Acta Chir Orthop Traumatol Cech. 2011; 78(6)

Original papers

Surgical Treatment of Supracondylar Humerus Fractures in ChildrenOriginal papers

K. REISING, H. SCHMAL, M. KOHR, K. KUMINACK, N. P. SÜDKAMP, P. C. STROHM

Acta Chir Orthop Traumatol Cech. 2011; 78(6):519-523 | DOI: 10.55095/achot2011/082  

PURPOSE OF THE STUDYSurgical techniques for the treatment of supracondylar fractures in children are repeatedly the subject of discussion. The aim of the present study was to compare experience with the technique of crossed Kirschner wires at our own hospital with current literature.PATIENTS AND METHODSIn the period from 2000-2006 a total of 86 children aged 1.7 to 12.7 years were treated by means of crossed K-wire osteosynthesis. Follow up was conducted at an average of 32 months. Outcomes were evaluated based on von Laer's criteria.RESULTSReported complications were migration of the K-wires in 7% of cases and secondary dislocation...

Long-Term Results of the SVL Total Knee ArthroplastyOriginal papers

FULÍN P., BARTÁK V., POKORNÝ D., JAHODA D., TOMAIDES J., SOSNA A.

Acta Chir Orthop Traumatol Cech. 2011; 78(6):524-527 | DOI: 10.55095/achot2011/083  

PURPOSE OF THE STUDYThe aim of the study was to evaluate the long-term results of the total knee replacement Beznoska SVL implanted at the 1st Department of Orthopaedic Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital Prague, in the 1997/2009 period.MATERIAL AND METHODSThe SVL implant is a non-constrained knee replacement, anatomically similar to the bone it replaces, which preserves the posterior cruciate ligament. A total of 1101 knee joint replacements were evaluated in 973 patients, of whom 128 underwent bilateral arthroplasty. Kaplan-Meier curves were used to estimate the cumulative survival of implants....

Treatment of a Bone Bridge by Transplantation of Mesenchymal Stem Cells and Chondrocytes in a Composite Scaffold in Pigs. Experimental StudyOriginal papers

L. PLÁNKA, A. NEČAS, M. CRHA, P. PROKS, L. VOJTOVÁ, P. GÁL

Acta Chir Orthop Traumatol Cech. 2011; 78(6):528-536 | DOI: 10.55095/achot2011/084  

PURPOSE OF THE STUDYThe presented experimental study describes the results of using a combination of allogeneic mesenchymal cells (MSCs) with chondrocytes (CHCs) and a novel scaffold based on type I collagen and chitosan fibres. This biocomposite was transplanted into a defect produced by excision of a bone bridge to induce new cartilaginous tissue formation. The left femur was treated by transplantation into a defect of distal epiphysis; the right femur with implantation of the scaffold only served as control. A better therapeutic result was therefore expected in the left femur - the reduction of growth and angular deformities, and the histological...

Xenogeneic Protein Free Cultivation of Mesenchymal Multipotent Stromal CellsOriginal papers

D. STEHLÍK, R. PYTLÍK, H. RYCHTRMOCOVÁ, R. VESELÁ, Z. KOPEČNÝ, T. TRČ

Acta Chir Orthop Traumatol Cech. 2011; 78(6):537-543 | DOI: 10.55095/achot2011/085  

PURPOSE OF THE STUDYThe aim of this study was to compare the standard laboratory method of cultivation of mesenchymal multipotent stromal cells (MSC) and a novel technique of rapid MSC expansion focused on simple clinical use.MATERIAL AND METHODSBone marrow mononuclear cells of donors were cultured for 14 days by the standard and the new cultivation method. The standard method (STD) was based on an alpha MEM medium supplemented with foetal calf serum (FCS). The new animal protein-free method (CLI) was based on the clinical grade medium CellgroTM, pooled human serum and human recombinant growth factors (EGF, PDGF-BB, M-CSF, FGF-2) supplemented...

