip arthroplasty is indicated. A prerequisite for successful surgical outcome is urgently and correctly performed osteosynthesis allowing for early rehabilitation and mobilisation of the patient.
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Acta Chir Orthop Traumatol Cech · Jan 2013
Controlled Clinical TrialThe treatment of the proximal humeral fracture with the use of the PHN Nailing System: the importance of reduction.
Intramedullary nailing is a minimally invasive technique that respects humeral head. However, limited surgical approach does not permit an anatomical reduction. The significance of the reduction on the functional outcome has not been sufficiently investigated. The aim of the study was to examine the functional and radiological postoperative outcome in patients with proximal humeral fractures treated with intramedullary nailing and the significance of reduction. ⋯ The majority of the patients treated with closed reduction and internal fixation with PHN show good postoperative functional results. However, fracture malreduction reduction cannot be always avoided with the use of PHN. Nevertheless, the evaluation of the Constant-Murley score shows an absolute anatomical reduction in not necessary for satisfying functional outcome. The reduction in anteroposterior plane seems to play a more important role in the postsurgical functional outcome. A malreduction that exceeds 15° in both planes or a malreduction of more than 20° in either plane should be avoided.