Acta Chir Orthop Traumatol Cech. 1990; 57(4)

[Surgical treatment of the sequelae of ischemic postdysplasia femur head necrosis in children. II. Surgical technique].

P Dungl

Acta Chir Orthop Traumatol Cech. 1990; 57(4):289-309

The author presents its concept concerning the possibilities of the surgical treatment of the sequelae of the postdysplastic necrosis of the femoral head originating from the treatment of congenital dislocation or subluxation of the hip joint. The classification is based on the division according to Bucholz and Ogden into 4 types. Indicated for the surgical treatment are hips with the injury of the type II and III. In Grade II type the joint congruence is not affected and the method of operation is the redirection pelvic osteotomy. In children up to the age of 10 the author applies Salter osteotomy and in elder children and adolescents he performs...

[The esthetic effect of surgical treatment of idiopathic scoliosis].

I Müller, O Vlach, P Messner

Acta Chir Orthop Traumatol Cech. 1990; 57(4):310-312

Idiopathic scoliosis has a negative impact on the heart and lungs in the deformed chest, its creates a cosmetic defect, i.e. asymmetry of the paravertebral prominence, shortening of the trunk, asymmetry of the shoulders and protruding scapulae. Later it may cause pain and nervous disorders. In a group of 46 patients aged 15.5 years with thoracic right-sided idiopathic scoliosis the effect of operation by Harrington's instrumentation and spondylodesis on improvement of the curvature and the cosmetic effect were investigated. Preoperative curvature of 69 degrees according to Cobb improved to 35 degrees (by 50%) and the prominence from 38 mm before operation...

[Spondylothoracic dysplasia].

J Sklepek, O Vlach

Acta Chir Orthop Traumatol Cech. 1990; 57(4):313-317

The authors describe 4 cases of spondylothoracal dysplasia. In two of them the severity of scoliotic deformity necessitated surgical treatment, the other two cases are under observation, as numerous malformations are at present compensating each other. All of them fall into the type II with a good life prognosis. The analysis of patients and survey of findings from the available literature facilitates a better familiarization with this syndrome.

[Tuberculosis of the upper cervical spine].

O Vlach, J Cienciala

Acta Chir Orthop Traumatol Cech. 1990; 57(4):318-321

The authors present a case report on a 25-year-old female patient with the tuberculous spondylitis of 2nd cervical vertebra. For the treatment they choose a two-stage surgical procedure. Within the first stage they removed transorally the focus and filled in the defect in the body of the vertebra with autospongy bone grafts. In the second stage they stabilized the spine from the dorsal approach. Postoperative treatment in the plaster of Paris collar lasted three months. Thus the disease was quickly eliminated.

[The tasks and objectives of geriatric orthopedics].

F Makai

Acta Chir Orthop Traumatol Cech. 1990; 57(4):322-327

The ageing of population all over the world including Czechoslovakia where the share of people above 60 years of age is 14-15 per cent of the whole population (by the year 2010 this share should reach 20 per cent and a very frequent incidence of diseases and traumatism of osteoarticular apparatus in elderly people necessitates specialized care of geriatric patients. Geriatric orthopaedics is a combination of the principles of internal medicine and orthopaedics applied on old people. Geriatric orthopaedics deals with 3 major problem areas of diseases in old age: 1. osteoporosis, 2. osteo-arthrosis, 3. traumatism. The author concentrates on the problems...

[Traumatic indications for total hip joint prosthesis].

M Slavík, V Stědrý

Acta Chir Orthop Traumatol Cech. 1990; 57(4):328-338

In the years 1978-1986 the authors implanted 207 total prostheses in patients with the fracture of the femoral neck or after the fractures in the area of the hip joint. 50 patients were operated on for an acute fracture of the neck. The surgical technique in these indications does not differ on principle from the surgical technique of coxarthrosis. They point out a higher number of some peroperative complications. They checked 141 patients with and average follow-up of 47 months. In 4.2 per cent of late complications they reported roentgenological symptoms of loosening. Reoperation because of the loosening of the acetabular component was inevitable...

[Tissue loss injury of the proximal phalanx of the thumb and repair using a rib graft].

J Pech, P Vavrík, J Schutzner

Acta Chir Orthop Traumatol Cech. 1990; 57(4):339-346

In their case report the authors deal with the loss tissue injury of the proximal phalanx of the thumb caused by a circular saw. The first treatment on the day of the injury was carried out at the local clinic, the edges of the wound were trimmed and the residual small bone fragments were removed. Then suture was made of the dorsal aponeurosis and a K-wire was drilled in percutaneously through the distal phalanx into the base of the proximal phalanx in order to maintain the distance between the fragments. Wide-spectrum antibiotics were applied together with antitetanus-toxic injections and anti-gangrenous serum. After 9 weeks when the wound was healed...

[Definition of "polytrauma" and "polytraumatism"].

J Kroupa

Acta Chir Orthop Traumatol Cech. 1990; 57(4):347-360

Polytrauma (multitrauma) is a short verbal equivalent used for severely injured patients usually with associated injury (i.e. two or more severe injuries in at least two areas of the body), less often with a multiple injury (i.e. two or more severe injuries in one body area). An important condition for the use of the term polytrauma is the incidence of the traumatic shock and/or hemorrhagic hypotensis and a serious endangering of one or more vital functions of the organism. At least one out of two or more injuries or the sum total of all injuries endangers the life of the injured person with polytrauma. For its variable and non-homogeneous content...

[The information system at the Orthopedic Clinic of the Institute for Physicians and Pharmacists].

J Kolman, V Frühaufová, M Slavík

Acta Chir Orthop Traumatol Cech. 1990; 57(4):361-365

Technological progress in the eighties achieved in the development and implementation of computer technology facilitates new approaches to information processing. Informatics becomes one of the key branches of economy of advanced countries. Under the conditions of the present growth of the volume of information also health care must change the classical form of information processing if it is to fulfil its function properly. The consideration is presented on the possibilities of the introduction of computer technology in our clinics and the problems resulting from it. The experience is described with developing a data base information system of the...

[An instrument for injection of bone cements].

T Trc

Acta Chir Orthop Traumatol Cech. 1990; 57(4):366-369

The author describes the use of a specially developed instrument, which in combination with Chirana 30 ml syringe for one use facilitates the injection application of bone cement in the implantation of the femoral component of total hip arthroplasty or cervicocapital endoprosthesis of the hip. Emphasis is put on the availability of this instrument for all clinics and on the importance of the application of bone cement under pressure from the view point of longterm results of the above mentioned joint arthroplasty. No evident disadvantages in comparison with imported instruments have been found out.