Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Minimally Invasive Cancellous Bone Graft Harvesting in Trauma Indication - Clinical Part of the Study].
PURPOSE OF THE STUDY The clinical prospective study presents the results of minimally invasive harvesting of cancellous bone tissue in trauma indications. We focused on evaluating the clinical outcomes of this technique, particularly on the amount of cancellous bone harvested, the effectiveness of its use and complications. The pain in the bone graft harvest site is evaluated and compared with the pain after a standard harvest from the iliac crest. ⋯ The advantage of this technique is the proximity of the harvest site and the operative field and low level of pain. The minimally invasive graft harvesting represents a technique with a low risk of postoperative and late complications. Key words: bone graft, autografts, minimally invasive surgery, ilium, pain.
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Evaluation of a Combination of Waveform Amplitude Latency and Decrease of Waveform Amplitude Magnitude during Spinal Surgery in Intraoperative Neurophysiological Monitoring of Transcranial Motor Evoked Potentials and Its Incidence on Postoperative Neurological Deficit].
PURPOSE OF THE STUDY This retrospective study investigated the significance of a combination of peak latency of waveform amplitude and waveform amplitude in association with spinal deformities. The correlation with postoperative neurologic deficit was evaluated too. MATERIAL AND METHODS Between January 2007 and January 2018, a group of 113 patients was evaluated in the study who underwent spine surgery using intraoperative neurophysiological monitoring (IONM) focusing on transcranial motor evoked potential (tc-MEP) monitoring. ⋯ Further studies should set the alarm criteria more precisely for the waveform amplitude latency peak delay to achieve more effective spinal cord tc-MEP monitoring. Our concept of findings supports the neurophysiological monitoring findings in other studies. Key words: monitoring, IONM, intraoperative neurophysiological monitoring, tc-MEP, motor evoked potential, transcranial, amplitude, latency, peak.
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Acta Chir Orthop Traumatol Cech · Jan 2020
[Comparison of Hospital Preparedness to Deal with Crisis Situations in Mass Casualty Incidents According to the UN Human Development Index].
PURPOSE OF THE STUDY This thesis presents the very current topic of general hospital preparedness to deal with crisis situations in mass casualty incidents. MATERIAL AND METHODS The key part of the work consists in a questionnaire survey of 26 foreign and domestic respondents, which provides a very good description of this issue in various countries of the world. The group is divided into health facilities in developed and developing countries of the world according to the UN Human Development Index. ⋯ DISCUSSION The following discussions and evaluations, together with personal experience and thorough knowledge of real-life solutions, became the basis for recommendations of triage procedures, organization of surgery and traumatology departments and material equipment of medical facilities in the Czech Republic. CONCLUSIONS By applying the results of the habilitation thesis it is possible to achieve an optimal solution and increase the reliability in the preparedness of hospitals in dealing with crisis situations, especially to eliminate the discrepancy between theory and practice. Key words: mass casualty incidents, triage, hospital preparedness, disaster management response.
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PURPOSE OF THE STUDY The aim of our study is to show the pitfalls of performing skull X-rays in patients with head injuries and the lack of accuracy of this examination nowadays, and to clarify the current trend in the MTBI investigation algorithm. MATERIAL AND METHODS A retrospective study of 3,950 patients treated for acute head injury at the Department of Trauma Surgery (University Hospital Brno) in the period from 2015 to 2016. Inclusion criteria were the following: mild brain injury (GCS = 15), primary skull X-ray design in head injury diagnosis. ⋯ The purpose of MTBI diagnostics, however, should not be a rashly decision to perform a brain CT scan, but to put into practice the CT indication criteria in MTBI applying and respecting the validated guidelines known worldwide. CONCLUSIONS Our study, in which no X-ray examination revealed possible intracranial bleeding, clearly shows that nowadays the plain radiograph of the skull does not bring any benefit in the diagnosis of minor traumatic brain injury. Key words:skull X-ray, CT of the head, head injury, minor traumatic brain injury.
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Acta Chir Orthop Traumatol Cech · Jan 2019
[Evaluation of Efficacy of Systemic Administration of Tranexamic Acid (Exacyl) in Total Hip and Knee Arthroplasty - Prospective Cohort Study].
PURPOSE OF THE STUDY To evaluate the efficacy of the systemic administration of two doses of tranexamic acid (TXA) in total knee (TKA) and hip arthroplasty (THA). MATERIAL AND METHODS The study evaluated a total of 295 patients who underwent total knee and hip arthroplasty for osteoarthritis, prospectively followed up were the patients who had been administered the tranexamic acid (TXA), and this group was subsequently compared against the cohort - control group. Our evaluation was focused on perioperative and postoperative period. ⋯ A. S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications.