Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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A prerequisite for the successful implantation of an acetabular component in a defective bone tissue is, in addition to providing sufficient primary fixation of the implant, reconstruction of the acetabular bone bed. To achieve this, one of the options involves the use of an oblong implant. Data published on this topic are sparse and therefore the aim of this study was to gain a deeper insight into this issue. In addition, we wanted to compare the results achieved with the oblong component with those obtained using its original model. ⋯ Acetabular defects in the range of Paprosky types IIB to IIIA are indicated for the use of oblong implants in a basic position. The Arbond hydroxyapatite coating providing an osteoactive surface for the oblong cup described significantly improves the survival of this implant in comparison with the original model.
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Acta Chir Orthop Traumatol Cech · Oct 2009
Multicenter Study[Multicentric study of patients with pelvic injury: basic analysis of the study group].
The aim of the study was to make a basic analysis of the patients treated for pelvic fractures in the year 2007 at 14 institutions in the Czech Republic and Slovakia. ⋯ The evaluation of the basic demographic and epidemiologic data of patients with pelvic fractures included in this multi- centre study revealed the following facts: pelvic fractures were significantly more frequent in men; the most frequent cause of pelvic fracture was a road traffic accident; the number of injured men was highest at age 40 to 50, in motorbike accidents, falls from height and in injuries by falling objects; women outnumbered men at the age category over 80 and in suicidal jumping from a height; the most frequent types of fractures were those affecting osteoporotic bone in elderly women (A2.2, B2.1); surgical treatment of pelvic fractures was associated with a relatively high number of complications; death during primary hospitalization was higher in elderly patients. Key words: pelvic fracture, demography, epidemiology, type of fracture, associated injuries.
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Acta Chir Orthop Traumatol Cech · Oct 2009
[Mid-term results of 360-degree lumbar spondylodesis with the use of a tantalum implant for disc replacement].
The study presents the mid-term results in patients treated with circumferential, i.e., 360-degreee, fusion of the lumbar spine carried out by posterolateral instrumented spondylodesis and anterior intersomatic fusion using a tantalum implant for replacement of an intervertebral disc. The aim of the study was to verify tantalum implant quality, to evaluate segment fusion and to assess the outcome of this method by patients' subjective findings. ⋯ Avery stable fixation of the lumbar spinal segment can be achieved by using posterolateral fusion and ALIF.With this approach, ALIF is augmented with a porous tantalum cage, and the use of autogenous bone grafts, derived from the adjacent anterior vertebral borders and placed before the cage, results in high-quality anterior bridging spondylodesis in a lar- ge proportion of cases. The subjective evaluation by the patients is in agreement with the stability and fusion achieved.
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Acta Chir Orthop Traumatol Cech · Oct 2009
[Long-term results of the treatment of diaphyseal femur fractures in children].
Bone overgrowth of the femur after fracture in childhood treated either conservatively or surgically is well documented. The aim of this study was to investigate the frequency of bone overgrowth in childhood fractures treated by elastic stable intramedullary nailing (ESIN), to evaluate it in relation to conservative treatment and to compare its presence in the youngest age categories. ⋯ The use of ESIN for treatment of femoral fractures in childhood is not associated with a higher risk of long-bone over- growth, as compared with conservative therapy. Moreover, the authors' experience shows that the method of retrograde insertion of osteosynthetic material is safe even in distal diaphyseal fractures and does not increase risk of bone over- growth.
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Acta Chir Orthop Traumatol Cech · Oct 2009
[The DIAM spinal stabilisation system to treat degenerative disease of the lumbosacral spine].
Each dynamic stabilisation should preserve motion at the operated segment as well as reduce a load on the disc and intervertebral joints. One of the methods to achieve this is the implantation of interspinous spacers between lumbar spinous processes. In this study, the patients treated with the DIAM interspinous spacer (Medtronic, USA) were prospective- ly followed up with the aim to evaluate clinical outcomes and post-operative complications. ⋯ The implantation of a DIAM interspinous spacer is a less invasive and safe method of dynamic stabilisation of the spi- ne without intra- or post-operative complications that is well tolerated by the patient. At 3-year follow-up the patients reported improvement in their functional state, as measured with an ODI, by 64 % on the average. Their axial and nerve root pain was reduced by 71 % on the average. All patients showed improved clinical conditions and the outcomes were evaluated as excellent in 41 %, good in 51 % and fair in 7.5 % of the patients. The results of implantation were not significantly related to age, gender, operative indications, operated lumbosacral level, method of nerve root decompression or duration of pre-operative problems. No patient treated by the DIAM spacer had any recurrence of disc herniation.