Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2002
[Replacement of the vertebral body with an expansion implant (Synex)].
This paper describes replacement of the vertebral body with the expansion implant Synex. Usually, autologous bone graft is used to replace the vertebral body. In patients with bone cancer or multiple injuries to the spine, cement filling is preferred whereas, in other indicated cases, implants are inserted, of which Harms' titanium cage has been the most common one. However, this needs filling with a large amount of bone tissue and it is often difficult to adjust its size into the space available. Telescopic devices, on the other hand, are easier to implant and their application requires only a minimum amount of autologous bone tissue. ⋯ Synex is a sophisticated implant to replace severely damaged vertebral bodies regardless of the nature of lesion. Its application required additional stabilization by either posterior or anterior fixation (internal transpedicular fixator and Ventrofix or Kaneda, respectively). Its use is indicated in post-traumatic defects of vertebrae in acute or poorly healed scervical.
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Acta Chir Orthop Traumatol Cech · Jan 2002
[Use of bioceramics in the treatment of fractures of the thoraco-lumbar spine].
The primary reduction and stabilization of all types of injury to the thoracolumbar spine is currently performed from the posterior approach by an internal, transpedicular fixator. The exceptions are type A fractures, according to the AO classification, that can primarily be treated from the anterior approach. The aim of the study was to assess the effect of BAS-O bioceramic granules, inserted by transpedicular approach, on the development of post-operative kyphosis of the segments injured. ⋯ Bioceramic granules provide material for replacement of osseous tissue in the body of the vertebra as well as conditions necessary for bone restructuring. The loss of correction per segment is lower by about half in patients treated with bioceramic granules than in those who received a spongeous bone grafts.
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Acta Chir Orthop Traumatol Cech · Jan 2002
[Use of the elastic stable intramedullary nailing technique in non-typical pediatric fractures].
The "Elastic Stable Intramedullary Nailing" (E.S.I.N.) of French authors as a method of treatment of children's diaphyseal long bone fractures is well known from nineties of the last century. After we got familiar with the technique we wanted to introduce it in other indications, especially some metaphyseal long bone fractures and injuries of metacarpals, meta-tarsals and phalangeal bones in the growing skeleton. ⋯ The ESIN technique can be used in three groups of children's fractures. "Classic ESIN Procedure" in diaphyseal long bone fractures, "Non-typical ESIN Procedure" in metaphyseal long bone fractures and "ESIN-like Procedure" in metacarpal and phalangeal digital fractures.
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Acta Chir Orthop Traumatol Cech · Jan 2002
[Clinical examination of menisci in the era of arthroscopy].
A profound clinical history and examination in case of a soft-tissue injury of the knee joint has a principal significance for the diagnosis and the following treatment. Our aim was to compare the development of surgery of the soft-tissue injury of the knee in our region within a 25-year interval. The most frequently affected structures in the knee joint are the menisci. We have focussed on the evaluation of the extent to which selected clinical history and symptoms are actually associated with the affection of menisci. ⋯ Indication for surgery for the affection of menisci therefore has to be based on a careful analysis of clinical history and examination of the patient, it is not possible to rely on any of the menisci symptoms and their significance is only supportive. As the most significant symptoms we assess the clinical history of the verified knee swelling, click phenomena and locked knee in the knee joint, in the clinical examination pain and click phenomena of the joint lines.