[Congenital pseudoarthrosis of the leg - classification and treatment.].

P Dungl, D Krúpa

Acta Chir Orthop Traumatol Cech. 1997; 64(6):326-336

Congenital pseudoarthroses of the leg do not have a uniform etiology, clinical course, location nor affection of the fibula. As in any other congenital defect, treatment is very difficult and achievement of perfect functional and anatomical results is rather wishful thinking than reality. In the submitted paper the authors discuss different classifications - according to Andersen, Boyd, Campanacci and Crawford. The authors present their own modification of Boyd's method of a dual cortical graft, which involves taking a graft from one of the parents. At the authors department a total of 12 children with 12 inborn pseudoarthroses of the leg were operated....

["Pincer" fractures of the thoracolumbar spine.].

M Krbec, J Stulík

Acta Chir Orthop Traumatol Cech. 1997; 64(6):337-341

Based on a retrospective review of 101 injuries of the thoracolumbar spine operated at the Orthopaedic and Traumatological Clinic of the Third Medical Faculty, Charles University in 1991-1995 the authors followed up a group so-called pincer fractures. A typical feature of these fractures is a comminuted zone of the median portion of the vertebral body, dislocation of the anterior fragment of the vertebral body in a forward direction and filling of the gap which thus arises with material from the torn intervertebral disc. "Pincer" fractures tend to develop into pseudoarthroses. In the investigated group 14 fractures of this type were found (14 %). All...

[Experience with Non-cemented Walter - Motorlet Endoprostheses of the Hip Joint.].

P Hajný, V Stedrý

Acta Chir Orthop Traumatol Cech. 1997; 64(6):342-346

In 1987-1994 at the Orthopaedic Clinic of the Institute for Postgraduate Medical Training 67 non-cemented total endoprostheses of the hip joint, type Walter-Motorlet were implanted. The authors submit the evaluation of 39 endoprostheses 30-102 months after operation (mean follow-up period 62.5 months). The investigation comprised 14 patients where by March 1997 reimplantation of one or both components was performed. The mean age of the patients at the time of operation was 49 years. Secondary postdysplastic arthritis was the indication in 53.9 %, primary arthritis in 23.1 %, necrosis of the neck of the femur in 10.3 %. In the general evaluation according...

[Classification of anterior instability of the shoulder by arthroscopy - the authors clinical material.].

J Masár, S Petriscák

Acta Chir Orthop Traumatol Cech. 1997; 64(6):347-350

The authors review briefly the evaluation of anterior instability of the shoulder joint from different aspects. The objective of their work was to present different types of morphological changes, as suggested by Resch (6). During the two-year period since June 1995 so far a total of 96 patients with the clinical picture of anterior instability of the humeroscapular joint were examined arthroscopically. The group comprised 69 men and 27 women, all in productive age. Type 1 lesions according to Resch were found in 52 %, type 2 in 21 %, type 3 in 6 %, type 4 in 13 %, type 5 in 1 % and type 6 in 7 % of the patients, which is consistent with data reported...

[Surgical treatment of anterior cruciate ligament.].

P Kubát, J Stryhal

Acta Chir Orthop Traumatol Cech. 1997; 64(6):351-353

The authors evaluate a group of 57 patients with rupture of the anterior cruciatee ligament (ACL). The first group is formed by 23 patients where the acute ACL rupture was treated by suture. The second group comprises 35 patients with a confirmed untreated complete ACL lesion. For comparison Lysholm's score was used; anteroposterior instability was assessed objectively by a KT apparatus. The authors investigated the range of movements of the knee joint. The mean value of Lysholm's score in the first group was 84 points, in the second group 80.7 points. The mean shift of the tibia in relation to the femur was 11.2 mm in patients after suture of the...

[Our Experience with Treatment of Fractures of the Proximal Femur by Gamma-nail.].

M Stasa, T Malkus, M Trnovský

Acta Chir Orthop Traumatol Cech. 1997; 64(6):354-358

The authors present their own experience with the use of a standard and long gamma-nail, indications for surgery and advantages of its use. They draw attention to some imortant steps of the surgical technique. During the period from May 1995 to December 1996 they evaluated a group of eight patients, mean age 56 years (18-89 years), with an unstable pretrochanteric fracture fixed by a standard nail and a group of seven patients, mean age 42.2 years (21 - 72 years), with a complicated fracture of the proximal femur and diaphysis fixed by a long gamma-nail. Of fifteen operated patients eleven evaluated the result as excellent, two as good and one as poor....

[Gastrointestinal Tonometry in Orthopaedics (Results of a Prospective Randomized Pilot Study GATOAN-1 in Patients with General and Regional Anaesthesia During Replacement of the Hip Joint).].

P Porubcanský, J Masár, T Mikusková, Z Húzevka, S Belková, T Baska

Acta Chir Orthop Traumatol Cech. 1997; 64(6):359-362

In the submited pilot study the authors present a recently introduced method of monitoring of the regional perfusion by gastric tonometry during implantation of an endoprosthesis of the hip joint. The objective of the investigation was in addition to introduction of a new method to assess the influence of the type of anaesthesia on markers of the gastrointestinal tract perfusion. The method was used in 10 patients aged 27 - 75 years where in four instances a cemented endoprosthesis was implanted and an uncemented one in six cases. Five times general anaesthesia was used, 5 times regional anaesthesia. During monitoring the authors assessed PrCO2, pHi,...

[Incidence of congenital orthopaedic defect in the martin district (longitudinal survey).].

J Masár, I Hromec, L Babcan, P Ziska

Acta Chir Orthop Traumatol Cech. 1997; 64(6):363-365

The authors submit a model of the detection rate, monitoring and treatment of inborn defects of the locomotor system used in the Martin district. During the investigation period from 1972 - 1994 they examined and processed data from 41 281 neonates, i. e. 99,2 % of the total number of liveborn infants in the Martin district, focused specially on the hip joint and inborn defects of the foot. As to clinical symptoms of dysplasia coxae congenita they ascribe the greatest diagnostic value to Ortolani's phenomenon and abduction restricted to less than 60 degrees, which was recorded in 82 % and 52 % of the examined infants resp. As revealed by the incidence...

[Osteosynthesis of Fractures - Development, Complications and their Solution.].

J Bartonícek

Acta Chir Orthop Traumatol Cech. 1997; 64(6):366-370

[Arthropathy of the wrist - extrapulmonary sarcoidosis.].

J Masár, D Kurek, I Hromec

Acta Chir Orthop Traumatol Cech. 1997; 64(6):371-373

In the submitted paper the authors present a brief theoretical account and characteristics of sarcoidosis focused on its manifestations in the locomotor apparatus, found in 10 - 14 % of the patients. The course of this very rare form of sarcoidosis of the locomotor apparatus is demonstrated on a 50-year-old female patient with severe sarcoid arthropathy of the wrist. They draw special attention to diagnostic problems in extrapulmonary forms of sarcoidosis. Key words: sarcoidosis, arthropathy of the wrist, extrapulmonary sarcoidosis.