Acta Chir Orthop Traumatol Cech. 1998; 65(2)

[Valgus osteotomy in the treatment of sequelae of ischemic post-dysplastic necrosis of femoral head in children. Part I: surgical technique.].

O Cech, J Vávra

Acta Chir Orthop Traumatol Cech. 1998; 65(2):69-73

The authors deal with the surgical technique of the reconstruction of coxa vara in children. They present valgus osteotomy on the Pauwels principle with the simultaneous apophyseodesis of the growth plate of greater trochanter, lengthening of fermoral neck fixed by 120 degrees angled blade plate for adolescents allowing a parallel lengthening of the lower limb. The main indication for this technique is postdysplastic coxa vara and congenital coxa vara in children. However, it may be used also in adults. The benefits of the method consist in the possibility of exact planning of the surgery. Key words: valgus osteotomy, reconstruction, DDH, ischemic...

[Osteosynthesis of proximal Femur Fractures by Means of the Gamma Nail.].

J Bartonícek, P Dousa, M Krbec

Acta Chir Orthop Traumatol Cech. 1998; 65(2):74-83

The authors present analysis of a group of 75 patients with the fracture of proximal femur treated by the Gamma nail. The group consisted of 24 male and 51 female patients, average age 74 years (ranging from 24 to 91 years). Most frequent were intertrochanteric unstable fractures (Kyle III) - 41 %, subtrochanteric fractures accounted for 27 %. The average duration of the surgery was 70 minutes, the duration of x-ray exposure was 2,6 minutes. Healing in anatomical position was achieved in 91 %. Recorded were 8 peroperative complications (rotation of the head, inadequate reduction - 3 times, cut-out of the screw from the head - twice, breaking of the...

[Complications of osteosynthesis of proximal femur fractures by the gamma nail.].

J Bartonícek, P Dousa, M Krbec

Acta Chir Orthop Traumatol Cech. 1998; 65(2):84-89

UNLABELLED: Based on the analysis of their group of 75 patients treated for the fracture of proximal femur by means of the Gamma nail and on the analysis of data from the literature the authors present a comprehensive list of all complications resulting from this technique: inadequate reduction, -jamming of nail, fracture displacement by nail isertion, perforation of the head, incorrect length of the lag screw, problems with distal locking, fracture of the femoral shaft, rotation of head on the lag screw, rotation of diaphysis on the nail, failure of the healing of the wound and infection, breaking of the nail, non-union, healing in the varus position,...

[CT Guided Stabilization of Fractures of Upper Thoracic Spine (Th 2-5) by Internal Fixator.].

S Taller, R Lukás, P Suchomel, J Beran

Acta Chir Orthop Traumatol Cech. 1998; 65(2):100-104

The authors suggest a new method of stabilization of upper thoracie spine (Th 2 -Th 5) by an internal fixator. A safe and precise insertion of screws into the vertebrae from the posterior approach is performed by CT guided surgery.The surgery is carried out in a CT examination room providing conditions corresponding to an operating theatre. Of vital importance is the presence of an experienced roentgenologist. The screws are inserted through the basis of the transverse process and are firmly fixed in the verteral body. In case of a too narrow pedicle, its laterla wall usually gets broken and dislocated laterally. However, such an impairment of pedicle...

["Failed Back" Syndrome and First Experience in Application of ADCON(R)-L Preparation.].

O Vlach, R Chaloupka

Acta Chir Orthop Traumatol Cech. 1998; 65(2):105-106

Surgeries of lower lumbar spine with entering of the spinal canal (discectomy, decompression, PLIF and others) result in the development of lesser or greater peridural fibrosis. Major fibrous changes may be clinically manifested as the so called failed back syndrome which in many cases invalids the patient. The existing preventive measures have shown to be inadequate and therefore the authors appreciated the possiblity to test ADCON(R)-L gel produced by Gliatech, which mechanically prevents the development of fibrous scars and after some time it resorbs. Postoperative monitoring of the patients with the application of gel has so far not be a longterm...

[Gunshot wounds of the spine and spinal cord.].

J Lohnert, J Látal, J Baka, M Malý, A Poprac

Acta Chir Orthop Traumatol Cech. 1998; 65(2):107-112

The authors summarize the existing findings on the treatment of gunshot wounds of the spine and spinal cord which in their country have become an important cause of mortality and morbidity. Their own experience prove the findings of the authors, i.e. that the seriousness of the initial neurological condition can be hardly influenced and an urgent surgical decompression does not improve statistical prospects of the correction in any type of neurological deficit either, with the exception of cauda ae-quina syndrome. They point out that occurrence of complications such as infections, liquor fistula or instability is from the statistical viewpoint significantly...

[Ultrasonography in legg-calvé-perthes disease].

J Jochymek, J Poul

Acta Chir Orthop Traumatol Cech. 1998; 65(2):113-115

Several last reports showed a very good utility of US visualisation in Legg-Calvé-Perthes disease especially in the assessment of the lateral extrusion of the femoral head and the subchondral fracture. Prospective analysis of 43 patients with 53 affected hip joints in this study showed that the hip joint effusion and synovitis have to be differentiated. Effusion occured only in the early stages of the disease. Sensitivity of US detection of the femoral head deformity was 87,3 % in this group compared with X-ray diagnosis. Assessment of the lateral extrusion seems to be rather inaccurate due to the high inter-observer error. A new approach which was...

[Multiple Non-ossifying Fibroma (Case-report).].

J Holík, K Urban, Z Nozicka

Acta Chir Orthop Traumatol Cech. 1998; 65(2):116-121

The authors present the case-history of a patient with multiple non-ossifying fibroma causing pathological fractures in the long bones of the lower extremities, the vertebral bodies, ribs and bones of the brachial plexus. Since 1988 when the first pathological fracture occurred up to the present time when the tumour was found at other sites five biopsies of foci were made, all with the same histological finding. The pathological fracture in the distal portion of the right femur and the proximal portion of the left femur were treated by osteosynthesis and filled with bone cement. Subsequently in the case of the distal femur on the right side by resection...