Acta Chir Orthop Traumatol Cech. 1993; 60(4)
[Comparison of surgical and radioactive synovectomy in various disorders of the knee joint].
C Kopác, F Makai, J Frano, L Rehák, J Hlúbik, J Reznák, A Marosová
Acta Chir Orthop Traumatol Cech. 1993; 60(4):195-198
The authors evaluate after an interval of 1-20 years the long-term results of surgical synovectomy in 454 patients and radioactive synoviorthesis in 528 patients performed at the First Orthopaedic Clinic, Medical Faculty, Comenius University and Faculty Hospital in Bratislava and at the Orthopaedic and Traumatological Clinic of the Medical Faculty in Martin in 1969-1991. The most frequent diagnosis in surgical synovectomy is rheumatic synovitis in radioactive synovectomy arthrotic synovitis (47.6% and 68.6%). The authors evaluate both methods of synovectomy according to Aidem-Baker and compare the results of the two methods. They found significantly...
[Structure of compact bone and types of stress in the long bones in humans].
J Hert, P Fiala, M Petrtýl
Acta Chir Orthop Traumatol Cech. 1993; 60(4):199-208
The authors elaborated a new macroscopic method which made it possible to analyze the orientation of osteons in the entire diaphysis. All long bones of the human extremities were thus analyzed. In each bone the osteons are arranged in a specific pattern but according to a uniform plan. Most of them are oriented in an oblique direction and are arranged as two helices of opposite directions located on opposite sides of the bone. The two fields are separated by a sharp borderline. Biomechanical analysis revealed that the orientation of the osteons is consistent with the direction of the maximal principal stress which depends on the normal and torsional...
[Results of reconstructive surgery in fractures of the proximal humerus].
A Sosna, V Fric
Acta Chir Orthop Traumatol Cech. 1993; 60(4):209-217
In treatment of comminuted dislocation fractures of the proximal humerus the most serious therapeutic problem still remains the 6th group of Neer's classification, in particular fractures with four fragments and with a completely dislocated and devitalized head. The authors present in a retrospective study an overall comparison of results assembled in 30 patients (and 19 checked patients resp.) who were operated by the technique of anatomical reconstruction (13 and 8 patients resp.) or by the authors own technique of non-anatomical reconstruction (17 and 11 patients resp.), all operated on account of comminuted dislocation fractures of the proximal...
[The Strayer surgical technic as the basic operation for treatment of pes equinus in cerebral palsy].
V Smetana, A Schejbalová
Acta Chir Orthop Traumatol Cech. 1993; 60(4):218-224
The authors describe the technique of Strayer's operation (gastrocnemius recession) in the spastic form of cerebral palsy and draw attention to its indications, possible combinations with other operations and technical errors associated with its implementation. They evaluate 644 operations made by Strayer's method. In 361 regularly followed-up patients they evaluate from the long-term aspect combined operations of the lower extremities (which form a functional unit), using as a basis their own locomotor and position standards. They emphasize the necessity of a correct strategy, i.e. selection and sequence of surgical procedures. They recommend Strayer's...
[Genu flectum in cerebral palsy, elongation of the flexors of the knee joint and our modification].
V Smetana, A Schejbalová
Acta Chir Orthop Traumatol Cech. 1993; 60(4):225-231
The authors evaluate the results of prolongation of the flexors of the knee joint in 175 patients with a flexed position of the knee joint associated with the spastic form of cerebral palsy. They draw attention to the interrelationship of the position of the lower extremities in the area of the sole, knee and hip joint and emphasize the necessity of correct assessment of primary contractures. They emphasize also the evaluation of correct concurrent function of flexors and extensors of the knee and their balanced functioning. The authors prefer a single surgical operation in combined affections of the lower extremities to the system of so-called minor...
[Aggressive chondroblastoma].
C Povýsil, Z Matĕjovský, H Zídková, V Trnka
Acta Chir Orthop Traumatol Cech. 1993; 60(4):232-236
The authors report three observations of rather extensive aggressive chondroblastoma and draw attention to difficulties of histological diagnosis, which result out of a less typical histological picture, in which signs of differentiation into cartilaginous tissue may be missing. Differential diagnosis may be facilitated by proper recognition of the cytologic character of chondroblasts by the positivity of S-100 protein, and by proving characteristic properties of chondroblasts in electronmicroscopic examination. In treating this type of tumors an increased risk of local recurrence (in one of our patients) and aggressive behaviour to surrounding tissues...
[Hallux valgus--the Dega surgical technic].
V Silovský
Acta Chir Orthop Traumatol Cech. 1993; 60(4):237-239
The author gives an account of one possible approach to the surgical treatment of valgus deformities of the toe. He corrects by the described subcapital wedge-shaped osteotomy of the first metatarsal bone the valgus deviation of the toe in the first metatarsophalangeal joint and at the same time he remodels the metatarsal arch of the foot. The surgical procedure is described and the results of operations, incl. complications, are evaluated. During check-up examinations some 85% of the patients found the results of the operation satisfactory. 13.5% of the patients reported pain when burdening the extremity. 12% of the patients reported difficulties...
[Selection of treatment in femoral shaft fractures].
U Pfister
Acta Chir Orthop Traumatol Cech. 1993; 60(4):240-246
It is not possible and seems not reasonable to treat all kinds of femoral shaft fractures in the same way. Any type of osteosynthesis has its own advantages and disadvantages. The decision towards an operative procedure and the application of a special method depends on the individual situation of the patient and on the familiarity and experience of the orthopedic surgeon with the different available procedures. Single fractures, shaft fractures in combination with jointnear lesions, fractures in polytraumatized patients require a differentiated approach. Doubtless, nowadays the trend to treat all femoral shaft fractures by i.m. nailing is obvious....
[A brain injury caused by a fragment from a soda water carbon dioxide cartridge].
M Gajdos, M Stancák, F Lacko
Acta Chir Orthop Traumatol Cech. 1993; 60(4):247-249
The authors present a report on the treatment of a female patient with a brain injury caused by a splint from an exploded sparklet used for making soda water. The rare occurrence of gunshot wounds in peace time leads to embarrassment as regards treatment of patients with this type of injury. It was found that in gunshot wounds of the head and brain it is necessary to revise the pathway of the splint after craniotomy, remove the foreign body, bone fragments and debris, then close carefully the opening in the dura mater, remove the margins of the bone contaminated with the object which caused the injury and stitch the skin. The authors draw attention...
[Intrapelvic migration of a total hip prosthesis in rheumatoid arthritis].
G Vasko, L Jencíková
Acta Chir Orthop Traumatol Cech. 1993; 60(4):250-253
The authors discuss the risk of mechanical loosening and protrusion of a cemented endoprosthesis of the hip joint after operation which is one of the few possibilities of palliative treatment in patients with rheumatoid arthritis. They deal in particular with specific features of surgical approaches whereby they select a modified method described by Eftekhar which makes it possible to resolve even severe grades of intrapelvic migration of the socket of a total endoprosthesis. The authors discuss possible complications which can be prevented if the relationship of intrapelvic structures to the protruded prosthesis is elucidated before operation. In...