Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Dec 2008
[Long-term results of calcaneal fracture treatment by open reduction and internal fixation using a calcaneal locking compression plate from an extended lateral approach].
To report on the surgical treatment of intra-articular calcaneal fractures by open reduction and internal fixation with a calcaneal locking compression plate (LCP) from an extended lateral approach, and to retrospectively analyze the mid-term results in a group of patients treated by this technique. ⋯ The surgical treatment of displaced intra-articular fractures that involves open reduction from an extended lateral approach and internal fixation with a calcaneal LCP shows very good preliminary results. A CT examination is required for the diagnosis and classification of fractures and a correct indication for surgery. Good timing is of principal importance. An urgent surgical intervention is necessary in open fractures or in those in which soft tissues are squashed by bone fragments. In the other fractures, surgery is carried out after oedema subsidence. Foot compartment syndrome is a serious complication of calcaneal fractures and urgent fasciotomy is the only adequate therapy. Full weight-bearing of the operated extremity depends on the rate of bone healing; it is usually allowed at 3 months after surgery.
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Acta Chir Orthop Traumatol Cech · Dec 2008
[Patient - related risk factors for infected total arthroplasty].
To analyse risk factors for the development of prosthetic infection after total joint arthroplasty in our group of patients, and to contribute to the understanding of conditions leading to infection and, consequently, to its eliminations. ⋯ We recommend a thorough evaluation of risk factors in the patients planned to undergo total arthroplasty, assessment of factor significance and accumulation, and careful consideration of all pros and cons in patients at high risk of infection development.
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A detailed description of the Judet posterior approach to the scapula. ⋯ The discussed disadvantages of the Judet approach are relative and its benefits clearly prevail. Therefore it is recommended as the basic posterior approach for operative treatment of fractures of the scapula. Key words: scapula fractures, operative treatment, Judet approach.
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PURPOSE OF THE STUDY The conservative treatment of an odontoid fracture with immobilization in a halo-vest or collar often results in pseudoarthrosis. Therefore, surgical treatment is preferred, and the Magerl-Böhler anterior osteosynthesis of the C2 dens is one of the options for achieving good bony union. The aim of this study was to show that the success of reducing an odontoid fracture is related to the direction of fracture lines and that of displacement, and that anterior osteosynthesis of the C2 dens provides sufficient stability when fixed either with one or two screws. ⋯ CONCLUSION The anterior osteosynthesis of odontoid fractures was successful even in the patients in whom the fracture could not be sufficiently reduced. Union was achieved in all cases even though some fractures became displaced during bone healing and osteosynthesis therefore was not stable. Displacement and more difficult reduction were recorded more frequently in type A than in type B and C fractures.
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Acta Chir Orthop Traumatol Cech · Aug 2008
[ProDisc-C mobile replacement of an intervertebral disc. A prospective mono-centric two-year study].
To present the results of an independent mono-centric prospective study on patients with a mobile ProDisc-C implant. This cervical artificial disc replacement (CADR), which is one of the options for avoiding cervical spine fusion, was evaluated during two-years follow-up. ⋯ This two-year prospective study on patients with CADR shows very good and promising outcomes. It is evident that the implant increases the range of motion at the treated segment and reduces degenerative changes in the adjacent intervertebral spaces. On the other hand, CADR is associated with complications such as artificial disc kyphosis and heterotropic ossifications. An unequivocal requirement for a correct indication and a faultless operative technique was the conclusion drawn from a detailed analysis.