Acta Chir Orthop Traumatol Cech. 1993; 60(3)

[Leg lengthening using callotasis. 2. Evaluation of a group of patients with surgical treatment, discussion, literature].

T Trc, J Dokoupil

Acta Chir Orthop Traumatol Cech. 1993; 60(3):131-147

In part 2 of the article the authors evaluate a group of 45 completed cases of lengthening of long bones, using the method of consecutive distraction according to Ilizarev. On average a lengthening of 5.4 cm was achieved. The authors evaluate the procedure of lengthening, the period taken by therapy in relation to the patients' age. The mean period of treatment was 5.7 weeks per 1 cm lengthening and it depends distinctly on the patient's age. In a total of 16 patients at the same time also correction of the axis of the leg was made. A major part of the investigation is devoted to evaluation of complications which, consistent with the literature, are...

[Locked nailing of fractures of the long bones. 1. Fractures of the leg].

M Krbec, T Trc

Acta Chir Orthop Traumatol Cech. 1993; 60(3):148-152

The authors present an account of their initial experience with the use of a method of locked nailing of fractures of the leg, applying the technique described by Grosse and Kempf. They use original implants of Howmedica Co. They indicated for osteosynthesis closed fractures of the leg in the middle three fifths of the bone length, without major damage of soft tissues (grade 0 and 1 of Tscherne's classification). In injuries with imminent compartment syndrome they operated after a delay, in all others they operated early after injury. Using the described method, the authors operated 16 patients. In three instances they used static locking of the nail,...

[Complications after replacement of a knee joint endoprosthesis with a cementless "low contact stress" prosthesis].

M Weissinger, A Keppel, C Helmreich

Acta Chir Orthop Traumatol Cech. 1993; 60(3):153-157

Total endoprosthesis of the knee joint of the LCS type reduce due to the mobile placement of the menisci and rotatable components the mechanical demands on anchoring in bone and thus contribute to satisfactory biological integration. During the period between June 1, 1989 and December 31, 1991 in the orthopaedic department of the general hospital in Zwettel 41 patients had 42 total endoprostheses (LCS) of the knee joint implanted. The group comprised 34 women and 7 men. All patients were checked and evaluated according to Hungerdorf's schema. The age range was 62 to 79 years with an average of 65.8 years. The follow-up period was 8 to 38 months, mean...

[Technical problems in reoperation of hip joint prostheses].

V Stědrý, M Slavík

Acta Chir Orthop Traumatol Cech. 1993; 60(3):158-162

At the Orthopaedic Clinic of the Institute for Postgraduate Medical Training in the course of 10 years (1979-1989) 2340 primary implantations of total endoprostheses of the hip joint were performed. During the same period 168 total endoprostheses of the hip joint and 20 cervico-occipital prostheses were reoperated. The most frequent reason for reoperation was aseptic loosening of the acetabular component. The mean period between operation and reoperation in these patients was 98 months. In the group with loosening of the socket associated with mechanical destruction of the component the mean period which had elapsed since the primary operation was...

[Autofixation of the transposed tibial tuberosity in habitual patellar dislocation].

A Sosna, P Dupal

Acta Chir Orthop Traumatol Cech. 1993; 60(3):163-166

Habitual luxation of the patella is as a rule considered an indication for a stabilizing operation. As regards approaches to the surgical solution of this problem we can differentiate between operations of the proximal part of the extension apparatus, i.e. operations of the soft tissues and operations on the distal part of the extension apparatus, above all plastic operations and transposition of the insertion of the lig. patellae on the tuberositas tibiae. In the present paper the authors submit their own modification of transposition of the tuberositas tibiae, suitable in severe affections after closure of the epiphyseal space. The described technique...

[Revitalization of bone transplants using vascular implants].

J Válka, J Smahel, O Novák

Acta Chir Orthop Traumatol Cech. 1993; 60(3):167-170

For investigation of revascularization of free autogenous bone grafts by implantation of blood vessels the authors used rats as experimental material. The arteries or bundles of arteries were implanted into the spongiosa of the free bone transplant--a tall vertebra. It was revealed that capillary proliferation which promotes revascularization of the graft started in the adventitia of the implanted artery. Therefore it is not necessary to severe the artery, as recommended in methods used in previous studies. Revascularization occurs even when the implanted artery retains its original function. Implantation of blood vessels does not prevent extensive...

[Rehabilitation after total endoprosthesis replacement of the hip joint].

I Chlupatá, M Andrtová

Acta Chir Orthop Traumatol Cech. 1993; 60(3):171-172

The authors present an account on the rehabilitation programme used in patients after total endoprostheses, as practiced in their department. They draw attention to the importance of mutual collaboration of doctors and rehabilitation instructors. Without it even the best surgical operation would not produce the desirable effect. They also draw attention to the advantages of remedial exercise before operation and the necessity to start with remedial exercise immediately after surgery and continue after discharge from the hospital. In the conclusion they outline some problems they encountered during their work with patients after total endoprostheses.

[Dual x-ray absorptiometry in the diagnosis of osteoporosis].

J Vojtassák

Acta Chir Orthop Traumatol Cech. 1993; 60(3):173-179

The author presents a review providing information on contemporary modern radiological possibilities as regards the diagnosis of osteoporosis at the First Orthopaedic Clinic in Bratislava. At present this department possesses a densitometer LUNAR DPX-L. This apparatus assesses the bone density on the basis of double X-ray absorption. The software available at present makes it possible to assess the bone density of the lumbar spine in the anterio-posterior and lateral projection, as well as the proximal femur and whole body. The mean time required for assessment is 4 mins. 24 secs. to 16 mins. 30 secs. The mean radiation load of the patient is 1.5 mrem,...

[Arteriovenous aneurysm--an uncommon complication in open fractures of the leg].

J Knĕzek, J Cyprich, I Malý, M Kocourek

Acta Chir Orthop Traumatol Cech. 1993; 60(3):180-184

The authors describe a less common complication of external osteosynthesis--a false arteriovenous aneurysm. On the case-history of a patient they demonstrate the risk associated with insertion of nails, the necessity of careful follow-up of patients after operation, and in case of suspicion, the necessity of accurate diagnosis and urgent surgical operation.