[How shall we continue publishing activity?].

O Cech

Acta Chir Orthop Traumatol Cech. 1990; 57(1):1-2

[Sprengel's deformity].

M Matějícek, P Dungl, M Slavík, M Karpísek

Acta Chir Orthop Traumatol Cech. 1990; 57(1):3-14

The authors deal with etiology, pathological anatomy and clinical finding in inborn high-riding scapula--the so-called Sprengel deformity. What is the best treatment tactics? Is the conservative treatment more suitable than the surgical one, or vice versa? By comparing their own experience with the data in the specialized literature the authors advocate a strictly individualized approach to each affected patient. After determining the diagnosis of Sprengel deformity it is necessary to evaluate the position of the scapula and the extent of the limitation of the range of motion of the respective shoulder-girdle. At the same time it is essential to consider...

[Personal experience with Osgood-Schlatter disease].

O Bencúr, D Oslanec

Acta Chir Orthop Traumatol Cech. 1990; 57(1):15-20

The authors present a group of 49 patients treated over the period of ten years for the Osgood-Schlatter disease. Conservative treatment was employed in 5 patients and 44 patients were treated surgically by the excision of the loose fragment of apophysis. On the basis of the evaluation of the data the authors state that on average 40 months after operation there was no improvement of the condition in as many as 34 per cent of patients and they were not satisfied with the result of operation. After the analysis of the potential causes of failures they stress the necessity of deliberate indication for operation and the priority of the conservative treatment.

[Subcapital osteotomy of the femoral neck in the treatment of coxa vara in adolescence--long-term results].

M Pach, M Dostál, R Ditmar

Acta Chir Orthop Traumatol Cech. 1990; 57(1):21-26

The authors present a group of 16 adolescents suffering from coxa vara treated in the years 1967-1987 for a severe slipped capital femoral epiphysis by subcapital osteotomy. The authors deal with the etiology, symptomatology and treatment with special regard to the severe slip. Spica cast was applied in most operations and no internal fixation was used. In the so far latest female patient the femoral head was fixed after osteotomy by Kirschner wires according to Dyas Aries. In the discussion the authors report considerably lower percentage of complications in the longterm examination, mainly as concenns the avascular necrosis of the femoral head in...

[Surgical treatment of patients with juvenile cerebral palsy at the orthopedic clinic of the Charles University Medical School in Prague-Motol].

A Schejbalová, J Frýdl, V Mrzena, S Popelka

Acta Chir Orthop Traumatol Cech. 1990; 57(1):27-33

In the period of 1976-1987 there were in total 181 patients operated on with the diagnosis of infantile cerebral palsy at the Orthopaedic Clinic of the Faculty of Pediatrics of Charles University in Prague-Motol. 412 operations were performed in total in these patients. The indication was mainly the improvement of the statics and gait, therefore operations on lower extremities prevailed. Within the preoperative preparation it is essential to precisely classify the type of affection of the patient from the neurological viewpoint and mainly estimate the future physical and psychical abilities of the child which is of substantial importance in the postoperative...

[Factors affecting the surgical results of treatment of rotator cuff tears in the shoulder].

J Pěchoucek

Acta Chir Orthop Traumatol Cech. 1990; 57(1):34-39

The work presents the outcomes of clinical, radiological and mathematical analyses of 42 patients with the rupture of the whole width of the cuff of shoulder rotators treated operatively. The group comprised 34 male and 8 female patients, the average age 55.5 years. The mean period between the operation and final clinical evaluation was 23 months. According to the method chosen for the evaluation of the results by means of 100-point score acceptable result was achieved in 90 per cent of cases (excellent in 64 per cent, good in 26 per cent). Double t-test showed that significantly participating in the results were the following factors: the period between...

[Electromyographic findings in the gluteal muscles in the Watson-Jones and the Bauer surgical approaches to the hip joint].

J Chomiak, M Slavík, V Stĕdrý

Acta Chir Orthop Traumatol Cech. 1990; 57(1):40-47

The authors have made electromyographic examination of m. tensor fasciae latae and m. glutaeus medius and sometimes also minimus in patients after the implantation of total endoprosthesis of the hip joint by anterolateral Watson - Jones approach and transgluteal Bauer approach with the aim to find out if there occurs the anticipated transection of n. glutaeus usp. and dennervation of m. tensor fasciae latae and compare from this viewpoint both approaches. The examination was performed in 18 patients after the implantation of 20 total endoprostheses of the hip joint (out of which 10 hip joints were operated on by Watson - Jones approach and 10 by Bauer...

[Halo fixation for injuries of the cervical spine].

