Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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In conclusion, radial head fractures with 3 or more fragments have a high incidence of complications when treated with ORIF including hardware failure, malunion, nonunion, and the need for re-operation. Radial head arthroplasty has demonstrated good success in the treatment of complex, comminuted radial head fractures which are not amenable to non-opeative treatment or ORIF. Success can be optimized by diligent surgical dissection, avoiding inadvertent nerve injury, placement of an appropriately sized implant, repair of associated injuries, and early protected motion.
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Acta Chir Orthop Traumatol Cech · Feb 2010
[Urogenital trauma associated with pelvic ring fractures].
To evaluate, in a retrospective study, injuries to the urogenital tract in patients with pelvic ring fractures. MATERIAL In the years 1998-2007, a total of 308 patients with pelvic ring fractures were treated. The study did not comprise patients with low-energy fractures, such as apophyseolysis in children, osteoporotic bone fractures or pathologic fractures. It also did not include patients with multiple injuries who died within 6 hours of admission to the hospital. The group consisted of 186 men and 122 women with an average age of 34 (range, 6 to 76) years. ⋯ Injury to the urethra results in erectile dysfunction in 50 % of the injured patients it is often associated with urinary incontinence that has a strong effect on the patient's life quality. Isolated trauma to the urinary bladder has a good prognosis. The incidence of post-traumatic incontinence is not high, but reduces the patient's personal and social comfort. A prerequisite for a successful therapeutic outcome is a good cooperation of the orthopaedic surgeon and urologist. Key words: pelvic ring fractures, urogenital injury.
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Acta Chir Orthop Traumatol Cech · Jan 2010
Multicenter StudyChanges in epidemiology and treatment of pelvic ring fractures in Germany: an analysis on data of German Pelvic Multicenter Study Groups I and III (DGU/AO).
The diagnosis and treatment of pelvic ring injuries is demanding. Therefore, standardized classifications characterizing the stability and severity of pelvic ring fractures are essential to define clear algorithms for the treatment of these injuries. The first part of this article provides an overview of the etiology and classification of pelvic ring injuries. ⋯ In addition, we compare the present data with those of the German Pelvic Multicenter Study I and highlight changes in the epidemiology and treatment of pelvic ring fractures during the past decades. Taken together, we could observe an increasing number of elderly patients sustaining pelvic ring fractures. Regarding the treatment of pelvic ring fractures we found a rising use of external fixators and SI screws, while the number of laparotomies has markedly decreased.
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Acta Chir Orthop Traumatol Cech · Dec 2009
[Osteosynthesis for periprosthetic supracondylar fracture above a total knee arthroplasty using a locking compression plate].
The frequency of periprosthetic fractures related to total knee arthroplasty is increasing, with a prevalence of 1.3% on the average and with women being affected more often (4 out of 5 patients). Fractures of the distal femur are common, while tibial fractures are rare. Crucial for treatment is to distinguish fractures of the metaphysis above the femoral component, which remains firmly fixed, from those involving the knee joint replacement and component loosening. Supracondylar periprosthetic fractures are almost always managed surgically, using methods of osteosynthesis with an angle condylar or DCS plate, or a short retrograde- inserted supracondylar intramedullary nail. The recent use of implants such as LCPs with angle-stable screws has offered good prospects. This retrospective study presents our first experience with an LCP for treatment of supracondylar periprosthetic fractures of the knee joint. ⋯ Osteosynthesis with an angle-stable table LCP is an efficient method suitable also for the treatment of periprosthetic fractures of the distal femur above total knee arthroplasty. It offers all advantages of angle-stable implants. It is more effective for osteoporotic bone than a DCS implant or a condylar plate, because it provides better fixation stability for the distal fragment. However, further studies are needed to compare its efficiency with that of an IM nail.
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Acta Chir Orthop Traumatol Cech · Dec 2009
Results of treatment of subtrochanteric femoral fractures with the AO/ASIF Long Trochanteric Fixation Nail (LTFN).
This retrospective study reports on the clinical results of a group of 23 patients with subtrochanteric femoral fractures using the Long Trochanteric Fixation Nail (LTFN). ⋯ We conclude that the LTFN is a safe and reliable intramedullary device for the treatment of subtrochanteric fractures of the femur. Deambulation within the first postoperative surgery is possible when positioned properly. Its implantation requires more surgical time than the standard nails.