Zápis z jednání Výboru ČSOT konaného dne 21. 2. 2023 v Parkhotelu PrůhoniceReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2023; 90(2):146-147  

Pathological Lesions and Fractures of the Proximal FemurOriginal papers

M. URBAN, L. LUŇÁČEK, R. BARTOŠKA, J. MALÉŘ, J. SKÁLA-ROSENBAUM

Acta Chir Orthop Traumatol Cech. 2023; 90(2):138-145 | DOI: 10.55095/achot2023/019  

PURPOSE OF THE STUDY The aim of the study was to determine the incidence of primary malignancies metastasizing to the area of the proximal femur, to evaluate the localization of the lesions and fractures, to compare the results of the selected surgical therapy, survival time of the patients and postoperative complications. MATERIAL AND METHODS We retrospectively evaluated the group of patients operated on from 2012 to 2021. The study included 45 patients (24 women and 21 men) with a pathological lesion or a pathological fracture in the area of the proximal femur. The average age was 67 years (38-90). There were 30 (67%) cases of pathological...

The Tibia Plafond Horizontal Orientation Angle for Frontal Alignment Evaluation of the Distal Lower ExtremityOriginal papers

M. A. ALSHROUF, M. D. AHREND, C. KONRADS

Acta Chir Orthop Traumatol Cech. 2023; 90(2):133-137 | DOI: 10.55095/achot2023/018  

PURPOSE OF THE STUDY Osteotomies around the knee are an established technique for treating knee osteoarthritis and other knee conditions by redistributing the body's weight and force within and around the knee joint. The aim of this study was to determine if the Tibia Plafond Horizontal Orientation Angle (TPHA) is a reliable measure for describing ankle alignment of the distal tibia in the coronal plane. MATERIALS AND METHODS This retrospective study included patients who underwent supracondylar rotational osteotomies for correction of femoral torsion. All patients had standing radiographs taken preoperatively and postoperatively...

Modified Harrington Procedure in the Treatment of Extensive Tumor Defects of the AcetabulumOriginal papers

J. LESENSKÝ, O. BLECHA, J. VČELÁK

Acta Chir Orthop Traumatol Cech. 2023; 90(2):124-132 | DOI: 10.55095/achot2023/017  

PURPOSE OF THE STUDY The increasing prevalance of patients with metastatic bone cancer and their improved survival puts more emphasis on the quality of treatment of bone metastases. Although most pelvic lesions are treated non-operatively, extensive destruction of the acetabular segment poses a therapeutic challenge. A potential treatment option may be the modified Harrington procedure. MATERIAL AND METHODS At our department, this surgical procedure has been opted for in 14 patients (5 men and 9 women) since 2018. The mean age at the time of surgery was 59 years (range 42 to 73). Twelve patients suffered from metastatic cancer, one...

Surgical Treatment of Tuberculous SpondylodiscitisOriginal papers

J. VČELÁK, A. KRÁL, M. ŠLÉGL, J. LESENSKÝ, M. MACKO

Acta Chir Orthop Traumatol Cech. 2023; 90(2):116-123 | DOI: 10.55095/achot2023/016  

PURPOSE OF THE STUDY The paper presents a monocentric retrospective study of patients treated surgically for spinal tuberculosis. Clinical and radiological results are analysed, early and late complications are recorded. The study aims to answer the following questions. 1. Can we use instrumentation to restore the stability and alignment in the infected spinal focus? 2. Should we always perform radical anterior resection of TBC lesions? 3. What is the prognosis of surgical treatment of TBC patients with neurological deficit manifestation? MATERIAL AND METHODS Between 2010 and 2020, a total of 12 patients were treated for spinal tuberculosis...

Assessing Knee Stability in Adolescent Athletes with Osgood-Schlatter Disease Using the Y-Balance TestOriginal papers

V. HLADKY, A. KAPLAN, J. SMETANOVA, V. HAVLAS

Acta Chir Orthop Traumatol Cech. 2023; 90(2):108-115 | DOI: 10.55095/achot2023/015  

PURPOSE OF THE STUDY Osgood-Schlatter disease develops secondary to chronic patellar tendon overloading. The present study was designed to determine whether athletes with Osgood-Schlatter disease perform significantly worse in the Y-Balance Test compared to healthy subjects in a control group. MATERIAL AND METHODS The study involved ten boys (average age 13.7 years). Seven participants had bilateral knee pain, swelling and tenderness whereas three had unilateral knee pain, swelling and tenderness (left knee in two cases, and right knee in one). Overall, 17 knees were assessed (left knee in nine cases and right knee in eight).Ten healthy...

