[Physiological bowing of the human femur and its clinical significance.].

O Nanka, P Havránek

Acta Chir Orthop Traumatol Cech. 2000; 67(4):225-229

In the treatment of femoral diaphyseal fractures in children the authors observed variable and sometimes fainly much expresed dorsal angulation of the shaft of the femur in sagittal plane. The authors decided to find out if it had been caused by physiologic conditivus or axial displacement of the fragments. One hundred and thirty one thigh bones, where the age and sex was known, were chosen from collection of the Department of Anatomy, First Faculty of Medicine, Charles University, Prague. Ventral and dorsal cortex angulation of the shaft of the femoral were measured. The results are: 1. The angulation of the thigh bones decreases with increasing age...

[Dynamic of the filling of glenohumeral joint.].

J Lubojacký

Acta Chir Orthop Traumatol Cech. 2000; 67(4):230-233

The experimental study analyzed ultrasonographic image of the artificial filling of adducted glenohumeral joint on a cadaver in the half-sitting position in dependence on the instilled volume of liquid. Evaluated on the basis of statistical methods are: minimum detectable volume (3,7 +/- 1,5 ccm), the volume of axillary recess (5,2 +/-1,9 ccm), the amount of liquid expanding the articular capsule and subsequently passing into communicating recesses (11,4 +/- 4,1 ccm), and approximate maximal volume of the joint (326,0 +/- 5,3 ccm). Also the proportion berween the maximum volume of the joint and preceding values was identified, outside the minimum detectable...

[Iliopsoas muscle - one of the causes of neurogenous dislocation: technique of tenotomy and lengthening.].

A Schejbalová, V Smetana

Acta Chir Orthop Traumatol Cech. 2000; 67(4):234-238

An increased incidence of neurogenous dislocations in patients with infantile cerebral palsy led the authors mainly in the recent 4 years to change the surgical strategy in the region of hip joint. The authors describe their own technique of releasing of iliopsoas muscle in patients with infantile cerebral palsy and present indications of combinations of surgeries on muscles in he region of the hip joint. Surgery on muscles is performed and muscular balance is ensured in infantile cerebral palsy either in order to prevent later migration or even dislocation or in cases where the dislocation has already occurred as the basic or preliminary surgery for...

[Significance of monitoring of intracranial pressure in craniocerebral injuries.].

J Zelenák, M Hutan, K Kálig

Acta Chir Orthop Traumatol Cech. 2000; 67(4):239-242

The authors extend the analysis of the previously published group of 26 patients with a craniocerebral injury during a 20-month period of monitoring of intracranial pressure by means of epidural approach by new techniques. Since 1996 they have implanted a technically upgraded intracranial pressure censor intraparenchymatosely and since 1998 intraventricularly in total in 27 patients with craniocerebral injury during 36-month period. The significance of continuous monitoring of intracranial pressure in indicated cases consists in the prevention and treatment of intracranial hypertension (medicaments, ventilation regimen, nursing care) as in craniocerebral...

[Prophylaxis of tromboembolic disease after total hip replacement.].

P Dulícek, J Pavlata, K Karpas, K Urban, J Malý

Acta Chir Orthop Traumatol Cech. 2000; 67(4):243-245

Total hip replacement represents an operation with high risk of thromboembolic disease. An optimal strategy of thromboprophylaxis is very important. In our two groups of patients we compared two ways of prophylaxis both during hospitalization and after hospital discharge. 81 patients in the first group were treated with low molecular weight heparin (LMWH) - Fraxiparine during the stay in hospital and with a combination of three drugs - Aspirin, Curantyl and Secatoxin during 3 months after operation. 85 patients in the second group were also treated with LMWH during the stay in hospital but LMWH was early changed for Warfarin. Warfarin was taken 3 months...

[Dealing with Rhizarthrosis by Means of Arthrodesis with Finger Micro-plate Osteosynthesis.].

J Kána, R Kaspárek

Acta Chir Orthop Traumatol Cech. 2000; 67(4):246-249

The authors of the article describe possibilities of dealing with thumb CMC joint degenerative changes, concentrating on arthrodesis. They compare individual operations and refer about fixation of arthrodesis with micro plate osteosynthesis which enables early functional treatment. They perform the arthrodesis in patients with radiologically proved arthrosis, in most cases of stage III, who do not respond to conservative therapy. They state both short-term and long-term results in their own group of 18 operations (all of the operated patients state improvement of thumb function and relief of pain following the operation) and analyse reasons for failure...

[Traumatic hip dislocation in childhood.].

J Kubasovský, J Podhradský, L Tomcovcík, M Kitka

Acta Chir Orthop Traumatol Cech. 2000; 67(4):250-252

Traumatic dislocation of the hip is injury with increasing incidence which is caused mainly by car crashes. This injury is rare in children with incidence in 5 % of traumatic hip dislocations. Authors present two cases of hip dislocation in children. The first is posterior hip dislocation and the second is a very rare anterior dislocation. The reduction of dislocation in a general anesthesia within 6 hours is emphasized to achieve good final outcome and prevent complications. Key words: traumatic hip dislocation, children.

[The Question of Pavlík's Treatment of Developmental Dysplasia of the Hip.].

V Bialik, M Kokavec

Acta Chir Orthop Traumatol Cech. 2000; 67(4):253-258

[Weber's Classification of the Fracture-dislocation of the Ankle, its Interpretation and Conclusion for Clinical Practice.].

J Bartonícek, D Jehlicka

Acta Chir Orthop Traumatol Cech. 2000; 67(4):259-268

[Contemporary possibilities of the ultrasound diagnosis of developmental hip dislocation.].

J Poul

Acta Chir Orthop Traumatol Cech. 2000; 67(4):269-274

The report is focussed on the last report of Graf et al., which was published in Stolzalpe as a manual for hip sonography in relation to the other contemporary publications from all the world, dealing with the same problem. It seems, that the assessment of hip joint abnormalities in Graf's classification is basically valid, not however the mode of the estimation of dynamic hip sonography. Not only due to the technically improper testing of the hip stability in extension of hip and knee, but as well as for the over-estimation of the displacement of the femoral head, which can produce false-positive findings. Graf's categorisation is still characterised...

[Empyema of the knee joint in adults: diagnosis and therapy.].

D Mrácek

Acta Chir Orthop Traumatol Cech. 2000; 67(4):275-279

The author presents an overview of the current diagnostic procedures and the scheme used at the author's Department. The article also deals with therapeutical trends including arthroscopic treatment of empyema. Antibiotics necessary for the treatment of the disease are administered empirically. Most often as antibiotics of "the first choice" are recommended penicilin antibiotics with the inhibitor of beta-lactamase. The author points out the necessity of an early and adequate treatment of the empyema of the knee joint as a prevention of serious sequelae on the affected joint. Key words: empyema of the knee joint, diagnosis, therapy.

[Physical therapy after shoulder arthroplasty.].

D Pokorný, A Sosna, D Jahoda, J Pech, M Simková, M Szekeresová

Acta Chir Orthop Traumatol Cech. 2000; 67(4):280-290

A properly conducted rehabilitation of the shoulder after arthroplasty is an inseparable part of the total treatment and is a prerequisite for the achievement of a good functional result. It is suitable to begin with the exercises within 48 hours after the surgery. The initial mobilization of the joint and decompression of the subacromial space the passive motion of the shoulder is exercised. Later the passive exercise is followed by active training aimed at the strengthening of the muscles of the shoulder girdle.The rehabilitation programme has to be tailored to individual patients and controlled by the surgeon who is the only one who can evaluate...