Cerclage Handling for Improved Fracture Treatment. A Biomechanical Study on the Twisting ProcedureOriginal papers

D. WÄHNERT, M. LENZ, U. SCHLEGEL, S. PERREN, M. WINDOLF

Acta Chir Orthop Traumatol Cech. 2011; 78(3):208-214 | DOI: 10.55095/achot2011/033  

PURPOSE OF THE STUDYTwisting is clinically the most frequently applied method for tightening and maintaining cerclage fixation. The twisting procedure is controversially discussed. Several factors during twisting affect the mechanical behaviour of the cerclage. This in vitro study investigated the influence of different parameters of the twisting procedure on the fixation strength of the cerclage in an experimental setup with centripetal force application.MATERIAL AND METHODSCortical half shells of the femoral shaft were mounted on a testing fixture. 1.0 mm, 1.25 mm and 1.5 mm stainless steel wire cerclages as well as a 1.0mm cable cerclage...

Kyphotic Deformities of the Cervical SpineOriginal papers

J. ŠTULÍK, P. NESNÍDAL, P. ŠEBESTA, T. VYSKOČIL, J. KRYL

Acta Chir Orthop Traumatol Cech. 2011; 78(3):215-224 | DOI: 10.55095/achot2011/034  

PURPOSE OF THE STUDYThe development of a cervical kyphotic deformity can be associated with a degenerative disease, trauma, tumour, developmental anomaly and also a surgical procedure. Post-operative kyphosis can develop after both the anterior and posterior surgical approaches. The deformity can also result from systemic diseases, such as ankylosing spondylitis or rheumatoid arthritis. The aim of the study was to make the clinical and radiographic evaluation of a group of patients with kyphotic deformity treated at our department.MATERIALBetween May 2005 and April 2010, a total of 102 patients underwent correction of cervical kyphosis...

Valgus High Tibial Osteotomy - Long-Term ResultsOriginal papers

D. WACIAKOWSKI, K. URBAN, K. KARPAŠ

Acta Chir Orthop Traumatol Cech. 2011; 78(3):225-231 | DOI: 10.55095/achot2011/035  

PURPOSE OF THE STUDYThe aim of the study was to evaluate the long-term results in a group of patients treated by proximal tibial valgus osteotomy.MATERIALA group of 92 high tibial osteotomies performed in the 1985/1994 period were evaluated. All were indicated for primary osteoarthritis. Closing wedge osteotomy was the technique used. Staple-fixed osteotomy was immobilised in a plaster cast for 6 weeks in 44 cases. Osteotomy fixed with a plate in 35 or with a cerclage in 13 cases was immobilised for two weeks.METHODSRecurrent intensive pain and walking problems were regarded as a termination of the favourable effect of osteotomy....

Baker's Procedure in the Treatment of Pes Equinus in Cerebral Palsy PatientsOriginal papers

T. TRČ, V. HAVLAS, D. RYBKA

Acta Chir Orthop Traumatol Cech. 2011; 78(3):232-236 | DOI: 10.55095/achot2011/036  

PURPOSE OF THE STUDYSurgical procedures on muscles in cerebral palsy are regarded as essential interventions. The tactics for surgery on the triceps surae muscle in the treatment of spastic pes equinus involve several surgical options at different muscle levels.MATERIAL AND METHODSIn the 1992-2008 period, Baker's procedure, prolongation of the triceps muscle in the common part of the gastrocnemius and soleus aponeuroses, was indicated in 114 children, aged between 3 and 18 years, mostly with spastic hemiplegia (45.7 %) or diplegia (42.9 %). In both groups, the isolated Baker's procedures and the combined procedures were clinically assessment...

Arthroscopic Findings Concerning Rotator Cuff Lesions and Their Operative ManagementOriginal papers

L. URBÁNEK, P. VAŠEK, M. TUČEK

Acta Chir Orthop Traumatol Cech. 2011; 78(3):237-243 | DOI: 10.55095/achot2011/037  

PURPOSE OF THE STUDYOur objective is to introduce our simplified, easy-to-use classification of rotator cuff (RC) lesions, describe the frequency of individual findings in a considerably large series of shoulder joints examined by arthroscopy, evaluate the results of the operative management of individual lesion types, and recommend optimal surgical approaches.MATERIALOver the course of 10 years (between October 1st, 2000 and December 31st, 2009), 756 arthroscopic operations on the shoulder joint were performed. RC lesions were identified in 516 cases. We categorized the lesions using our own classification. Patient characteristics were...

Femoral Lengthening. A Critical Review of Ten-Year ResultsOriginal papers

L. KAISER-ŠRÁMKOVÁ, J. POUL, J. STRAKA, K. URBÁŠEK, T. PAVLÍK, M. CVANOVÁ

Acta Chir Orthop Traumatol Cech. 2011; 78(3):244-248 | DOI: 10.55095/achot2011/038  

PURPOSE OF THE STUDYTo evaluate the results of femoral lengthening in the patients treated from 2000 to 2009 in whom complete radiographic data were available and the lengthening procedure involved mainly the use of a Mephisto fixator.MATERIAL AND METHODSA total of 28 femoral lengthening procedures were carried out in 26 patients, 16 girls and 10 boys. The external fixator Mephisto was used in 24 cases; fixators Prospon and Orthofix in one and three cases, respectively. Fifteen patients were treated for congenital short femur, the rest had secondary femoral shortening due to following pathologies: distal femoral epiphysiolysis in five children,...

