Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Multivariate analysis of blood loss during primary total hip or knee arthroplasty].
The primary aim of the study was to identify characteristics predicting the blood loss associated with primary total hip (THA) and knee (TKA) arthroplasty surgery. The other objective was to find out which characteristics were important for peri-operative allogeneic blood transfusion in the same group of patients. ⋯ The patients with low pre-operative Hb levels have a high probability that they will require allogeneic blood transfusion during primary THA and TKA. Autologous blood donation can decrease this probability significantly (here proved only for THA patients). The multivariate model of blood loss published here could assist in estimation of peri-operative blood loss and potential risk of blood transfusion requirements.
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Acta Chir Orthop Traumatol Cech · Jan 2013
Cervical spondylotic myelopathy: the outcome and potential complications of surgical treatment.
Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in patients over 60 years old. Symptoms often develop gradually and insidiously and are characterized by neck stiffness, arm pain, numbness and clumsiness of hands, as well as weakness of the hands and legs frequently leading to a change in mobility. Surgery is performed primarily to prevent the progression of symptoms but also with the aim of improving existing symptoms. Aim of our study was to assess the outcomes and potential complications of surgical decompression of cervical spondylotic myelopathy (CSM). ⋯ Surgical decompression offers a real chance of improvement in the functional outcome of CSM, especially during the earlier stages of the disease. The surgical decision needs to be considered carefully due to the advanced age of the patient population and the greater burden of co-morbidities, which increase the surgical risks significantly.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Hinged external fixation in orthopaedic and trauma surgery of the elbow].
A hinged external fixator of the elbow provides stable fixation of the joint while maintaining the range of its motion. The aim of the study was to evaluate a group of patients in whom an external fixator was used to manage severe injuries to the elbow, namely, traumatic unstable dislocation, unstable fracture-dislocation, and elbow fractures not permitting management by primary osteosynthesis. This also involved assessment of early elbow mobilisation and a comparison of this group with a group of patients treated conservatively for less severe elbow injuries. ⋯ Elbow injuries differ from patient to patient and therefore the approach to their treatment has to be individual in every patient. A hinged external fixator provides stable fixation and allows for early movement of the elbow. Maintenance of the range of motion facilitated by the hinged fixator is not at the expense of joint stability or fracture non-union. Based on the results presented here, we recommend the use of external fixation in severe unstable elbow fractures and in fractures in which primary osteosynthesis cannot be used because of soft tissue injury.
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Acta Chir Orthop Traumatol Cech · Jan 2013
Supraacetabular external fixation for pain control in geriatric type B pelvic injuries.
PURPOUSE OF THE STUDY: Pelvic ring fractures in the geriatric population are of increasing frequency. Often insufficiency fractures or occult fractures are described. With a classical injury mechanism the majority of these injuries are the result of a low energy trauma, typically a fall from standing or during walking.Clinically, many patients report immediate anterior groin pain but detailed clinical examination often shows significant posterior pelvic pain. CT evaluation often reveals posterior pelvic ring injury, in the majority of cases a sacral compression fracture. Despite adequate diagnostics, many of these patients suffer from persistent pain, which can be observed up to 8 weeks after injury. To asses the role of external fixator in pain relief and early mobilisation in this group of patients the study was performed. ⋯ This simple operative procedure, therefore, can be used for pain control and sufficient mobilization to avoid secondary medical complications.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Surgical management of talus fractures: mid-term functional and radiographic outcomes].
The aim of this prospective study was to present injury characteristics and to evaluate therapeutic procedures and midterm functional and radiographic results of the surgical management of talus fractures. ⋯ Our results confirmed that the management of talar fractures by means of osteosynthesis is indicated even in nondisplaced Hawkins type 1 fractures, staged treatment is effective in dislocated and open fractures, delayed surgery is a safe procedure for less dislocated fractures and injuries requiring complex care should be referred to foot surgery centres.