Acta Chir Orthop Traumatol Cech. 1994; 61(3)

[Initial Results with Non-cemented Walter-Motorlet Prostheses of the Hip Joint.].

I Landor, A Sosna, V Fric, D Jahoda

Acta Chir Orthop Traumatol Cech. 1994; 61(3):132-137

The authors present their experience with the use of non-cemented total endoprostheses of the hip joint. During a 5-year period at the First Orthopaedic Clinic of the First Medical Faculty, Charles University, Prague 178 non-cemented hip joint prostheses were implanted. The authors evaluated, using internationally accepted criteria, 69 patiens with non-cemented prostheses of the hip joint Walter-Motorlet after an interval of more than 20 months. The intensity of pain was reduced, the consumption of analgesics lower. The patients' capacity to look after themselves improved. The distance patients are able to cover without resting increased. Heterotopic...

[Arthroscopic Surgical Technique and its Short-term Results in the Treatment of Relapsing Anterior Dislocation of the Shoulder.].

M Weissinger, A Keppel, K Thenner

Acta Chir Orthop Traumatol Cech. 1994; 61(3):138-145

In the submitted paper the autors describe the arthroscopic technique of treatment of relapsing anterior and combined low-anterior dislocation of the shoulder. The principle is a three-layer reconstruction tehchnique of the anterior portion of the joint. It involves reinsertion of the ruptured complex labrum-ligaments, three glenohumoral ligaments and the tendon of the m. subscapularis on the anterior surface of the cervix of the scapula blood stained in advance. Across the listed structures 4-6 U-shaped stitches which are pulled through a canal bored in the cervix of the scapula on the dorsal side and these stitches are fastened by knots over the...

[Degenerative changes in the small joints of the foot.].

J Kottová

Acta Chir Orthop Traumatol Cech. 1994; 61(3):146-151

In post-mortem material of the Institute of Anatomy a total of 137 joints of the foot from adult men (age 50-90 years) were subjected to macroscopic examination. The author analyzes the course of degenerative changes and their localization on articular surfaces and at the same time draws attention to changes of the synovial layer of the articular capsule. Key words: articular cartilage, synovial lining, degenerative changes.

["High" supracondylar fracture of the humerus in children.].

P Havránek

Acta Chir Orthop Traumatol Cech. 1994; 61(3):152-155

Fractures of the distal part of the humerus in children where the line of fracture is higher than in typical supracondylar or transcondylar fractures, i. e. on the borderline of the distal metaphysis and diaphysis, differ from classical supracondylar and diaphyseal fractures and call also for a different therapeutic approach. In these "high" supracondylar fractures the risk of feared rotation of the peripheral fragment with a tendency of varus deformity and the formation of a peak-shaped process of the rotated metaphysis preventing flexion in the joint is smaller, however, the fragments have a low stability due to extensive damage of the periostium....

[Surgical technique in pes equinocavus.].

M Richtr, A Sosna

Acta Chir Orthop Traumatol Cech. 1994; 61(3):156-166

The authors compare the results of different types of surgery of pes equinocavus. In severe deformities of the foot with a predominating equinous component they propose their own method of correction osteotomy of the foot at two levels with arthrodesis of the ankle. They safeguard the position by means of a tibiometatarsal frame. For stabilization of the achieved correction they use shortened dorsal structures. The recommended method is very accurate and reliable and makes it possible to influence in a sensitive way all components of the deformity of the foot. Key words: pes equinocavus, arthrodesis of the ankle, external osteosynthesis.

[Our Experience with Stephenson and Donovan's Operation when Dealing with Adduction Contractures in Infantile Cerebral Palsy.].

V Smetana, A Schejbalová

Acta Chir Orthop Traumatol Cech. 1994; 61(3):167-170

The authors evaluate 39 transpositions of adductors performed by Stephenson and Donovan's procedure in 1970-1992 in patients with infantile cerebral palsy. The authors consider this operation one of the basic ones, along with tenotomy of the adductors, when dealing with muscular disbalance and contractures in the area of the hip joint. Based on long-term experience the authors give the main indication of this operation, i.e. marked inner rotation of the hip associated with moderate adduction. They draw attention to the fact that if the operation is properly indicated, it can influence on a marked way the general posture, standing and gait of patients...

