Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Oct 2010
[Comprehensive diagnosis of infection in revision total replacements of large joints].
To make comprehensive diagnoses of the infections associated with revision total knee and hip arthroplasties in our group of patients ⋯ In our group of patients, the CRP and ESR values proved to be useful in making the diagnosis of infection. For this pur- pose, WBC counts in blood samples were not sensitive enough. Biopsy findings had low sensitivity, but appeared to be a specific marker of infection. Prolonged cultivations of samples and cultivation under anaerobic conditions resulted in a marked increase in isolates obtained, as compared with the routine cultivation technique.
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Acta Chir Orthop Traumatol Cech · Oct 2010
[Ipsilateral fractures of the proximal femur and the femoral shaft].
The aim of the study was a retrospective evaluation of the surgical treatment of 171 fractures of the proximal femur and the femoral shaft. ⋯ In case of fractures of the femoral shaft, in high-energy trauma particularly, it is necessary to check the patient for a potential proximal femur fracture. The diagnosis should be made on the basis of a radiograph of the pelvis in internal rotation and axial projection and CT scans for evaluation of the proximal femur, including 2D CT reconstructions. Prior to nailing of the femoral shaft, sciascopic examination must be made of the hip in both projections. Fixation by a reconstruction nail is a suitable method for treatment of ipsilateral fractures.We consider the risk of complications adequate to the mechanism of injury and its severity.
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Acta Chir Orthop Traumatol Cech · Oct 2010
[Complications of dynamic hip screw treatment for proximal femoral fractures].
To present the results of Dynamic Hip Screw (DHS) osteosynthesis for the treatment of proximal femoral fractures with a focus on specific complications of this method. MATERIAL From 1997 till 2007, the authors performed 367 DHS osteosyntheses to treat 341 patients with fractures of the proximal femur. The average patient age was 81.8 years (21-101). Twenty-six patients had surgery for bilateral fractures. ⋯ The authors regard DHS as an effective method to treat stable pertrochanteric fractures and fractures of the femoral neck in younger patients. Complications most often occur as a result of technical mistakes made by surgeons.
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Acta Chir Orthop Traumatol Cech · Aug 2010
Case Reports[Pulmonary polymethylmetacrylate embolism: a rare complication of percutaneous vertebroplasty].
Percutaneous vertebroplasty is a minimally invasive surgical technique involving transpedicular injection of polymethylmetacrylate into the vertebral body. The aim of this procedure is to enhance the mechanical strength of a pathologically changed vertebra. ⋯ Although this method is less invasive, relatively straight-forward and effective, there may be complications. The authors present the case of a 70-year-old woman who, on the second day after surgery, developed a rare symptomatic pulmonary polymethylmetacrylate embolism after per- cutaneous vertebroplasty performed for osteoporotic fractures of the lumbar spine.
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Acta Chir Orthop Traumatol Cech · Aug 2010
[Intra-operative myelography in treatment of fractures of thoracolumbar spine].
The aim of this retrospective study was to evaluate the results of intra-operative myelography as the method used to assess the reduction of bone fragments from the posterior margin of the vertebral body. ⋯ Intra-operative myelography is still a currently used method. Its advantages include a simple procedure without removal of posterior column structures, and the possibility of objective recording and continuous observation of the dural sac. The free flow of contrast medium makes obstruction of the spinal canal impossible. The consequences of a false negative finding can be successfully treated at the second stage.