Tricalcium Phosphate Mixed with Autologous Bone Marrow in the Treatment of Benign Cystic Bone Lesions in ChildrenOriginal papers

Š. ONDRUŠ, M. STRAKA, J. BAJEROVÁ

Acta Chir Orthop Traumatol Cech. 2011; 78(6):544-550 | DOI: 10.55095/achot2011/086  

PURPOSE OF THE STUDYTo test the hypothesis that the application of tricalcium phosphate (TCP) mixed with autologous bone marrow can achieve better and faster healing of benign bone lesions than the application of tricalcium phosphate granules alone.MATERIAL AND METHODSThe prospective study included two groups, each consisting of 10 patients, treated for benign cystic bone lesions at the Department of Paediatric Surgery, Orthopaedics and Trauma Surgery from July 1, 2008 to June 30, 2010. The bone cysts involved non-ossifying fibroma, enchodroma, fibrous dysplasia, aneurysmal bone cyst and juvenile bone cyst. One group was treated using ChronOS(TM)...

Impact of Kyphoplasty Treatment for Vertebral Compression Fractures on Pain and Function in 105 PatientsOriginal papers

Z. KLEZL, J. A. CLAMP, J. BECKER, M. JONES, D. CALTHORPE, R. BOMMIREDDY

Acta Chir Orthop Traumatol Cech. 2011; 78(6):551-555 | DOI: 10.55095/achot2011/087  

PURPOSE OF THE STUDYVertebral compression fractures are very common. Symptomatic relief with conservative therapy is often difficult to achieve. Balloon kyphoplasty is a relatively new technique which stabilises the vertebral body and restores spinal alignment in recent fractures, it achieves significant pain relief and improved functional outcome is reported.The aim of this prospective study was to determine the level of pain relief and functional outcome in patients who were initially treated conservatively for 4-6 weeks and if symptoms did not have tendency to resolve, then had kyphoplasty surgery.MATERIAL AND METHODS105 patients...

Identification of the Lumbosacral Nerve Plexus during the Extreme Lateral Interbody Fusion ProcedureOriginal papers

L. HRABÁLEK, M. ADAMUS, T. WANEK

Acta Chir Orthop Traumatol Cech. 2011; 78(6):556-561 | DOI: 10.55095/achot2011/088  

PURPOSE OF THE STUDYThe aim of this clinical observation study was to determine the extent to which muscle relaxation induced by anesthesia must be intra-operatively reversed for a reliable identification, by intra-operative monitoring, of the lumbosacral (LS) nerve roots during extreme lateral interbody fusion (XLIF).MATERAL AND METHODSGeneral anesthesia (midazolam, propofol, sufentanil, oxygen/air/sevofluran - rocuronium) was administrated to all patients. Train-of-four (TOF) stimulation of the ulnar nerve at 10-second intervals and an electromyographic response of the adductor pollicis muscle were used, and the duration of neuromuscular...

Anterior Interbody Fusion of the Cervical Spine with a Zero-P Spacer. Radiographic Results with a Minimum Follow-up of One Year in a Prospective StudyOriginal papers

VANĚK P., BRADÁČ O., SAUR K.

Acta Chir Orthop Traumatol Cech. 2011; 78(6):562-567 | DOI: 10.55095/achot2011/089  

PURPOSE OF THE STUDYThe aim of this study was to compare the efficacy of anterior cervical microdiscectomy and fusion carried out using a newly designed interbody spacer with that of a standard cage plate construct in patients with symptomatic cervical spine spodylosis. The comparison was based on radiographic results and fusion rates.MATERIALA total number of 113 consecutive patients were enrolled in this prospective study between October 2008 and July 2009. Mono- or bisegmental spondylosis was diagnosed in the patients in whom conservative treatment of cervicobrachial symptoms had had no effect. Patients with myelopathy were not included.METHODSAll...

Single Cannulated Screws for Stabilisation of Pelvic Ring and Acetabular FracturesOriginal papers

S. TALLER, R. LUKÁŠ, J. ŠRÁM

Acta Chir Orthop Traumatol Cech. 2011; 78(6):568-577 | DOI: 10.55095/achot2011/090  

PURPOSE OF THE STUDYCurrent trends in minimally invasive surgery together with advances in computed tomography and fluoroscopic guidance allow us to perform close reduction and percutaneous fixation also in non-displaced or minimally displaced fractures of the pelvic ring and acetabulum. Authors report the method of percutaneous screw fixation.MATERIAL AND METHODSDuring the period from 1998 to 2010, a total of 568 patients were surgically treated for fractures of the pelvic ring and acetabulum. The patient series included 132 men and 46 women with an average age of 41.6 years (from 15 to 88 years). In this cohort, 225 single screws were...

