Acta Chir Orthop Traumatol Cech. 2001; 68(4)

Conus hip prosthesis.

H Wagner, M Wagner

Acta Chir Orthop Traumatol Cech. 2001; 68(4):213-221

50 years ago, prosthetic replacement of the hip joint ushered in a new epoch in orthopaedics. Total hip replacement made it possible to remove a severely diseased, painful hip and restore normal function and a normal quality of life to the afflicted patient. The early results of total hip replacement are almost all spectacular and hip replacement has become the most successful type of orthopaedic surgery. These good results using an approach that was technically relatively simple resulted in a temptation to implant prosthetic hip joints with ever increasing frequency in ever younger patients. This led to the emergence of new problems, which were not...

[Mechanical loading of the human femoral neck].

J Hert, P Fiala, J Jírová

Acta Chir Orthop Traumatol Cech. 2001; 68(4):222-229

PURPOSE OF THE STUDY: The aim of the study is to explain what is the actual loading of human proximal femur.MATERIAL: Measuring of stress is based on 5 femurs of normal shape (bones obtained from dissection and ossuary). In order to determine the direction of the resultant force the authors used 30 ossuary bones of different age but of analogical shape.METHODS: By means of their own graphic method the authors identified the direction of appositional growth of femoral neck which contains with the longitudinal diaphyseal axis the angle of 26 degrees (alpha angle). The value of the angle is identical with the direction of the resultant force acting...

[The Zweymuller endoprosthesis in hip joint revision surgery].

V Stědrý, P Dungl, P Hajný, M Biegel, A Podskubka

Acta Chir Orthop Traumatol Cech. 2001; 68(4):230-238

PURPOSE OF THE STUDY: The aim of the study is the verification of the applicability of the Zweymüller system of total hip replacement in dependence on the size of defects of acetabulum and femur and evaluation of early results in patients operated on in 1998 and 1999.MATERIAL: In 1998 and 1999 we reimplanted 125 total hip replacements. In 60 revision surgeries we used at least one component of Zweymüller Bicon Plus system. We prospectively followed defects of acetabulum and femur in DGOT classification. The size of the stem was planned, final indication of the cup was determined peroperatively.METHODS: During the implantation of the cup...

[Transposition and hemitransposition of the anterior tibial muscle in the treatment of pes equinovarus].

A Schejbalová, V Smetana

Acta Chir Orthop Traumatol Cech. 2001; 68(4):239-243

PURPOSE OF THE STUDY: Authors present transposition and hemitransposition of anterior tibial muscle as one of the supporting surgeries in the treatment of neurogenous but also congenital club foot.MATERIAL: In the period of 30 years they indicated and performed transposition of anterior tibial muscle 79 times in 75 patients and hemitransposition of anterior tibial muscle in 27 patients. Most frequently they used this method in patients with childrens' cerebral palsy, least frequently in patients with congenital club foot.METHODS: The authors prefer hemitransposition of anterior tibial muscle (Biesalski-Mayer) at the younger age and transposition...

[Personal experience with injuries of the flexor tendons of the hand].

H Cervenková

Acta Chir Orthop Traumatol Cech. 2001; 68(4):244-248

PURPOSE OF THE STUDY: The study presents a retrospective evaluation of a group of 198 patients with 242 acute injuries of tendons of flexors of the hand in the period between 1995-1999. Evaluation covers the outcomes of the primary treatment as compared to the secondary reconstruction surgery--mainly in zone II after Kleinert.MATERIAL: The followed up group (242 injuries of flexor tendons) consisted of 79% of men and of 21% women. Hundred-and-twelve patients (46%) had the flexor tendon affected in zone II.METHODS: According to anatomical location the injuries were classified into five zones after Kleinert. Primary treatment in zone I consists...

[Surgical treatment of hand syndactyly in Apert syndrome].

S Guzanin, M Zábavníková, P Kacmár, R Sabovcík, T Kluka

Acta Chir Orthop Traumatol Cech. 2001; 68(4):249-255

Authors describe 6 cases (3 women, 3 men) affected by Apert syndrome (acrocephalosyndactyly). Clinical material has been documented since 1953. They concentrate on the description of individual clinical cases on the basis of objective and radiograph examination of patients. They describe surgical procedure of syndactyly between the thumb and 2nd-5th digits on both hands. Prior to 1998 they started with separation of digits at the age of 3-5 years. After 1998 they began with it as early as at the age of 3-6 months. For the reconstruction of lateral aspects of separated digits and for the creation of inter-digital space they use "zig-zag" incision and...

[The Bosworth ankle fracture (case report)].

D Jehlicka, J Bartonícek, M Rysavý

Acta Chir Orthop Traumatol Cech. 2001; 68(4):256-260

The authors describe an atypical case of the so called Bosworth fracture of ankle. A woman, 26 years suffered a fracture of fibula in the proximal third of the shaft, the distal fibular fragment was displaced from the fibular insicure of distal tibia posteromedially where it remained locked behind posterior tibial tubercle, and a fracture of medial malleolus and fracture of the posterolateral fragment of distal tibia. Thus it was a fracture-dislocation of ankle of Weber C type. The primary examination showed an evident external rotation deformity of the foot with regard to tibia. Conservative reduction was performed with a subsequent surgical revision,...

[Risk assessment of irradiation of tissue with metal implants].

M Kulhavý, P Stankus, E Kindlová, P Hraběta, M Sejdová, J Kovarík

Acta Chir Orthop Traumatol Cech. 2001; 68(4):261-264

Authors examine the influence of metal implants on the distribution of ionizing radiation in tissue. In vivo measurements in a patient are seldom possible. The risk can be assessed with sufficient accuracy on the basis of various experimental dosimetric methods, histological changes in the irradiated volume and the tolerance to the physical stress, published in the available literature. The analysis shows that the risk of significant dose inhomogeneity or the treatment toxicity is minimal if mentioned principles are adhered to. Radiotherapy indications and dosage should not be markedly changed on the basis of the presence of metal in the irradiated volume.