Acta Chir Orthop Traumatol Cech. 1994; 61(6)

[Arthroscopic treatment of lateral dislocation of the patella.].

M Weissinger, A Keppel, C Helmreich

Acta Chir Orthop Traumatol Cech. 1994; 61(6):324-327

Between Jan. 1, 1988 and Dec. 31, 1993 at the Orthopaedic Department of the hospital in Zwettl 12 patients with lateral dislocation of the patella were operated arthroscopically. In two habitual, in 10 relapsing and in one a new dislocation of the patella was involved. The patients were followed up clinically and radiologically, the mean follow-up period being 47 months. Every patient was subjected to complete arthroscopic examination of the knee joint. In the final stage of diagnostic arthroscopy an optical instrument was introduced from a medial retropatellar approach and lateral release was carried out. Subsequently from a 1.5 cm skin incision in...

[Ipsilateral fractures of the diaphysis and upper femur.].

J Látal, M Sajter, R Demovic, E Sivík, S Vajcziková, P Simko, V Lazar, J Lohnert, J Sabol

Acta Chir Orthop Traumatol Cech. 1994; 61(6):328-333

Ipsilateral segmental fractures of the diaphysis and the upper end of the femur are relatively rare. They are encountered more frequently in patients with multiple injuries. The basic prerequisite of treatment is an early and accurate diagnosis which may prove difficult in particular in patients with multiple injuries. Conservative treatment is associated with a high incidence of complications, therefore the authors recommend urgent or early surgical stabilization of both fractures. As a rule the method of open reposition and stabilization by plates according to principles of the AO school with the known advantages and shortcomings of this method is...

[Comparison of treatment of fractures of the tibia by plates and by küntscher nails.].

J Palarcík, V Melichar

Acta Chir Orthop Traumatol Cech. 1994; 61(6):334-336

In a retrospective investigation the authors compare the results achieved in a group of casualties with a fresh fracture of the tibia/fracture of the leg as a single injury, who were treated by osteosynthesis with a plate (15 patients) or an intramedullary Küntscher nail (19 patients). The two groups were evaluated as identical and the achieved results do not differ significantly. An intramedullary nail has a wider range of use, it is irreplaceable in fractures with a long comminuted zone or fractures at different levels. Satisfactory results can be obtained by both approaches, if the indication is adequate. Key words: fractures of the tibia (leg),...

[Fractures of the humerus in multiple injuries (comparison with the same injury in a group of single injuries/associated injuries).].

J Palarcík, P Bucek, L Michek, O Vlach

Acta Chir Orthop Traumatol Cech. 1994; 61(6):337-340

The authors compare retrospectively, based on material of the Research Institute of Traumatology and Special Surgery in Brno (1985-1990), a group of 13 patients who suffered fractures of the diaphysis of the humerus as part of a multiple injury with a group of 29 patients who suffered the same injury as a monotrauma or associated injury. Both groups are characterized, the therapeutic approach is described as well as the complications which developed. The patients were checked on average after 45 months following the injury (12-96 months) and the results are reviewed. The authors consider the groups comparable and the results achieved in the two groups...

[Hallux Valgus in Cerebral Palsy and Surgery by Author's Modification.].

V Smetana, A Schejbalová

Acta Chir Orthop Traumatol Cech. 1994; 61(6):341-343

The authors present their own surgical procedure used in hallux valgus of spastic origin in cerebral palsy in children and adolescents. In 11 patients they made a plastic operation in the area of the metatarsophalangeal joint by splitting the tendon of the m. extensor hallucis longus by shifting its medial half into the fold of the capsule of this joint on the inner side into the area of the m. abductor hallucis. Favourable postoperative results were recorded between the age of 10 and 14 years. With advancing age the success of the operation declines and other types of surgery should be considered. The described plastic operation is one of the possible...

[Reconstruction of the Extensor Apparatus of the Wrist and the Hand in RA.].

J Pech, S Popelka

Acta Chir Orthop Traumatol Cech. 1994; 61(6):344-350

Reconstruction of the extensor apparatus of the wrist and the hand is one of the common rheumato-surgical operations. Primary suture of the tendon which produces the best results is only rarely possible. The patient usually attends late, very frequently does not even notice at first an isolated rupture of the extensor. The authors recorded in a group of 39 rheumato-surgical operations of the wrist a disorder of the extensor apparatus in 14 instances. In nine instances the repair of the extensor was part of a total arthrodesis of the carpus, in two instances part of simple synovectomy, in one instance the authors repaired extensors in conjunction with...