Fixation of Knee Osteochondral Lesions in Pediatric Patients with Magnesium-Based ImplantsOriginal papers

F. HANÁK, V. HAVLAS

Acta Chir Orthop Traumatol Cech. 2023; 90(2):100-107 | DOI: 10.55095/achot2023/014  

PURPOSE OF THE STUDY Fixation of osteochondral fragments are relatively common procedures in pediatric orthopaedic surgery. The use of biodegradable magnesium implants in these indications appears to be a promising alternative to polymer implants due to their favorable mechanical properties and biological behavior. The purpose of this study is to evaluate the short-term clinical and radiological outcomes of the fixation of unstable or displaced osteochondral fractures and osteochondritis dissecans lesions in the knee joint using MAGNEZIX® screws and pins in pediatric patients. MATERIAL AND METHODS In this study, 12 patients (5...

Treatment of Hip Dislocation in Cerebral Palsy with Extraarticular InterventionOriginal papers

İ. A. SARIKAYA, S. E. BIRSEL, O. A. ERDAL, B. GÖRGÜN, A. ŞEKER, M. İNAN

Acta Chir Orthop Traumatol Cech. 2023; 90(2):92-99 | DOI: 10.55095/achot2023/013  

PURPOSE OF THE STUDY Hip dislocation is one of the major causes of disability in children with cerebral palsy (CP). Surgical treatment can be achieved using different techniques including proximal femoral varus derotation osteotomy (FVDRO), pelvic osteotomies, and open hip reduction (OHR). However, we claim that pathologies originating from extraarticular structures in the dislocated hip in CP can be reconstructed by extraarticular methods and OHR may not always be necessary. Therefore, this study aims to discuss the results of hip reconstruction with extraarticular intervention in patients with CP. MATERIAL AND METHODS In total,...

Type IV Titanium Hypersensitivity: Rare, or Rarely Detected?Current concepts review

J. VOVES, O. MĚRKA, K. ČABANOVÁ, J. JANOŠEK, G. BAJOR

Acta Chir Orthop Traumatol Cech. 2023; 90(2):85-91 | DOI: 10.55095/achot2023/012  

The presented review aims to summarize the current knowledge of hypersensitivity to titanium - a material widely used in medical applications thanks to its exceptional chemical stability, resistance to corrosion, low specific weight and high strength. The hypersensitivity to metals is usually caused by the Type IV immunopathological reaction. Case reports on allergic reactions to titanium are rare but the actual occurrence can be expected to be much higher, especially due to its problematic detection. Although cutaneous patch tests are widely accepted and used for the diagnosis of hypersensitivity of numerous metals (e.g. Ni), it is notoriously unreliable...

Comments on Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021 - What to Do in the Initial Hours?In-service-training

P. SKLIENKA, M. FRELICH, E. KUŠÍKOVÁ, F. BURŠA, Z. CICHÝ, R. MADEJA

Acta Chir Orthop Traumatol Cech. 2023; 90(1):67-74 | DOI: 10.55095/achot2023/011  

High-Grade Chondrosarcoma of the Proximal Phalanx: an Unusual Case of a Rare EntityCase report

A. PAGNOTTA, V. M. FORMICA, S. TACCOGNA, G. SUMMA, C. ZOCCALI

Acta Chir Orthop Traumatol Cech. 2023; 90(1):63-66 | DOI: 10.55095/achot2023/010  

Chondrosarcoma of the hand is a rare disease, but is one of the more common malignancies of the hand. Biopsies and imaging are a fundamental step in determining correct diagnosis, grading and selection for best treatment.We describe the case of a 77-year-old male complaining of a painless swelling in the proximal phalanx of the third ray of left hand. A biopsy was performed and the histology revealed a G2 chondrosarcoma. The patient underwent III ray amputation with metacarpal bone disarticulation and sacrifice of the radial digit nerve of the fourth ray. Definitive histology revealed grade 3 CS. Eighteen months after surgery, the patient is apparently...

