Acta Chir Orthop Traumatol Cech. 1999; 66(5)

Review of constrained acetabular component in total hip replacement.

H U Cameron, V Smula

Acta Chir Orthop Traumatol Cech. 1999; 66(5):263-265

Recurrent dislocation following total hip replacement remains a very significant problem with indifferent results when treated conventionally. A constrained acetabular component has been developed. A cohort of 40 cases has been followed from 1-10 years (mean 3.5 years). One redislocation occurred and 2 metal shells loosened and were revised. These results demonstrate that when indicated this cup is very useful. The teoretical increase in wear debris generation caused by neck/cup impingement has not proved clinically significant, but the potential for this occurrence should limit the use of this cup to situation where it is clearly indicated. Key words:...

[Mosaicplasty in treatment of deep chondral knee defects - first experience.].

P Visna, J Adler, V Pokorný, J Selucký, L Pasa

Acta Chir Orthop Traumatol Cech. 1999; 66(5):266-271

The mosaicplasty as a method for solving the deep chondral defects is a one-stage technology with autogenous osteochondral graft application. The small cylinder's forming graft are obtained from a nonweightbearing site of knee cartilage and graft is further applied by press-fit technique to former prepared cartilage defects on the weightbearing site. Authors analyse the indications of this method and mention the possible risk and technical troubles during the treatment of the first group of patients. Key words: mosaicplasty, deep chondral defects, autologous osteochondral transplantation.

[Polymerase chain reaction in diagnosis of infection of total knee replacement.].

Z Rozkydal, J Benedík, T Tomás, M Dendis, R Horváth

Acta Chir Orthop Traumatol Cech. 1999; 66(5):272-276

Polymerase chain reaction allows a direct detection of DNA of bacterial pathogens in synovial fluid. With the help of artificially synthetized nucleotides, the so called primers, and in the presence of DNA polymerase enzyme it is possible to produce a great number of copies of the DNA being investigated and subsequently detect them. Authors used this method in 32 symptomatic knees after TKR (P.F.C. cemented type - Johnson and Johnson). Group I (pyogenic infection) comprised 14 patients. Their clinical condition required operation - extraction of TKR, debridement, spacer, lavage. All of them were PCR positive. Only 6 patients had a positive bacteriological...

[Analysis of group of patients treated in 1997 for proximal femur fractures -economic aspects.].

V Dzupa, J Artonícek

Acta Chir Orthop Traumatol Cech. 1999; 66(5):277-279

The article presents an overview of costs relating to the treatment of 244 patients with a total number of 248 fractures of proximal femur hospitalized at the authors' department in 1997, amounting approximately to 9,4 mil. Kc. Average price of hospitalization was 37 862 Kc. A comparison with data from General Health Insurance Company of the same year which recorded 13 126 accounts of patients treated for the above mentioned diagnosis and spent on their treatment 383,2 mil. Kc shows that the average cost of hospitalization at the authors' department is higher by 8 666 Kc. This difference is for greater part caused by the average time of hospitalization...

[Intraarticular fractures of the distal aspect of the radius.].

E Rylichová

Acta Chir Orthop Traumatol Cech. 1999; 66(5):280-285

Intraarticular fractures of distal radius are caused often by high energy trauma in patients of middle and younger age. These fractures have to be distinguished from extraarticular fractures and treat them accordingly. Even a small incongruency of the articular surface of radius may lead to posttraumatic osteoarthritis. The choice of the method of treatment is determined mainly by the type of fracture, its stability and degree of dislocation. Surgical methods include open reduction and internal fixation, external fixation, application of bone grafts. Semiconservative can be considered the method of percutaneous fixation by K-wires. Recently an increasing...

[Cementless Femoral Revision THR after Wagner- Medium-term Results.].