S Taller, R Lukás

Acta Chir Orthop Traumatol Cech. 1990; 57(1):48-55

The authors present the treatment of 16 serious cervical spine fractures by halo traction with the restoration of anatomic condition and significant improvement of the neurological state. The authors describe the technical equipment of their own construction, the method and advantages of the treatment. The results achieved have proved that the halo traction considerably improves the possibilities of the conservative treatment of cervical spine injuries. With reliable fixation in the anatomic position it promotes more rapid mobilization of the patient and substantially reduces the period of hospitalization.

[The preoperative radiographic image in traction and of the postural angle in relation to postoperative correction of the scoliotic curvature].

P Janícek, O Vlach, M Sachlová

Acta Chir Orthop Traumatol Cech. 1990; 57(1):56-59

The authors evaluated a group of 297 patients after the surgical correction and stabilization of the spine, out of which there were 171 idiopathic, 98 congenital, 14 neuromuscular deformities and 14 deformities were connected with neurofibromatosis. By the statistical comparison of the values of curvature when the patient is standing prior to operation, lying in distraction of 200N and lying in side-bend to the convex of the curve with the value of correction after operation the authors have proved that it is sufficient to carry out only the examination in the maximum voluntary side-bend with the exception of the deformities of neuromuscular origin...

[The present occurrence of scoliosis and spondylolisthesis].

R Chaloupka, O Vlach

Acta Chir Orthop Traumatol Cech. 1990; 57(1):60-64

On the basis of the clinical material of 319 individuals suffering from spondylolysis and spondylolisthesis the authors examined the current occurrence of scoliosis and spondylolisthesis. After eliminating the curves up to 20 degrees and all disruptions of isthmus without slide they found only 18 patients. The slide was on the average 35 per cent (8 per cent to 100 per cent), scoliotic curve 35 degrees (21-71 degrees). The scoliotic curve was idiopathic in 13 cases and once it occurred in case of Marfan syndrome. Only 2 curves were of spastic and 2 of olisthetic type with the maximum of 41 degrees. The analysis has shown that in the selection of more...

[Is it possible to objectively study back pain in orthopedic practice?].

J Vojtassák, E Huraj

Acta Chir Orthop Traumatol Cech. 1990; 57(1):65-69

The authors concentrate on vertebral diseases in the polyclinic practice, they emphasize their sociomedical significance. The statistical data are presented to document the number of examinations and the prevalence of work inability during the last 5 years which has an increasing tendency. To emphasize the problem of the objectification of the vertebral painful syndrome at the polyclinic they present two case reports, draw attention to the dissension of views of polyclinic specialists as concerns etiopathogenesis of vertebral diseases and related to it the problem of objectification with regard to work ability. According to the authors' view the vertebral...

[Use of Nutramin VLI Spofa for parenteral nutrition in the early post-injury period in polytrauma].

F Vyhnánek, M Procházka, K Kruf, H Koubková, V Bulant, O Vojtísek, J Kletenský

Acta Chir Orthop Traumatol Cech. 1990; 57(1):70-76

The solution of branched-chain amino acids of gradually increasing concertration ranging from 22.7 to 43 per cent was administered to 15 patients with polytrauma as part of parenteral nutrition. Parenteral nutrition was started with during 24 hours after the trauma. The effect of parenteral nutrition was objectified by a twenty-four hour balance of water, ions, energy and nitrogen and by a follow-up of kinetics of amino acids in the plasma. It was found out that the increase of the share of branched-chain amino acids up to 43 per cent resulted in a pharmacodynamically efficient level of valine. There occurred gradual adjustment both of the levels of...

[Selected immunologic indicators in malignant bone tumors].

A Keleová, E Huraj, E Jahnová, S Janota, S Nyulassy

Acta Chir Orthop Traumatol Cech. 1990; 57(1):77-88

In patients with the malignant tumor of bone (17 osteosarcomas, 8 Ewing tumors) longterm observations were made, and namely at the beginning of the disease, after the surgical removal of the tumor, during chemotherapy and in the terminal phase of the disease. The observations concentrated on the following selected immunology parameters: active lymphocytes T, lymphocytes T, lymphocytes B, large granular lymphocytes, IgG, IgA, IgM and circulating immune complexes. In non-treated patients prior to diagnosing the disease, reduction of active lymphocytes T was found out while the total lymphocytes T remained unchanged. However, no significant differences...

[Indicators for arthroscopy of the bone joint].

I Horský

Acta Chir Orthop Traumatol Cech. 1990; 57(1):89-92

Everyday practice has convinced us that the diagnosis of the affection and mainly of the injury of the knee joint is far from being so simple as it may seem at first glance and as it is still considered by many orthopaedic surgeons and traumatologists. The determination of proper diagnosis must be based first of all on anamnestic data, thorough clinical and other supporting examinations. It has been found out that both the sensitivity and specificiy of individual tests are lower than it has been so far assumed. It is given by a number of factors such as: the personal experience of the physician, his specialization, adherence to the proper performance...