Acta Chir Orthop Traumatol Cech. 1993; 60(2)

[Leg lengthening using callotasis. I. History of lengthening of extremities and surgical technics].

T Trc

Acta Chir Orthop Traumatol Cech. 1993; 60(2):67-75

In the first part of the article divided into two sections the authors describe the history of approaches to limb length discrepancy and they compare several methods and discuss their advantages and disadvantages. The surgical method proper used at the clinic is described incl. preoperative preparation and deliberations as used at the clinic up to the procedure used for removing the fixator after completion of the lengthening of long bones. The operation proper is described in detail from application of the apparatus to performance of osteotomy. The lengthening process is also described.

[Factors affecting the development of para-articular ossification in total hip replacement].

I Landor, P Vavrík, S Havelka, D Jahoda

Acta Chir Orthop Traumatol Cech. 1993; 60(2):76-80

The authors evaluated the prevalence of paraarticular ossifications in three groups of patients after a minimum interval of one year following the administration of a total prosthesis. For evaluation they used Brooker's classification. The first group comprised 40 patients who during the first six weeks after administration of a cemented prosthesis of the hip joint took 75 mg of Indomethacin per day in three doses. The second control group comprised 50 patients, i.e. 61 operated hip joints (11 bilateral prostheses) to whom Indomethacin was not administered during the postoperative period, nor any other antiphlogistic preparations. The third group comprised...

[Personal experience with the use of the Herbert screw in orthopedics and traumatology].

L Hruska, R Kubes, V Frühaufová

Acta Chir Orthop Traumatol Cech. 1993; 60(2):81-87

The authors present in the submitted paper their initial experience as well as theoretical possibilities of using Herbert's screw. This is a relatively new type of implant developed originally for stable compressive osteosynthesis of small bones. This screw is made from a titanium alloy in sizes of 16-32 mm and is based on the principle of traction screws. It has, however, compared with the latter some advantages and thus makes a reduction of the period of postoperative fixation possible. It is supplied along with the insertion instruments which facilitate peroperative reposition and retention of fragments for easier insertion of the screw. In the...

Secondary intramedullary nailing of complicated fractures of lower extremities.

Z Klezl, G Rennirt, D Seligson

Acta Chir Orthop Traumatol Cech. 1993; 60(2):88-92

Between 1984 and 1991, 16 patients with 23 fractures of the lower extremities were treated with external skeletal fixation and subsequent intramedullary nailing. There were 7 closed fractures, 1 closed fracture with vascular injury, 2 Grade I, 3 Grade II and 10 Grade III injuries, sansistiny of 5 Grade IIIA, 2 Grade IIIB and 3 Grade IIIC fractures. The fractures were maintained in external fixation for an average of 14 days (range 4 to 32 days) after which the fixateur was removed and an intramedullary nail placed during the same procedure in all cases. Two of the twenty-three fractures, 9%, subsequently developed deep infections involving the intramedullary...

[Initial experience with peroperative autotransfusion in spinal surgery].

I Cundrle, O Vlach, I Zimová, M Pospísilová

Acta Chir Orthop Traumatol Cech. 1993; 60(2):93-97

The authors describe combinations of anaesthesiological methods which enabled them during extensive spondylosurgical operations in 66 patients to reduce the consumption of homologous blood during operation to 90 ml, on the first day after operation to 300 ml and on the second day after operation to 120 ml. In six patients they used preoperative collection of the patient's own blood, in 45 patients acute normovolaemic haemodilution, in all patients controlled hypotension with sodium nitroprusside to a mean arterial pressure of 8-9 kPa and peroperative collection of blood by means of an autotransfusion apparatus Dideco Stat with a standard programme...

[Arthroscopic meniscopexy].

V Drápal

Acta Chir Orthop Traumatol Cech. 1993; 60(2):98-99

The author analyses indications and therapeutic possibilities of arthroscopic meniscopexy and presents his own results assembled at the First Orthopaedic Clinic of the Masaryk University in Brno. He describes the surgical technique used, i.e. OUTSIDE-IN, in treatment of recent paracapsular ruptures of the meniscus, postoperative fixation and the rehabilitation programme. The author discusses also the necessity of a rigid plaster fixation and advocates fixation of the knee joint by a bandage as proposed by R. Jones with elimination of burdening for a period of eight weeks.