First Experience with Diaphragm Pacing System in the Czech RepublicCase report

J. KŘÍŽ, S. JAROŠČIAKOVÁ, K. ŠEDIVÁ, V. HYŠPERSKÁ, K. ČADOVÁ, Z. PŘIKRYLOVÁ

Acta Chir Orthop Traumatol Cech. 2023; 90(1):59-62 | DOI: 10.55095/achot2023/009  

Patients with impaired diaphragm function are dependent on long-term mechanical ventilation. It is associated with numerous health complications as well as significant economic burden. Intramuscular diaphragm stimulation through laparoscopic implantation of pacing electrodes is a safe method which enables restoring breathing using diaphragm in a considerable number of patients. The first implantation of diaphragm pacing system in the Czech Republic was performed in a thirty-four-year-old patient suffering from a high-level cervical spinal cord lesion. After eight years of mechanical ventilation support, just five months from initiation of stimulation,...

5^th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?Original papers

J. DEMEL, L. PLANKA, R. STICHHAUER, A. VRTKOVA, G. BAJOR, M. HAVLICEK, L. PLEVA

Acta Chir Orthop Traumatol Cech. 2023; 90(1):53-58 | DOI: 10.55095/achot2023/008  

PURPOSE OF THE STUDYFifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department.MATERIAL AND METHODSPatients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study....

Posterior Tibial Slope as a Morphological Risk Factor for Anterior Cruciate Ligament Reconstruction: a Retrospective Cohort StudyOriginal papers

R. KALINA, D. MELECKÝ, P. NEORAL, J. GALLO, M. SIGMUND

Acta Chir Orthop Traumatol Cech. 2023; 90(1):47-52 | DOI: 10.55095/achot2023/007  

PURPOSE OF THE STUDYIncreased tibial slope facilitates anterior translation of tibia relative to the femur, thereby increasing the load on both the native and replaced anterior cruciate ligament. This study aims to retrospectively review the posterior tibial slope in a cohort of our patients after the ACL reconstruction and revision ACL reconstruction. Based on the results obtained by measurements, we aimed to confirm or disprove the claim that the increased posterior tibial slope is one of the risk factors of the ACL reconstruction failure. Another aim of the study was to assess whether there are any correlations between the posterior tibial slope...

Benefit of Arthroscopy in Differential Diagnostics and Therapy of Lateral EpicondylitisOriginal papers

A. KŘIVÁČEK, Z. VODIČKA, F. KREJČÍ, L. PAPEŽOVÁ, D. MUSIL

Acta Chir Orthop Traumatol Cech. 2023; 90(1):41-46 | DOI: 10.55095/achot2023/006  

PURPOSE OF THE STUDYThe aim of this study is to confirm that the involvement of arthroscopy in the surgical treatment of painful elbow syndrome, when proper and long enough conservative treatment failed, has better results than open radial epicondylitis surgery alone.MATERIAL AND METHODSA total of 144 patients included 65 men and 79 women, with the mean age of 45.3 years, namely 44.4 years (range 18-61 years) in men and 45.8 years (range 18-60 years) in women. Each patient was clinically examined, an anteroposterior and lateral X-ray of the elbow were performed, and proper therapy was chosen - either primary diagnostic and therapeutic arthroscopy...

Which is the Best Solution for Achieving Maximal Interfragmentary Compression of the Scaphoid Fractures - One or Two Herbert Screws?Original papers

L. SIMEONOV

Acta Chir Orthop Traumatol Cech. 2023; 90(1):34-40 | DOI: 10.55095/achot2023/005  

PURPOSE OF THE STUDYTo compare the treatment outcome of scaphoid facture fixation with one versus two Herbert screws (HBS).MATERIAL AND METHODS72 patients underwent open reduction internal fixation (ORIF) following acute scaphoid fracture, and were followed prospectively by one surgeon. All fractures were Herbert & Fisher classification type B, the most common fracture lines being oblique (n=38) and transverse (n=34). Fractures with similar fracture lines were randomly assigned into two groups; fractures stabilized with one HBS (n=42) and fractures stabilized with two HBS (n=30). A specific methodology was developed for placement of...

