Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jun 2007
[Muscle flap transfer of the treatment of infected tibial and malleolar fractures and chronic osteomyelitis of the tibia].
The aim of the study was to evaluate the results of treatment in patients with infected fractures or chronic osteomyelitis in the tibial and ankle regions by radical debridement of skeletal and soft tissues and coverage of the defect, using free flap transfer or muscle flap transposition. ⋯ The treatment of infected tibial and malleolar fractures by debridement and subsequent coverage of soft tissue defects, using muscle flap transfer, permits elimination of infection in most of the patients, but often requires subsequent surgery in order to provide biological stimulation for healing of defective fractures. Treatment of osteomyelitis of the tibia by this method is demanding, but has a good prospect of healing in a period shorter than is necessary for treatment without muscle flap transfer.
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Acta Chir Orthop Traumatol Cech · Jun 2007
Randomized Controlled Trial[Intra-articular analgesia after anterior cruciate ligament reconstruction].
In this double-blind prospective study, pain after reconstruction of the anterior cruciate ligament (ACL) was evaluated using the visual analogue scale (VAS). Comparisons were made between patients administered an intra-articular analgesic mixture of adrenaline, morphine and bupivacaine (Marcaine) and those without it, between patients surgically treated by the BTB technique and those undergoing hamstring tendon ACL reconstruction, and between men and women undergoing the same procedure. ⋯ The use of intra-articular analgesia has a significant effect on the reduction of opiate amounts administered to patients during the 24-hour post-operative period after ACL reconstruction, regardless of the surgical technique used. These patients also reported slightly lower perception of pain, as assessed by the VAS pain score. The effect was higher in men than in women.
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Cervical spine injuries in young adults are usually caused by high-energy trauma. However, a typical injury to the cervical spine can also occur in older patients, in whom it is often associated with the presence of osteoporosis and relatively low-energy trauma, similarly to distal radial or proximal femoral fractures, or fractures of the thoracolumbar spine. The aim of this study was to evaluate a group of elderly patients with cervical spine injuries treated at our department. ⋯ In patients older than 65 years, injuries to the upper cervical spine are usually caused by low-energy trauma. In this age category, neurological deficit is found more often than in younger patients and is typically manifested as a central cord syndrome.
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Acta Chir Orthop Traumatol Cech · Apr 2007
Case ReportsTotal spondylectomy of C2: a new surgical technique.
According to the available sources, no case of total spondylectomy of C2 with preservation of roots, preservation of vertebral arteries and a short fixation without occipitocervical fusion has been so far described in the literature. We decided to perform a radical surgery in a man, now 27 y. o., with solitary metastasis of thyroid adenocarcinoma. In the first step, we applied the posterior surgical approach. ⋯ The mandible was fixed by two Miniplate System plates and supported by a dental plate. Total spondylectomy of C2 with preservation of vertebral arteries and roots stabilized only by a short fixation is an extreme surgical procedure suitable only for exceptional cases of young patients with a good bone quality. With regard to potential complications it is of vital importance to consider carefully such operation and consult the proposed therapy with the patient.
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Acta Chir Orthop Traumatol Cech · Apr 2007
[Osteosynthesis of hip and femoral shaft fractures using the PFN-long].
A group of 79 patients with ipsilateral fractures of the hip and femoral shaft treated with the use of a long proximal femoral nail (PFN-long) was retrospectively evaluated. ⋯ The PFN-long is a high-quality implant that increases our options of treatment. Of all the reconstruction nails, it has most advantages. The availability of only three sizes (in three lengths with one thickness) is a certain disadvantage.