Acta Chir Orthop Traumatol Cech. 1998; 65(4)

[Zásady operacního osetrení metastáz pátere.].

O Vlach, R Chaloupka

Acta Chir Orthop Traumatol Cech. 1998; 65(4):199-201

The authors describe the principles of the treatment of spinal metastases. In the case of rapid progression of neural symptoms the surgery should be performed in the first 24 hours after the symptoms onset. In the case of slow progression or normal neurology the surgery follows the detailed assessment. According to the tumor extent is decided posterior, anterior or combined surgery. The decompression with or without stabilization is indicated in 12 months life expectancy. In longer survival an extensive surgery is indicated. The goal of this treatment is the spine realignment and its stabilization. Surgery improves the life quality and enables the...

[Possibilities and limits of manual medicine in treatment of low back pain.].

L Hruska

Acta Chir Orthop Traumatol Cech. 1998; 65(4):202-206

Low back pain is a syndrome when the actual pathological and anatomical diagnosis remains often hidden. The clearly defined findings such as congenital anomalies, degenerative lesion, intervertebral disc protrusion, inflammations, rheumatic diseases, tumours and others should include functional disorders which may be found both in a healthy region and in the region stigmatised in this way. One of the efficient possibilities of the treatment influencing the functional component is manual medicine (sometimes called myoskeletal medicine).The physician acquainted with this method is able to perform a detailed functional examination of individual motoric...

[The response of methylprednisolon therapy to interleukin-6 release in spinal injuries.].

P Visna, P Wendsche, P Svoboda, I Kantorová

Acta Chir Orthop Traumatol Cech. 1998; 65(4):207-210

The prospective study continues the investigations published in "Dynamics of Cytokines in the Blood and Liquor at the Spinal Injured Patients". In previous publication we documented a statistical significant dependence of IL-6 concentration in the blood and liquor to various degrees of neurological lesion classified by Frankel scale. We followed the influence of Methylprednisolon (Solumedrol, UpJohn) therapy to the IL-6 level in blood and liquor, as the supposed selective mediator for spinal trauma. In investigated group we documented the positive influence of Solumedrol therapy to final neurological status and significant decrease of IL-6 liquor concentration...

["Tension" and "pressure" osteons - reality or myth?].

J Hert, P Fiala, J Kaiser, P Vais

Acta Chir Orthop Traumatol Cech. 1998; 65(4):211-216

The underlying study tests the hypothesis on the existence of two types of osteons, the "tension" and the "pressure" ones. Osteons of the first type should be built under the influence of tension and should manifest greater strength in tension. The contrary applies to the "pressure" osteons. The ultimate strength of the bone tissue in tension and compression was studied on samples from the medial wall of the femoral diaphysis, subjected in vivo to compression, and on samples from the lateral wall, subjected to tension. All samples were manufactured with the long axis corresponding to the orientation of osteons, arranged in two helical antirotary systems...

[Dependence of mechanical strength on the architecture of the compact bone of human shaft.].

P Fiala, J Hert, M Petrtýl, J Kaiser

Acta Chir Orthop Traumatol Cech. 1998; 65(4):217-224

A secondarilly remodelled bone (the haversian bone) forming a wall of human shaft represents a significantly anisotropic material, which has different strengths in different directions. One of the factors influencing mechanical properties (strength in particular) of the bone is the architectonics of the compact bone. Osteons of the haversian bone are arranged in the direction of the dominant first principal stress and create two antirotational spiral systems in the opposite walls of the shaft. The aim of the work was to found out how the bone tensile strength depends on the orientation of osteons and check whether the premise applies that the architectonics...

[Acetabular Replacements in THR in Dysplastic Osteoarthritis of the Hip.].

V Stefanco, F Makai, L Rehák, A Svec

Acta Chir Orthop Traumatol Cech. 1998; 65(4):225-230

The authors present different options of the surgical treatment of dysplastic osteoarthritis of the hip. For the acetabular replacement they use Harris-Galante, Zweymúller and Balgrist cementless cups. They evaluate results for a five-year postoperative period in 182 patients. On the basis of Merle d'Aubigne and Postel evaluation system the results were excellent in 79,6 % and very good in 12,1 %.The authors recorded only a relatively small percentage of complications (10,9 %) relating to the wound infect, loosening of the cup, trombophlebitis and palsy of n. peronaeus com. or n. femoralis. The authors emphasise the importance of CT examination of...

[Bioactive Glass-ceramic ATB Carrier Treatment of Chronic Osteomyelitis.].

D Zítko, K Urban

Acta Chir Orthop Traumatol Cech. 1998; 65(4):231-237

Since 1993 the authors have applied in the surgical treatment of chronic osteomyelitis bioactive glass-ceramic material BAS-0 and BAS-HA for filling the osteomyelitic cavity in 20 patients. Prior to the operation the glass-ceramic material was saturated with ATB solution (Bycomycin, Lycomycin). At the same time ATB were administered also in general. The most suitable for the given purpose is the porous form of the mentioned materials. Due to the lack of porous glass-ceramics, dense material was used with 15 % apparent porosity in 11 patients and a combination of fine cullet of BAS-0 and BAS-HA and Beriplast fibrin glue in 4 patients. 19 patients were...

[Dynamika uvolnování neomycinu a linkomycinu in vitro ze sklokeramických materiálů].

I Hanovcová, K Urban

Acta Chir Orthop Traumatol Cech. 1998; 65(4):238-244

The dynamics of release of neomycin and lincomycin from glass-ceramic materials BAS-0, BAS-HA and BAS-R in the form of cullet was monitored in vitro. After the saturation by individual antibiotics the glass-ceramic samples were overlaid with fibrin glue and after it became solid they were covered with buffered physiological solution. In the samples taken at planned intervals in the course of 2 months eluted ATB quantity was determined by agar well method. Release of ATB from glass-ceramics proceeded in two phases, elution slowed down in most cases after 6 hours. With the use of composites there occurred another slowing down of the speed of elution...

[Basic principles of the treatment of metastasis of adenocarcinoma of long bones and pelvis.].

P Janícek, V Spurný, S Ondrůsek

Acta Chir Orthop Traumatol Cech. 1998; 65(4):245-249

Authors evaluated longterm results of the survival of patients with metastasis of adenocarcinoma in long bones and pelvis in 72 cases which were treated and followed at Ist Orthpaedic Clinic of the Faculty Hospital of St. Ann in Brno in the period of 1970-1995. Patients were divided into two groups. One group of patients was treated with intralesional operation and in the second group the metastasis was radically resected. The period of survival in the second group was longer. Authors also present a general survey of adjuvant therapy of metastasis of adenocarcinoma in bones. Key words: metastasis of adenocarcinoma in long bones and pelvis, method of...

[Our Strategy of the Treatment of Giant-cell Tumours Part I - Strategy.].

J Paukovic, J Kordos

Acta Chir Orthop Traumatol Cech. 1998; 65(4):250-252

The authors present a treatment procedure in giant-cell tumours of limbs applied in the recent three years at Ist Orthopaedic Clinic in Bratislava. The procedure begins with cytologic verification (in most cases within one stage procedure by peroperative cytologic examination) followed by careful curretage of the lesion, irrigation by liquid non-diluted solution of phenol, irrigation with pure 96% ethylalcohol, irrigation with physiological solution, filling with bone cement. In the methodological part of the contribution the authors discuss toxicity of phenol and risks of this treatment which they confront with the existing data in the literature....