V Stedrý, J Pilnácek

Acta Chir Orthop Traumatol Cech. 1999; 66(5):286-289

Authors report on a group of patients operated on in the period 1992-1994. In large bone defects of proximal femur a cementless revision stem of type Wagner was used. The group comprised 13 patients, the most frequent indication was septic loosening of THR handled by a two-phase procedure and aseptic loosening of both components using implants 265 and 306 mm long and with a diameter 14-22 mm. In 12 patients also the cup was revised. Nine patients were checked in 1999 by Harris Hip Score with one excellent result, two good results, three fair and three poor results. Radiograph proved bone ingrowth in all patients as well as secondary biological stabilization...

[Fusion of the knee joint by the method of two external fixators in septic arthritis of the knee.].

P Závitkovský, J Pilnácek

Acta Chir Orthop Traumatol Cech. 1999; 66(5):290-294

Authors present the method of fusion of the knee joint by means of two external fixators in the treatment of septic arthritis of the knee. The orthopaedic clinic IPVZ FN uses this method in the therapy of septic arthritis and infected TKR. The method is fast and safe and is an alternative to a two-stage implantation of TKR destructed by septic arthritis or to a two-stage reimplantation of TKR in case of infected joint replacement. The article presents the surgical procedure and outcomes of a group of 26 patients. Key words: fusion of the knee joint, external fixation, septic arthritis of the knee, infected TKR.

[Resection of radial head for traumatological indication.].

M Majernícek, T Malkus

Acta Chir Orthop Traumatol Cech. 1999; 66(5):295-298

Authors evaluate a group of 35 patients who underwent in the period 1987-1996 a resection of radial head for traumatological indication. They review the results after an early resection in 16 patients, 81 % of which are without complaints. Late resection in 19 patients significantly increased the range of motion and in 75 % it contributed to easing of pain. In the conclusion the authors emphasize the difficult indication of an early and late resection. Key words: injury of elbow, fractures of radial head, resection of radial head.

[Blunt injury of abdomen as a part of polytrauma.].

P Chmátal, J Jarosek, L Lednický

Acta Chir Orthop Traumatol Cech. 1999; 66(5):299-302

In the period from 1 July till 31 August 1998 Central Military Hospital Praha treated 28 multiply injured patients (with polytrauma including blunt injury of abdomen, of which 27 were operated on and 1 patient was treated conservatively. The mean injury severity score was 39.3. CT was used for diagnosis in 21 patients and its total accuracy in the group of patients was 83%. Liver and spleen were injured in 70 % of cases. Of other regions it was the chest (89% of cases) and head (75% of cases) which were most frequently injured. The most imortant for the prognosis of a patient in our group is the injury of head. A successful initial procedure in multiply...

[Injuries of diaphragm in our group of patients.].

J Zelenák, M Hutan, K Kálig, J Kutarna

Acta Chir Orthop Traumatol Cech. 1999; 66(5):303-306

In thoracic and abdomen surgeries the injury of diaphragm is often neglected. Clinical symptoms vary and in patients with polytrauma they are usually disguised. The authors analyze a group of 9 patients with polytrauma with the injury of diaphragm during a five-year period (from 1 September 1993 to 31 August 1998) specifying diagnostic possibilities and stressing the necessity to revise the diaphragm in laparotomy or thoracothomy for associated injuries. The prognosis of the injury is given by associated injuries. Key words: injury of diaphragm, polytraumatic patient.

[Total replacement of elbow joint.].

J Vojtassák, I Rohál

Acta Chir Orthop Traumatol Cech. 1999; 66(5):307-312

Authors report in the article on two female patients with total replacement of the elbow joint of GSB III type (semiconstrain endoprosthesis). In both patients it was the case of posttraumatic deformation of the elbow joint resulting in a necrotic mal-union defect with pain. In one patient there occured twice the dissociation of the components which had to be treated by open reduction. The condition was solved by conversion of endoprosthesis to the constrain type by means of wire loop and bone cement. At present (six months after the surgery) both patients feel well and are satisfied with the result. On the basis of clinical and x-ray examinations...