Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Surgical treatment of arthritis of the carpometacarpal joint of the thumb--personal experience with soft-tissue arthroplasty].
The authors deal with surgical treatment of osteoarthritis of carpometacarpal joint of the thumb. They present results of three different techniques of interposition arthroplasty. ⋯ Interposition arthroplasty is a suitable solution of osteoarthritis of carpometacarpal joint after the failure of conservative treatment in patients in whom no extreme activity of the affected hand is expected. Burton-Pellegrini procedure is technically more demanding, however, it provides the best results and the fastest recovery. Total resection of trapezium proved efficient as it contributes to a better orientation during operation and to good results.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Treatment of thoracolumbar spinal fractures using internal fixators (evaluation of 120 cases)].
A group of 120 patients was evaluated with acute injury of Th-L spine who were operated on from posterior approach with the use of Dick AO fixator or USS fixator in the period of 1991-1996. ⋯ 1. Absolute majority of injuries of thoracolumbar spine may be treated from the posterior approach. In this it is necessary to restore the stability of the anterior column. An indispensable part of the operation is a flawless posterior fusion. 2. Some types of injuries require a complementary anterior approach in the first or second step. This applies mainly to the injuries with a defect of anterior column evaluated on the basis of classification after Gaines. 3. A primary isolated anterior approach to the treatment of the injury of Th-L spine is not in our view suitable as a routine.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Reconstruction of the acetabulum during replacement of the aseptically loosened polyethylene cup].
The aim of the study was to verify the method after Slooff in our modification, i.e. "a cemented cup--cancellous bone grafts--a metal net" for the revision surgery of aseptic loosening of cemented polyethylene acetabular cup in combined defects of acetabulum. ⋯ The method of cemented cup--cancellous bone grafts--metal net after Slooff is in our modification one of the accepted options of the reconstruction of acetabulum. Its benefit is the possibility of early weight bearing of the limb operated on. The stress on the bone grafts under an elastic construction conduces to a relatively fast good secondary osteointegration. The method can be recommended for II and III Degrees of acetabular bone loss according to AAOS classification. Of no less importance is also the economic aspect of the whole reconstruction.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Rotational acetabular osteotomy in the treatment of Legg-Calve-Perthes disease].
The material of prospective study involving 57 surgically treated hips in 55 patients suffering with a severe form of Legg-Calvé-Perthes disease (LCPD) was analysed by the use of statistical methods to depict the influence of age, of sex, of the amount of head involvement on the outcomes of surgical treatment by rotational acetabular osteotomy (Salter or Steel osteotomy from 9 years of age). ⋯ Submitted study was prepared to be matched nextly with the conservative group, which will be published in another publication. Internal analysis of the presented cohort disclosed that presented surgical treatment (Salter or Steel osteotomy respectively) assured, that irrespective of higher age, the important parameters like epiphyseal quotient and acetabulum-head index did not become worse than in younger groups. Even in the group over 9 years of age, 87.5% were categorised like excellent and fair results in Stulberg classification.
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Acta Chir Orthop Traumatol Cech · Jan 2001
[Personal experience with injuries of the flexor tendons of the hand].
The study presents a retrospective evaluation of a group of 198 patients with 242 acute injuries of tendons of flexors of the hand in the period between 1995-1999. Evaluation covers the outcomes of the primary treatment as compared to the secondary reconstruction surgery--mainly in zone II after Kleinert. ⋯ Treatment of the flexor tendons of the hand should be performed as soon as possible with a full comfort for the patient (operating theatre, total or local anesthesia) as well as for the surgeon (assistance, perfect suture material). Reconstruction surgery is considerably less successful. In all zones after the primary surgery excellent or good results are at least by 10%, in zone II even by 16%, more frequent than in the secondary surgery.