[Advantages of digitalization and analysis of roentgenograms of bones by microcomputer.].

J Tkácik, F Makai, M Keppert, B Valko

Acta Chir Orthop Traumatol Cech. 1994; 61(6):351-357

The creation of an experimental group for digitalization of two-dimensional X-ray pictures of bones was the starting point for the application of selected procedures for their computer-assisted analysis. During processing of the picture first the primary digitalized picture was corrected (e. g. subtraction of the background, correction of the non-homogenity of the scanning element and light source) and subsequently the picture was prepared by spot or local transformations (e. g. semithresholding, equalization, Sobel's operator and subtraction of two differently prepared pictures) while preserving the geometry of the original objects on the picture....

[Secondary and tertiary endoprosthesis of the hip joint.].

G Vasko, L Jencíková

Acta Chir Orthop Traumatol Cech. 1994; 61(6):358-359

The authors analyze mechanical and biological causes of loosening of cemented total endoprosthesis of the hip joint. They reflect on the "most suitable" time of reoperation, based on clinical experience and the X-ray finding. The authors investigated on account of loosening of the first and second endoprosthesis of the hip joint resp. a group of 28 patients. They present an account of their experience with some new non-cemented types of prostheses during primary or secondary revisions of total prostheses of the hip joint. Key words: total endoprosthesis of the hip joint, aseptic loosening, reimplantation of a total endoprosthesis of the hip joint,...

[Iatrogenic gonitis.].

L Jencíková, G Vasko

Acta Chir Orthop Traumatol Cech. 1994; 61(6):360-361

The authors pay attention to problems of iatrogenic gonitis. They analyze the causes of their development, draw attention to possible negative influences of intraarticular treatment in patients with articular affections in the field of orthopaedics. During the last seven years thy recorded 34 cases of purulent iatrogenic gonitis after ambulatory administration of corticoids and chondroprotective substances. They emphasize the very good and rapid therapeutic effect of corticoids, however, it is important to consider also side-effects of preparations, in particular possible development and progression of pyogenic arthritis. Only good knowledge of topographic...

[Complaints associated with locomotor system and other health problems of female health professionals.].

I Müller, B Chlubnová

Acta Chir Orthop Traumatol Cech. 1994; 61(6):362-364

In a group of 393 nurses, laboratory assistants and rehabilitation workers, mean age 37.5 years, employed in the health services for an average period of 17.7 years the authors assessed, using an anonymous questionnaire, complaints regarding the locomotor apparatus and other health problems. Although the majority of respondents liked their jobs, 74% of the subjects suffered from vertebrogenic pain, painful feet (45 %), and headache (46 %). One third of the examined subjects reported insomnia and vertigo. Overweight was minimal in the investigated group. Physical activity was very restricted (only 14% of the women were regularly engaged in sports);...

[Impossibility of artificial ventilation in a prone position in a patient with deformity of the spine (case-history).].

I Cundrle, O Vlach, H Ondrásková

Acta Chir Orthop Traumatol Cech. 1994; 61(6):365-368

The authors present the case of a 15-year-old female patient (Jehova's Witness) who was operated at the age of two on account of a Wilms' tumour of the kidney and irradiated with subsequent postirra-diation scoliosis. In 1990-1993 she was six times subjected to anaesthesia for distraction with a Harrington rod and repeated redistractions. All anaesthesias were of the general type, with artificial pulmonary ventilation in the prone position and without complications. Anaesthesiological methods and procedures were used which made it possible to avoid administration of blood or blood derivatives. In March 1993 the patient was prepared with erythropoietin...

[Protracted development of an epidural haematoma (case history).].

M Kala, L Blahut, V Benýsek, M Houdek

Acta Chir Orthop Traumatol Cech. 1994; 61(6):369-371

The authors describe the case of a patient who suffered multiple injuries and who after diagnosis of anisocoria was subjected to CT examination of the brain with a negative result. Because of deterioration of the clinical condition CT of the brain was repeated after five hours; it revealed an epidural haematoma in the left frontal area which led to indication of urgent surgery. The patient recovered. Key words: epidural haematoma, diagnosis, computed tomography.