Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Arthroscopic stabilisation of acute acromioclavicular dislocation using the TighRope device].
To present the TightRope (Arthrex, Naples, FL) technique and its results in the arthroscopic stabilisation of acute acromioclavicular joint (ACJ) dislocation carried out at our department. ⋯ Arthroscopic stabilisation of acute ACJ dislocations using a single TightRope implant is an elegant minimally invasive method with good results in indicated cases. It proves efficient particularly in Rockwood type III injuries in patients who have to do repetitive overhead activities. Acute type IV and type V ACJ dislocations treated by this technique show a loss of full reduction on radiographs more frequently, although no effect on the clinical outcome is evident.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Open reduction and plate fixation (ORIF LCP) for treatment of bilateral calcaneal fractures].
Calcaneal fractures are frequent injuries which may interfere with the patient's daily activities for a long time. They usually occur as the result of an axial load causing impaction of the talus into the calcaneus. They can also be bilateral. Falls and jumps from height are the most frequent causes. ⋯ The surgical treatment of intra-articular fractures using open reduction from the extended lateral approach and internal fixation with a calcaneal LCP has achieved good results. CT scans are necessary for the diagnosis, fracture classification and indication for a surgical procedure. The timing of surgery plays a decisive role. Open fractures and fractures associated with severe soft tissue injury are treated urgently, other fractures at an appropriate time. Our results showed a significantly higher rate of complications in the patients with bilateral calcaneal fractures, as compared with the patients with unilateral fractures, as well as less satisfactory outcomes. High-energy trauma resulting in bilateral fractures predisposes to comminuted fractures with dislocation, which leads to more serious damage to subtalar joint function.
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Acta Chir Orthop Traumatol Cech · Jan 2013
ReviewEvaluation tools and outcomes after osteosynthesis of unstable type B and C pelvic ring injuries.
The evaluation of present long-term studies on results after surgical stabilization of the pelvic ring is difficult, as different treatment concepts are used and the majority of these studies are not comparable regarding selected evaluation parameters. Additionally, no standardized measurement instrument exists to analyze the clinical and radiological result after pelvic ring injuries. Only short-term evaluations with a mandatorily recommended minimum follow-up time of one year are available. ⋯ Therefore, in the future it is necessary to develop a sufficient pelvic outcome instrument which addresses these parameters. Additionally, results of treatment of specific fracture types depend on the chosen stabilization method. Overall, as single centres have only "limited" experience in treating pelvic ring injuries within a short period of time, and there is a wide range of completely different injury types and different treatment concepts, for future evaluation of long-term results after pelvic ring injuries prospective, multicenter outcome studies are recommended.
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Acta Chir Orthop Traumatol Cech · Jan 2013
Multicenter Study[Type AO/ASIF B3 fractures of the thoracic and lumbar spine].
Type B3 thoracic and lumbar fractures are often found in spines with previous hyperossification processes such as ankylosing spondylarthritis (AS) or diffuse idiopathic skeletal hyperostosis (DISH). They occur most frequently due to high-energy trauma in a healthy spine and as fall-related domestic injury in a spine affected by hyperossification. Generally, they are less frequent than type B3 cervical spine fractures. In this retrospective study involving two centres, the incidence of these fractures, their characterisation, therapy and complications associated with them were investigated. ⋯ A different approach to these fractures is required in comparison with other spinal fractures. Type B3 fractures have some features common with type C fractures and are frequent in spines affected by spinal disease. In hyperossification disorders, paradoxically associated with advanced osteoporosis, fracture treatment requires long instrumentation. In healthy spines, fractures are treated with short instrumentation. In AS and DISH patients, the diagnosis may be delayed because these patients suffer from chronic spine pain and the pain due to fracture may be attributed to an accelerated chronic condition.
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Acta Chir Orthop Traumatol Cech · Jan 2013
[Minimally invasive anterolateral surgical approach for total hip arthroplasty: seven-year results].
To evaluate the results of using the minimally invasive surgical-anterolateral approach (MIS-AL) for total hip arthroplasty at 7-year follow-up. ⋯ The minimally invasive technique for total hip replacement is no revolution in this field but is an alternative for a selected category of patients whose condition in the early post-operative period would benefit from less-invasive surgery. The MIS-AL approach does not replace the conventional total hip arthroplasty. It may play a role early after surgery but has no superior outcomes in the long-term post-operative period. In well indicated cases it is the method of choice with good mid-term results.