[Basic indicators of cellular immunity in patients with chronic staphylococcal osteomyelitis].

R Pudil, K Karpas, I Hanovcová

Acta Chir Orthop Traumatol Cech. 1993; 60(2):100-103

The objective of the presented work is to compare the state of the immune system in patients with chronic osteomyelitis with a group of the healthy population. The authors followed up on a long-term basis a group of 24 patients with chronic osteomyelitis of staphylococcal origin; they completed immunological examinations comprising cellular and humoral immunity (in particular assessment of T-lymphocytes and their sub-populations by means of monoclonal antibodies, examination of phagocytic capacities of blood elements, assessment of selected plasma protein and immunoglobulin levels). Comparison of results of these examinations in patients with chronic...

[The closed method of intramedullary fixation of forearm fractures].

M Kitka, V Blasko, J Kubasovský

Acta Chir Orthop Traumatol Cech. 1993; 60(2):104-106

The authors demonstrate a group of 27 patients subjected to intramedullary osteosynthesis of the forearm by means of Kirschner wires, using closed surgery. They prefer the described method in patients suffering from multiple injuries who have devastated soft parts of the forearm and in unstable fractures in children. The authors draw attention to the fact that they have achieved very good results by the simple surgical method they described.

[Personal experience with treatment of Pipkin fractures of the femoral head].

M Lutonský, J Dlask, J Brtková

Acta Chir Orthop Traumatol Cech. 1993; 60(2):107-110

In the introduction the authors analyze the classification and incidence of fractures of the Pipkin type. This is a rare injury which develops as a rule in 10% of posterior type dislocations during motor car crashes. The authors present a theoretical review of all therapeutic possibilities in specific types of fractures. The group comprises 17 patients during a follow-up period of 16 years, mean age of the patients 39.6 years. In 82% the cause of the injury was a car accident. Type IV fractures were most frequent, consistent with data in the literature only one type III fracture was recorded. Sixteen patients were operated incl. three operated after...

[Possibilities of using the sartorius muscle in the treatment of chronic osteoarticular infections].

J Pilnácek, D Stockarová

Acta Chir Orthop Traumatol Cech. 1993; 60(2):111-113

In a group of 17 patients with chronic osteoarticular infection for filling of the chronic cavity the sartorius muscle was used. In eight instances chronic osteomyelitis of the distal femur was involved, in nine instances by means of the sartorius muscle the acetabulum was filled (after removal of an infected total endoprosthesis or after resection of the hip joint on account of purulent coxitis). In the first group the authors recorded 75% satisfactory results and therefore they recommend to use the sartorius muscle for filling chronic osteomyelitic cavities in the distal part of the femur with a fistula on the inner side of the thigh. In the second...

[The role of pharmacology in the comprehensive prophylaxis of post-traumatic fat embolism].

J Kroupa

Acta Chir Orthop Traumatol Cech. 1993; 60(2):114-122

Immediate high-standard provisions implemented as soon as possible after serious injuries with the aim to prevent the development of shock or to treat incipient and developing shock is one of the most important aspects of prophylaxis of the syndrome of traumatic fat embolism (FE). An important place is held by the rostoration of normal microcirculation, replacement of blood losses and the control of hypoxia, in particular by artificial pulmonary ventilation. A high caloric intake both by the parenteral and enteral route has among others the objective to prevent excessive development of lipolysis. Surgical operations with the exception of urgent ones...

[Amputation and prosthesis design in severe congenital defects of the lower extremity (case reports)].

K Cízek

Acta Chir Orthop Traumatol Cech. 1993; 60(2):123-127

The author presents an account of three patients with severe congenital defects of the lower extremities who relied on a long-term basis on complex prosthetic appliances. In the mentioned patients the author amputated part of the malformed extremity in such a way as to preserve the "plantar" stump and it was thus possible, when solving the technical aspects of the appliance, to improve also the cosmetic covering of the defect.