Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2018
Comparative Study[Two-Stage Revision for Periprosthetic Infection of the Total Hip Arthroplasty: a Comparison of Two Methods].
PURPOSE OF THE STUDY The purpose of the study is a retrospective comparison of results of the two-stage revision total hip arthroplasty using a non-articulating and an articulating spacer to treat periprosthetic joint infection (PJI). Two basic hypotheses are evaluated: (1) the clinical outcomes of the patients treated with "hand made" articulating cement spacer are better than in non-articulating patient's group in two-stage revision for PJI of the total hip arthroplasty and (2) PJI recurrence is higher in the group of patients treated with an articulating spacer group. MATERIAL AND METHODS The evaluated group consists of a total of 57 patients (23 women, 34 men) with the mean age of 61.2 years. ⋯ CONCLUSIONS The results demonstrate the better clinical outcomes and the higher revision rate of patients with an articulating cement spacer in two stage revision. We didn't find any differences between the risk of PJI recurrence in both groups. Key words:periprosthetic infection, total hip replacement, cement spacer, two stage revision, articulating spacer, nonarticulating spacer.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Multicenter Study Clinical Trial[Comparison of Two Methods of Minimally Invasive Osteosynthesis for Proximal Radius Fractures in Paediatric Patients].
PURPOSE OF THE STUDY The presented study was construed as a retrospective multicentric clinical study focused on paediatric skeletal injuries of the proximal radius. As a general rule, the Type I displaced fractures (Judet classification) are treated conservatively, with no reduction. In the case of Type II-IV displacement, the fracture necessitates reduction or is also transfixed by a Kirschner wire (K-wire) or a Prevot nail (P-nail) where subsequent fragment instability occurs. ⋯ CONCLUSIONS The clinical results clearly show that when comparing the complications after the radial head fracture in children there is no statistically significant difference between the methods of osteosynthesis. This study shall serve as a starting point for the currently ongoing prospective multicentric study evaluating the modified ESIN technique using a pre-bent Kirschner wire. Key words:children, fracture, radius, proximal, osteosynthesis.
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Acta Chir Orthop Traumatol Cech · Jan 2018
[Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis].
PURPOSE OF THE STUDY The triplane fracture of the distal tibial epiphysis is characterised by the fracture line in typical three planes which can, however, differ case by case. The authors use the CT imaging as the perfect examination method to determine the nature of the fracture to plan the osteosynthesis. MATERIAL AND METHODS In the five-year retrospective study of a group of patients treated at their own department in the period 2011-2015 the authors assess a total of 55 patients with a triplane fracture. ⋯ CONCLUSIONS An X-ray obtained from 4 views is a standard examination in diagnosing a triplane fracture. A CT scan than makes it possible to precisely locate the fracture line, to determine the size of fragments and to plan the optimal placement of osteosynthetic material. Key words: tibial fractures, distal tibia fractures, paediatric fractures, triplane fracture, physeal fracture, CT imaging, minimally invasive osteosynthesis, treatment of distal tibia, osteosynthesis planning.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Use of Mother-Child Screws in the Treatment of Coronoid Fractures in Terrible Triad Injury of the Elbow.
PURPOSE OF THE STUDY This study aims to analyze the clinical and radiographic outcomes of a consecutive series of 18 patients with terrible triad injury. The coronoid fractures of these patients were repaired using Mother-Child screw (MCS). MATERIAL AND METHODS Twelve men and six women (mean age: 47.2 years) with terrible triad injury of the elbow were followed up for a mean of 17.6 months (range: 13-42 months). ⋯ Fracture healing was observed in all patients. CONCLUSIONS This study shows that coronoid fracture treatment with MCS may be a new, effective and easy therapeutic option in terrible triad injury. Key words:terrible triad of the elbow, coronoid process, radial head, functional outcome.
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Acta Chir Orthop Traumatol Cech · Jan 2018
Randomized Controlled Trial[Long-Term Results of Computer-Navigated Total Knee Arthroplasties Performed by Low-Volume and Less Experienced Surgeon].
PURPOSE OF THE STUDY The study aims to evaluate the long-term results of computer-navigated total knee arthroplasties performed by less experienced surgeon performing a small number of procedures per year. MATERIAL AND METHODS In the prospective randomised study functional and radiological results, rate of revision and probability of clinical and radiological survival were compared in 30 computer-navigated (in 28 patients: 19 women, 9 men, with the mean age of 66.9 years) and 31 conventionally implanted (in 30 patients: 27 women, 3 men, with the mean age of 66.5 years) cemented total knee replacements without patellar resurfacing. The group was composed of patients who underwent surgery performed by the same surgeon who at the time of enrolment of patient in the study had no previous experience with the total knee replacement surgery and performed up to 30 such procedures annually. ⋯ However, the question remains unanswered if more accurate positioning of the implants achieved with computer navigation decrease the revision rate and extend the long-term survival of knee endoprostheses. CONCLUSIONS Kinematic computer navigation allowed a less experienced and low-volume orthopaedic surgeon to make the implantation of endoprostheses more accurate, to decrease the total revision rate, and thus to ensure a higher probability of long-term survival of total knee arthroplasties. Key words:computer navigation, total replacement, knee joint, long-term outcomes, low-volume surgeon, less experienced surgeon.