Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2002
[A strategy for reduction of blood loss in total hip joint endoprosthesis].
The aim of the work is to evaluate 42 patients with THA with the use of alternative approaches to blood transfusion. ⋯ The use of alternative procedures of blood loss reduction may be divided into three principles: 1. acceptable extent of anemia, 2. preoperative optimisation of the number of erythrocytes and the level of hemoglobin, 3. minimisation of bleeding during the surgery. By observation of these principles it is possible to reduce the use of blood transfusions in extensive orthopaedic operations.
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Acta Chir Orthop Traumatol Cech · Jan 2002
[Recurrent dislocation of the patella--arthroscopic therapy].
The authors present results of the surgical treatment of the recurring patella dislocation. They use the surgical technique of medial percutaneous raphe by absorbable PDS suture and lateral release with arthroscopis assistance. ⋯ Arthroscopically performed lateral release and medial raphe by percutaneously inserted suture and with AS assistance has a number of unquestionable benefits. The performance is associated with only minimum complications. It reduces the duration of hospitalization, immobilization of the limb, duration of physiotherapy as well as the total duration of the incapacity to work. The cosmetic result is good. It is possible to operate on also on young patients prior to the final ossification in the area of the tibial tubercle. A prerequisite of a good result is an accurate performance of the operation and subsequent physical therapy. Contraindications include marked degenerative changes in the femoropatellar joint, instability of the knee, patella dislocation in TKR. Q angle exceeding 30 degrees and valgus deformity of the limb exceeding 15 degrees. A high number of dislocations and the resulting more severe damage to the cartilage reduce the potential for achieving excellent results.
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Acta Chir Orthop Traumatol Cech · Jan 2002
Multicenter Study[Primary osteosynthesis of the odontoid process: a multicenter study].
Direct osteosynthesis is a method of choice for the treatment of odontoid process fractures. It is based on insertion, from the anterior approach, of one or two screws from the C2 body into the apex of the odontoid across the fracture line. The tensile action of screws results in compression of fragments and stabilization of the fracture. The aim of the study was to evaluate a group of patients treated by this method and to compare our results with those reported in the foreign literature. ⋯ Direct osteosynthesis is a method of choice for most of the type II and indicated cases of type III fractures of the odontoid process of the axis. This surgical procedure facilitates restoration of anatomical conditions of the spine and its immediate stability. Consequently, patients can be readily mobilized and rehabilitated.
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Assessment of the authors' group of patients with a fracture of sternum and comparison with available literary findings. ⋯ The incidence of the fracture of sternum has recently increased. Isolated injuries of the chest do not pose any diagnostic or therapeutic problem. Of much greater severity are associated injuries of lungs and mediastinal organs which require a precise diagnosis and careful observation of the patient.
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Acta Chir Orthop Traumatol Cech · Jan 2001
Case Reports[Complications with the acetabular cup in the CLS total hip joint endoprosthesis].
The aim of the study is to present complications of acetabular component of CLS total hip replacement and their solution. ⋯ Of the total number of 2231 implanted CLS cups in the period of 1986-1999 only 25 complications were recorded requiring a revision surgery, i.e. 1.1% of all cases. Complications relating to the cup were treated in case of acetabular defects by means of metal acetabular rings, cancellous bone grafting and cemented cups. In infections a two-step procedure was used with a repeated application of CLS cup, Prostalac technique or Girdlestone procedure.