Acta Chir Orthop Traumatol Cech. 1995; 62(4)

[Contribution to the problem of classification of fractures of the proximal end of the humerus in adults.].

V Fric, A Sosna

Acta Chir Orthop Traumatol Cech. 1995; 62(4):196-206

A classification is useful only if it helps the surgeon to resolve a given fracture. This applies obviously also to fractures of the proximal end of the humerus. In the submitted paper the authors review the problem of classification of fractures of the proximal humerus which could help orthopaedists and traumatologists to decide on the therapeutic approach to these serious injuries. For a long time it did not prove possible to elaborate a classification which meets contemporary theoretical demands and practical needs. Some hitherto used older classifications are based on the course of the fracture line or the mechanism of the injury; they do not assess...

[Modified semitubular blade plate for fixation of proximal humerus fractures part I: surgical technique.].

J Bartonícek, J Stehlík, M Dlouhý

Acta Chir Orthop Traumatol Cech. 1995; 62(4):207-220

Based on our experience with proximal humerus fractures or non-unions in a group of 35 patients we describe the technique using a modified semitubular blade plate. This implant provides sufficient stability while preserving blood supply. Originally a semitubular blade plate modified after Weber was used which at present we have replaced with a similar plate with the blade shape of our own design. This plate is indicated in two- and some three-part fractures of proximal humerus and in non-unions occurring in this area. The approach is through a deltopectoral incision without the osteotomy of the coracoid process. It is advantageous to open the articular...

[First results after implantation of an individual endoprosthesis of the coxa according to aldinger.].

F Makai, I Jancík

Acta Chir Orthop Traumatol Cech. 1995; 62(4):221-225

In the introduction of the paper the authors draw attention to the advantages of individually made total endoprostheses of the hip joint (TEP). They mention three reasons which made them implant individual TEP, as described by Aldinger, i. e. the highest percentage of dysplastic coxarthroses in their clinical material requiring an individual approach to the deformed proximal femur, failures of TEP according to Müller in dysplastic coxarthroses and finally complications when inserting some non-cemented TEP in the above indication. When evaluating the results of implantation of Aldinger's individual TEP in 50 young patients (mean age 40,5 years) after...

[Replacement of an intervertebral disc, using a ceramic prosthesis, in the treatment of degenerative diseases of the spine.].

M Filip, P Veselský, Z Strnad, P Laník

Acta Chir Orthop Traumatol Cech. 1995; 62(4):226-231

The authors tested in experimentally a suitable shape and approach to replacement of an intervertebral disc by means of an endoprosthesis made from glass-ceramic material of Lasak Co. In experiments on post-mortem material they succeded eventually in creating the optimal shape and finding a route of administration of the endoprosthesis into the intervertebral space. The endoprosthesis should create a spondylodesis and primary fixation of the affected portion of the lumbar spine. In some instances it thus will not be necessary, after insertion of the ceramic prosthesis into the intervertebral space, to make a supplementary instrumental fixation. Key...

[Microsurgical technique in injuries of peripheral nerves part I: clinical study.].

M Sames, V Benes

Acta Chir Orthop Traumatol Cech. 1995; 62(4):232-235

The authors evaluate the quality of regeneration following microsurgery of distal injuries of the nervus medianus and ulnaris. For the evaluation of reinnervation proper and comparison with other authors they emphasize the necessity to respect objective criteria of useful recovery, i. e. a two-point discrimination sensitivity test up to 12 mm in the entire autozone of the nerve. The result of the microsuture depend on the surgeon's experience, on the time interval (injury - final operation) and on age. In early operations useful recovery was achieved by 45 % of the patients of all age groups. In late operations useful recovery was achieved only by...

[Microsurgical Technique in Injuries of Pheripheral Nerves Part II: Experimental Study (Comparison of Microsuture with the Technique of Gluing by Means of Plasma Coagulum of the Ischiadic Nerve).].

M Sames, J Blahos Ml, R Rokyta, V Benes Ml

Acta Chir Orthop Traumatol Cech. 1995; 62(4):236-238

In a group of 20 rabbits the authors compared regeneration of the nervus ischiadicus after microsuture and after gluing the severed nerve with plasma coagulum. In 10 rabbits of group A epineural suture was performed, in 10 rabbits of group B the severed nerve was glued with autologous plasma coagulum. During a three-month regeneration period the authors examined the threshold of sensation 90 days after surgery the anastomosis was examined and also the rate of conduction across the anastomosis. Firmness of the suture was proved in 100% (group A), in two glued nerves dehiscence of the anastomosis occurred, the coagulum was found to be firm in 80 % (group...

[Injury of the proximal physis of the tibia in children.].

T Pesl, P Havránek

Acta Chir Orthop Traumatol Cech. 1995; 62(4):239-243

During the last nine years (1986 to 1994) the authors treated 27 children with injuries of the proximal growth plate of the tibia, i. e. 0,8 % of all skeletal injuries treated during the above period at the clinic. Injuries type 2 Salter were encountered most frequently, in almost half the patients. In four instances a dislocated injury was involved which was treated by closed reposition, in one instance by open reposition and internal fixation. In the total number of patients one complication of partial growth stimulation occured with a subsequent angulation deformity of the proximal tibia (4,5%) and in one instance (4,5%) an early complication in...

[Fractures of the distal end of the radius.].

J Fousek, J Cyprich

Acta Chir Orthop Traumatol Cech. 1995; 62(4):244-247

The authors evaluate in a group of 92 patients the results of conservative treatment of fractures of the distal radius. They draw attention to terminological inaccuracies in the evaluation of these fractures. This leads to a relatively high percentage of poor results in their patients, though their results are comparable with those of other authors. As a guideline for treatment they suggest the AO classification and on its basis they propose a more active approach to the treatment of these fractures. Key words: fracture of the distal end of the radius, reposition, redislocation.

[Rhabdomyosarcoma of the thoracic spine.].

M Gajdos, J Výrostko, N Duranová, A Kollová

Acta Chir Orthop Traumatol Cech. 1995; 62(4):248-250

The authors present a report on the diagnosis and treatment of a patient with paraplegia of the lower extremities caused by a rhabdomyosarcoma of the 10th thoracic vertebra which spread epidurally. Key words: rhabdomyosarcoma, compression in spinal canal.

[Aneurysmal bone cyst.].

M Gajdos, I Sulla, J Výrostko

Acta Chir Orthop Traumatol Cech. 1995; 62(4):251-253

The authors present a report on a female patient with an aneurysmatic bone cyst affecting the entire body of the fifth lumbar vertebra. They draw attention to the rare incidence, diagnostic and therapeutic possibilities of aneurysmal bone cysts with this localization. Key words: aneurysmal bone cyst.