Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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The authors present a retrospective evaluation of a group of patients with injury to the lower cervical spine. The aim of the study is to show current trends in the diagnosis and treatment of this trauma. ⋯ The diagnosis of injuries to the lower cervical spine is based on the medical history, X-ray images in three basic projections and a CT scan. The necessity of a pre-operative MRI examination has recently been discussed. The use of the anterior approach in treatment of the injured lower spine is safe and effective. It allows us to carry out decompression as well as insertion of a graft and plate under direct visual control. It is associated with a minimum of complications and a high probability of bony fusion. Only immediate decompression will facilitate the regeneration of an injured spinal cord. Key words: cervical spine, spinal injury, anterior fixation.
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Acta Chir Orthop Traumatol Cech · Jan 2004
[Arthroscopy in the diagnosis and therapy of wrist disorders].
Arthroscopy of the wrist is a method facilitating the establishment of diagnosis in patients with wrist complaints which may also serve for surgical management of some of the causes of wrist pathology. The author presents his first experience with carpal arthroscopy as a diagnostic method as well as a therapeutic technique performed in one or two stages. ⋯ In our hospital acute arthroscopy is indicated when carpal connective tissue lesions, potentially leading to wrist instability, are suspected, when damage to carpal ligaments is found by X-ray examination or when an acute TFCC lesion is suspected. Arthroscopically-guided osteosynthesis of the distal radius appears to be a prospective method. In patients with chronic complaints, wrist arthroscopy is indicated in suspected TFCC lesions with ulnar-carpal impingement, in chronic carpal synovitis, and before sperious operations on the carpal bones in order to ascertain the state of cartilage and plan the appropriate surgery.
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Acta Chir Orthop Traumatol Cech · Jan 2004
[Multiple-level instrumented anterior cervical fusion: a risk factor for pseudoarthrosis? A prospective study with a minimum of 3-year follow-up].
This prospective study with minimal 3-year follow-up was performed to compare fusion rates, course of fusion, collapse incidence and occurrence of subsidence in one- and two-level instrumented anterior cervical fusions (ACDF) and thus to proof the hypothesis that use of internal fixation decreases the risk of non-union in bi-segmental ACDFs to the same level that can be expected in mono-segmental procedure. ⋯ This study demonstrates that internal fixation used in multilevel ACDF decreases risk of pseudoarthrosis to the same level that can be expected in monosegmental procedures.
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Acta Chir Orthop Traumatol Cech · Jan 2004
Multicenter Study[Transarticular fixation of C1-C2: a multicenter retrospective study].
Transarticular C1-2 fixation is a surgical alternative in treatment of atlantoaxial instability. Although the method provides very good immediate and long-term stability, it still involves several disadvantages. The group of patients as reported from various institutions are usually very small and hardly comparable. In order to objectively compare the results of the method, we collected the groups of patients treated in four institutions dealing with surgery of the cervical spine in Czech Republic. ⋯ Transarticular technique of instrumental atlantoaxial fusion is an effective method with multiple application in treatment of craniocervical and upper cervical spine instability. The gain of immediate stability with acceptable risk of possible complications is the major advantage of this procedure. The results of our multicentric retrospective study confirm the expected high fusion rate and are comparable to previously published reports.
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Acta Chir Orthop Traumatol Cech · Jan 2004
[Long-term results of the Schenker cementless femoral component].
The aim of the work is to evaluate the results achieved in the group of patients with implanted Schenker cementless femoral component (Schenker, Switzerland) and discuss the method of solution of loosening of these components in the group of patients who underwent revision surgery. ⋯ A favourable clinical finding and a good integration of the cementless femoral component Schenker were recorded within the average follow-up of 12 years only in 5 patients. All of them were young at the time of surgery and had a very good quality of bone. As a conclusion authors state that in general, Schenker cementless femoral component has not proved to be successful in clinical practice. For revision surgery of the loosened Schenker cementless femoral component it is necessary to use a titanium cementless component with a surface allowing long-term osteointegration.