Developmental Dysplasia of the Hip - Epidemiological Determinants and Age Assessment Regarding Time of Surgical CorrectionOriginal papers

S. MILASINOVIĆ, R. BRDAR, I. PETRONIĆ, D. NIKOLIĆ

Acta Chir Orthop Traumatol Cech. 2011; 78(3):249-252 | DOI: 10.55095/achot2011/039  

PURPOSE OF THE STUDYAim of the study was to analyze age structure of the patients with developmental dysplasia of the hip (DDH) at the time of the operation and epidemiological determinants: gender distribution, proportion of left or right hip affection, type of delivery and mode of labor presentation.MATERIAL AND METHODSThe population of 78 children with DDH was evaluated. Three age groups were analyzed: first group younger than 24 months of life, second group between 24 and 48 months and third group older than 48 months of life. Male and female gender was separately evaluated as well as type of delivery and mode of labor presentation....

A Contribution of Instrumental Gait Analysis to the Establishment of Surgical Indications in Cerebral PalsyOriginal papers

J. POUL, K. URBÁŠEK, J. BAJEROVÁ, J. JADRNÝ, A. FEDROVÁ, L. KAISER-ŠRÁMKOVÁ

Acta Chir Orthop Traumatol Cech. 2011; 78(3):253-257 | DOI: 10.55095/achot2011/040  

PURPOSE OF THE STUDYTo evaluate our experience with indications for surgery based on instrumental gait analysis in cerebral palsy children, and to compare them with those drawn from the results of clinical examination.MATERIAL AND METHODSThe gait analysis laboratory was built in the Paediatric Hospital of the Faculty of Medicine in Brno in the 2008/09 period with support of the Norwegian funds. It is equipped with eight optical cameras, two auxiliary motion-picture video cameras, two force platforms and a telemetry system for electromyography. Between June 2009 and March 2010 a total of 297 children with spastic cerebral palsy, 66 with...

A Contribution of Multidetector Computed Tomography to Indications for Chest Wall Stabilisation in Multiple Rib FracturesOriginal papers

F. VYHNÁNEK, P. SKÁLA, D. ŠKRABALOVÁ

Acta Chir Orthop Traumatol Cech. 2011; 78(3):258-261 | DOI: 10.55095/achot2011/041  

PURPOSE OF THE STUDYMultidetector computed tomography (MDCT) is more sensitive for the detection of injury to the thoracic wall and intra-thoracic organs than a plain chest radiograph. The chest wall deformity and instability following multiple rib fracture involves fractures of four or more adjacent ribs at two levels, sometimes including a sternal fracture. It may also be associated with lung trauma (pneumothorax, haemothorax, rupture, laceration or pulmonary contussion). An isolated multiple-rib fracture can successfully be treated conservatively. Early intubation and mechanical ventilation are indicated in patients with progressive respiratory...

Humerus Shaft Fractures - Where Are We Today?Current concepts review

P.C. STROHM, K. REISING, T. HAMMER, N.P. SÜDKAMP, M. JAEGER, H. SCHMAL

Acta Chir Orthop Traumatol Cech. 2011; 78(3):185-189 | DOI: 10.55095/achot2011/030  

Humeral shaft fractures account for about 1-3% of all fractures. These fractures are regarded as the domain of non-surgical management. This is certainly still the contemporary view but there is an obvious trend towards surgical stabilization. Surgical treatment of humeral shaft fractures has nonetheless been greatly facilitated by the development of new implants. In particular, a new generation of nails that general permit immediate mobilization have become available for improved management of longitudinal and multi-segmental fractures. Retrograde and antegrade nails have advantages and disadvantages and selection procedure is often based on the distal...

Cerclage, Evolution and Potential of a Cinderella Technology. An Overview with Reference to Periprosthetic FracturesCurrent concepts review

S. M. PERREN, A. FERNANDEZ DELL'OCA, M. LENZ, M. WINDOLF

Acta Chir Orthop Traumatol Cech. 2011; 78(3):190-199 | DOI: 10.55095/achot2011/031  

Periprosthetic fractures are increasingly frequent. The fracture may be located over the shaft of the prosthesis, at its tip or below (21). The treatment of explosion fractures is difficult because the shaft blocks the application of implants, like screws, which need to penetrate the medullary cavity.The cerclage, as a simple periosteal loop, made of wire or more recently cable, does not only avoid the medullary cavity. Its centripetal mode of action is well suited for reducing and maintaining radially displaced fractures. Furthermore, the cerclage lends itself well for minimally invasive internal fixation.New insight challenges the disrepute...

Vascular Injuries in Joint Replacement SurgeryCurrent concepts review

K. NOVOTNÝ, R. PÁDR, I. LANDOR, A. SOSNA

Acta Chir Orthop Traumatol Cech. 2011; 78(3):200-207 | DOI: 10.55095/achot2011/032  

Iatrogenic injuries to blood vessels in joint replacement surgery are rare events that occur as few per thousand. However, their sequelae are serious. The patient may either bleed to death, because vascular injury is not obvious and therefore difficult to diagnose, or lose the limb due to ischaemia. The highest risk of vascular injury is associated with repeat surgery and loosening of the acetabular component.We distinguish sharp and blunt force injuries. The former are caused by implants, sharp instruments, bone fragments or bone cement debris. The latter arise from stretching over a part of implanted material.Bleeding can be inapparent or...

Fractures of the Proximal Femur: Improving OutcomesReview

JAMES P. WADDELL (ED.)

Acta Chir Orthop Traumatol Cech. 2011; 78(3):266  

Failed Compression Osteosynthesis of the Dens Axis Treated by Anterior C1-C2 Transarticular Stabilisation. Case ReportCase report

J. KOČIŠ, M. KELBL

Acta Chir Orthop Traumatol Cech. 2011; 78(3):262-265 | DOI: 10.55095/achot2011/042  

We describe the case of an 80-year-old female patient who had undergone anterior C1-C2 transarticular stabilisation and was subsequently treated by the triple-screw method for failed compression osteosynthesis of a AO type III dens axis fracture.