Current concepts review

Periprosthetic Humeral Fractures after Shoulder and Elbow ArthroplastyCurrent concepts review

S. GREINER, V. STEIN, M. SCHEIBEL

Acta Chir Orthop Traumatol Cech. 2011; 78(6):490-500 | DOI: 10.55095/achot2011/079  

Due to rapidly increasing numbers of arthroplasty surgeries of the upper extremity, periprosthetic humeral fractures after shoulder and elbow arthroplasty, formerly described as rare, may hence increase in the near future. Therefore the aim of the present work was to give an overview of the existing literature including possible classifications as well as an update on treatment concepts and experiences with own cases.After a literature research have been done, existing prevalence, classifications and treatment options, mostly described in case series, were processed to create an overview of the existing state of knowledge. Additionally 7 own cases...

The Many Faces of Chondrosarcoma of Bone
Own Cases and Review of the Literature with an Emphasis on Radiology, Pathology and TreatmentCurrent concepts review

G. W. HERGET, M. UHL, O. G. OPITZ, C. P. ADLER, N. P. SÜDKAMP, S. KNÖLLER

Acta Chir Orthop Traumatol Cech. 2011; 78(6):501-509 | DOI: 10.55095/achot2011/080  

Chondrosarcoma is the third most frequent primary malignant tumor of bone, constituting up to 16% of the malignant osseous neoplasms. Up to date several genetic alterations and markers were described concerning the pathogenesis and the progression of the chondrosarcoma, which represents actually a heterogeneous group of different types including conventional intramedullary, clear cell, myxoid, mesenchymal, and dedifferentiated chondrosarcoma.The pathologic appearance varies, however, in general they grow with a lobulated pattern. Histologically the hyaline cartilage demonstrates high water content and typically enchondral ossification is apparent....

Preoperative Diagnosis of Prosthetic Joint InfectionCurrent concepts review

JIŘÍ GALLO, MILAN KAMÍNEK

Acta Chir Orthop Traumatol Cech. 2011; 78(6):510-518 | DOI: 10.55095/achot2011/081  

Making pre-operative diagnosis of intermediate and low-grade infections of prosthetic joint infection (PJI) is demanding and requires both clinical experience and good knowledge of diagnostic test performance. It is also necessary to know the rules of working with diagnostic tests based on the expected change in pre-test probability of PJI or the diagnostic odds ratio. This also requires a multi-modal approach with a rational combination of relevant tests because none of them can have both 100% sensitivity and 100% specificity. Suspicion of a developing PJI should be aroused by relevant information present in the patient s medical history and confirmed...

Case report

Total Knee Arthroplasty in Severe Valgus Deformity in a Patient with AchondroplasiaCase report

K. KOUDELA Jr., K. KOUDELA Sr., J. KOUDELOVÁ

Acta Chir Orthop Traumatol Cech. 2011; 78(6):578-582 | DOI: 10.55095/achot2011/091  

The authors present the results of total knee replacement in a 66-year-old woman with achondroplasia. The condition was diagnosed on the basis of clinical and radiographic findings; molecular genetic examination confirmed that the patient was heterozygous for the G1138A mutation responsible for substitution of an arginine for a glycine residue at position 380 (G380R). The patient presented with an unusual finding of severe fixed 20-degree valgus deformity, so far not published, which did not conform with the clinical features of achondroplasia. The authors presumed that the deformity had developed due to asymmetric growth of the distal femoral diaphysis...

Osteochondroma of the Iliac Crest. Case ReportCase report

M. KOKAVEC, M. GAJDOŠ, V. DŽUPA

Acta Chir Orthop Traumatol Cech. 2011; 78(6):583-585 | DOI: 10.55095/achot2011/092  

The authors present the case of a 16-year-old boy with osteochondroma of the iliac crest which gradually resulted in gluteal muscle atrophy, developing curvature of the spine and compression of the external iliac artery. Osteochondroma excision prevented the development of circulatory disorders in the ipsilateral lower extremity, and effective physical therapy enabled the well cooperating patient to restore fully his gluteal muscle strength and normal gait pattern.