Instabilities of the Thumb Carpometacarpal Joint: Our Surgical OutcomesOriginal papers

J. PILNÝ, D. KACHLÍK, P. ZEMAN, K. HORÁČKOVÁ, P. HÁJEK

Acta Chir Orthop Traumatol Cech. 2023; 90(1):29-33 | DOI: 10.55095/achot2023/004  

PURPOSE OF THE STUDYCarpometacarpal (CMC) instabilities of the thumb joint occur after injuries or due to joint overload in patients with congenital joint hypermobility. They are often undiagnosed and, if left untreated, are the basis for the development of rhizarthrosis in young individuals. The authors present the results of the Eaton-Littler technique.MATERIAL AND METHODSThe authors present a set of 53 CMC joints of patients with an average age of 26.8 years (15-43 years) operated on in the years 2005-2017. Post-traumatic conditions were found in 10 patients and in 43 cases instability was caused by hyperlaxity, also demonstrated in...

Scapholunate Ligament Partial Tears; Tear Localization, Extrinsic Ligament Injury Association and Conservative Treatment Responses Prior to Instability: Cross-Sectional StudyOriginal papers

B. KARAALIOGLU, O. KORKMAZ, K. YILMAZ, S. SARI, B. ŞENER, A. KARA

Acta Chir Orthop Traumatol Cech. 2023; 90(1):22-28 | DOI: 10.55095/achot2023/003  

PURPOSE OF THE STUDYScapholunate interosseous ligament (SLIOL) tears with accompanying extrinsic ligament rupture have been associated with scapholunate (SL) instability. SLIOL partial tears were examined in terms of tear localization, grade and accompanying extrinsic ligament injury. Conservative treatment responses were scrutinized according to injury types.MATERIAL AND METHODSPatients with SLIOL tear without dissociation were evaluated retrospectively. Magnetic resonance (MR) images were reexamined in terms of tear localization (volar, dorsal or combined volar and dorsal tears), grade of injury (partial or complete) and extrinsic ligament...

Functional and Radiologic Results of Posteromedial Limited Surgery in Developmental Dysplasia of the HipOriginal papers

K. UZEL, M. GEM, İ. ŞAHIN, M. O. ZIYADANOĞULLARI, M. M. ESKANDARI, H. ARSLAN

Acta Chir Orthop Traumatol Cech. 2023; 90(1):17-21 | DOI: 10.55095/achot2023/002  

PURPOSE OF THE STUDYIn treatment algorithm of developmental dysplasia of the hip, posteromedial limited surgery is placed between closed reduction and medial open articular reduction. The aim of the present study was to assess the functional and radiologic results of this method.MATERIAL AND METHODSThis retrospective study was performed in 37 Tönnis grade II and III dysplastic hips of 30 patients. The mean age of the patients at operation was 12.4 months. The mean follow-up time was 24.5 months. Posteromedial limited surgery was applied when sufficient stable concentric reduction was not achieved by closed technique. No pre-operative traction...

Management Strategy and Evaluation of Surgical Outcomes in Patients with Recurrent Patellar Instability between 2010-2020Original papers

R. ČAPEK, D. MUSIL, L. NEVŠÍMAL, P. SADOVSKÝ, T. TRNKA

Acta Chir Orthop Traumatol Cech. 2023; 90(1):9-16 | DOI: 10.55095/achot2023/001  

PURPOSE OF THE STUDYThe study retrospectively reviews the outcomes of patella stabilisation surgeries performed at our department in the period 2010-2020. It aimed to provide a more thorough evaluation, to compare the respective types of MPFL reconstruction and to confirm the beneficial effect of tibial tubercle ventromedialization on patella height.MATERIAL AND METHODSIn the period 2010-2020, a total of 72 stabilisation surgeries of patellofemoral joint in 60 patients with objective patellar instability (OPI) were performed at our department. The surgical treatment outcomes were evaluated retrospectively using a questionnaire, including...