Biological internal fixation: its background, methods, requirements, potential and limits.

S M Perren

Acta Chir Orthop Traumatol Cech. 2000; 67(1):6-12

The surgical treatment of fractures made essential progress when stable internal fixation allowing for immediate painless mobility of soft tissues and articulations was postulated and achieved. This step required basic understanding of biomechanics of fixation and of bone reaction to compression and micromotion. The definition of teaching modalities and the clinical documentation were further steps leading to general acceptance of this type of treatment. After a period of interest, which was focussed mainly on biomechanics it became obvious that biology was not only important for reliable bone and soft tissue healing but especially important for good...

[Pararectal miniinvazive retroperitoneal approach to the lumbosacral spine.].

M Krbec, J Stulík

Acta Chir Orthop Traumatol Cech. 2000; 67(1):13-16

The authors describe the technique of the anterior miniinvasive retroperitoneal pararectal approach to the lumbosacral spine. The technique was verified on cadaveric specimens.The miniinvasive operation requires a special set of instruments (a fixed frame), long instruments and a light cable. The advantage of the approach is a small peroperative traumatization and a relatively low labour intensity. The use of the miniinvasive technique requires a good knowledge of the technique of a routine extensive approach. Key words: surgical approaches, spine, lumbosacral spine.

[Unstable pertrochanteric fractures, biomechanic, classification and therapy.].

O Cech, R Kostál, J Váchal

Acta Chir Orthop Traumatol Cech. 2000; 67(1):17-27

The authors deal with unstable pertrochanteric, intertrochanteric and subtrochanteric fractures extending as far as calcar femorale. The treatment of pertrochanteric issues is a serious issue as their total number in the Czech Republic exceeds 5.000 annually and with the exception of those which are contraindicated due to their health condition, all patients are indicated to surgery. In the treatment of unstable pertrochanteric fractures there occurs failure of internal fixation also with the use of implants such as dynamic hip screw or Gamma nail. The cause of unsuccessful treatment of unstable fractures is the defect in calcar femorale - impairment...

[Our experience with the removal of infected hip arthroplasty.].

P Sponer, K Karpas, D Zítko

Acta Chir Orthop Traumatol Cech. 2000; 67(1):28-32

In total 67 infected hip arthroplasties in the group of 26 men and 41 women were removed at the Orthopaedic Clinic in Hradec Králové in the period of 1984-1998.Twenty three patients (11 men and 12 women) showed up for the follow up with an average period of 5 years after the removal of the implant.The follow up consisted in the examination of the range of movements and a protocol was filled in. The acquired data then served for the calculation of the Haris score of the hip joints operated on. Seven patients had no pain, slight or moderate pain not affecting the daily routine activities were reported by 10 patients. However, none of the patients was...

[Dislocation of the cemented total hip endoprosthesis - risk and therapy.].

B Steno, S Murárik, M Lisý, M Demitrovic

Acta Chir Orthop Traumatol Cech. 2000; 67(1):33-35

In 11 out of 1699 patients, who underwent a total hip replacement with a cemented THR during a 10 year period, dislocation of the prosthesis occured in the postoperative period. The operations were made using an anterolateral approach. Dislocation occured in 7 patients after a primary implantation (0,42 %) and in 4 patients after a revision operation (1,6 %). Reorientation of the acetabular component was necessary in 1 case, in 5 cases closed reduction was successful, in 3 cases open reduction was needed. Acetabular augmentation using a polyethylen acetabular shell and cortical screws was performed in 2 patients with recurrent dislocation of the prosthesis....

[Magnetic resonance imaging of growth plates nailing of the forearm and leg bones.].

B Drugová, T Michaljanic

Acta Chir Orthop Traumatol Cech. 2000; 67(1):36-38

Results of the presented study indicate that MR imaging is a suitable method for demonstration of the abnormalities of the growth cartilage associated with the intramedullary fixation of the long bones of the forearm and leg. MR imaging permits noninvasive evaluation of the cartilage of the growth plate and the demonstration of the osseous bridges and the residual fibrous channels. Key words: osteosynthesis, growth plate, osseous bridge, MR imaging.

[Classification of the fractures of the proximal femur part I - classification of the femoral neck fractures.].

J Bartonícek, P Dousa

Acta Chir Orthop Traumatol Cech. 2000; 67(1):39-45

[An interesting case of actinomycotic affection of the lower limb.].

M Netval, R Branald, T Hudec

Acta Chir Orthop Traumatol Cech. 2000; 67(1):46-48

The authors deal with a rare case of a 14-year actinomycotic affection of the left lower limb in at present 39 years old female patient. They point out the difficulty and mistakes in the diagnosis of the mentioned disease. During the 14 years the patient was hospitalized, examined and treated at approximately 6-7 clinics all over the republic with different conclusions within the differential diagnosis. It is a fact that the history of the patient was underestimated, not all possibilities of the examination within differential diagnosis were used and at one clinic the histological finding got even lost, the examination was not repeated and the treatment...

[Leiomyosarcoma of the bone.].

O Jelínek, K Husek, J Cerný

Acta Chir Orthop Traumatol Cech. 2000; 67(1):49-52

The case history presents a patient with a rare malignant bone tumor - leiomyosarcoma in the region of distal femur. A large resection of the tumor was made with a specially tailored distal femur replacement. The authors emphasize the necessity of a detailed histological examination including immuno-histochemistry which proved the diagnosis of leiomyosarcoma as opposed to the original diagnosis of fibrosarcoma. Key words: bone leiomyosarcoma, bone fibrosarcoma, immunohistochemical markers.