[Initial Experience with Morscher's Elongation Osteotomy in Coxa Brevis.].

M Dostál, R Ditmar, M Pach

Acta Chir Orthop Traumatol Cech. 1994; 61(3):171-176

The authors present their initial experience with triple osteotomy of the proximal femur with elongation of the neck of the coxa brevis. The objective of elongation osteotomy is to achieve sufficiency of the abductors after reduction and distalization of the greater trochanter and to improve the biomechanics of the hip joint. The same indication applies to double intertrochanteric Wagner or Dungle osteotomy which achieves also similar results. At the Orthopaedic Clinic of the Medical Faculty, Palacký University Olomouc in the course of 13 months eight patients were operated. The authors describe briefly the surgical procedure, explain the necessity...

Surgical treatment for infections of the cervical spine.

M DI Silvestre, P Prosperi, A Capelli, G Gargiulo

Acta Chir Orthop Traumatol Cech. 1994; 61(3):177-180

Non-specific and tuberculous infections of the cervical spine are a rare disease in developed countries. In 1962-1988 in the Orhopaedic Institute Rizzoli 32 patients with spondylitis of the cervical spine were treated. Twenty-nine patients came from Italy and three from Africa. Tuberculous infection was present in 23 patients, non-specific infection in nine. Eight tuberculous infections were in the atlanto-axial junction, the remaining ones at lower levels. The diagnosis was assessed by clinical and X-ray methods, only in four instances it was verified by histological examination. Conservative treatment was provided in 26 patients and surgery in five....

[Importance of blunt injuries of the chest for assessment of the therapeutic procedure and prognosis in multiple injuries.].

F Vyhnánek, O Vojtísek, L Novák, J Sturma

Acta Chir Orthop Traumatol Cech. 1994; 61(3):181-184

Based on analysis of a group of 62 casualties with multiple injuries where a blunt chest injury was found, the authors submit some principles for assessment of the priority of the therapeutic procedure. The patients were hospitalized at the intensive care unit of the Surgical Clinic of the Third Medical Faculty in Prague between 1989 and 1992. Craniocerebral injury was the most frequent associated injury, its sequelae were the cause of death in the majority of injured patients who died. In the treatment of chest injuries with an unstable thoracic wall, with contusion of the lungs and associated craniocerebral injury artificial ventilation is still...

[Salmon calcitonin nasal spray and calcium sandoz forte in the prevention and treatment of osteoporotic fractures in postmenopausal women (information on clinical trial).].

J Vojtassák, F Makai, K Rausová, R Vojtek, A Svec, A Sefranková

Acta Chir Orthop Traumatol Cech. 1994; 61(3):185-187

At the First Orthopaedic Clinic in Bratislava, Hlboká 7, since August 24, 1992 a clinical trial is under way which is focused on the effectiveness of treatment with salmon Calcitonin (Miacalcic Sandoz) and calcium (Sandoz) in postmenopausal osteoporosis. On the above mentioned day Sandoz Co. supplied the Clinic with a densitometer Lunar DPX-L working on the principle of double X-ray absorptiometry. The preparation for this clinical trial started at the beginning of 1992. By the end of June in the trial 62 female patients were included. The authors plan to include another 36 patients were included. The authors plan to include another 36 patients by...

Fatigue Fractures of First Generation Porous Coated Non-cemented Hip Prostheses.

W Plötz, I Schittich, H Rechl, J Träger, R Gradinger, E Hipp

Acta Chir Orthop Traumatol Cech. 1994; 61(3):188-191

We show two case reports to discuss the problem of fatigue fractures of non-cemented porous coated total hip prosthesis. Fatigue fractures occur in the region of highest tensile stresses. Because of the surface irregularities of the porous coating, tensile stresses in the surface of the stems are increased depending on the configuration of the pore. A thick porous coating also decreases the cross section of the stem. In addition the manufacturing process, the application of a porous layer can weaken the stem. Finally, cementless prostheses are implanted especially in young active patients, who exert high forces on their hip. For cementless porous coated...