Skeletal Metastatic Disease of the Femur: Results by Management with Intramedullary NailingOriginal papers

S. MÄRDIAN, K.-D. SCHASER, M. RUPPERT, I. MELCHER, N. P. HAAS, P. SCHWABE

Acta Chir Orthop Traumatol Cech. 2015; 82(3):192-197 | DOI: 10.55095/achot2015/028  

PURPOSE OF THE STUDYThis study aimed to analyse the outcome following intramedullary nailing for metastases of the femur in a large cohort with special regard to mechanical, implant associated complications and patient survival. Furthermore, we aimed to identify factors influencing the overall survival.MATERIAL AND METHODSAll patients (n = 74) that underwent intramedullary nailing for metastatic disease of the femur between 2004 and 2008 and were retrospectively reviewed. Data were recorded from the patients' medical record and the outpatients' clinics files. Details about the tumour biology, the surgery performed as well as the postoperative...

Measurement of Compartment Elasticity Using Pressure Related Ultrasound: A Method to Identify Patients with Potential Compartment SyndromeOriginal papers

R. M. SELLEI, S. J. HINGMANN, P. KOBBE, C. WEBER, J. E. GRICE, F. ZIMMERMAN, S. JEROMIN, A. GANSSLEN, F. HILDEBRAND, H. C. PAPE

Acta Chir Orthop Traumatol Cech. 2015; 82(3):198-202 | DOI: 10.55095/achot2015/029  

PURPOSE OF THE STUDYDecision-making in treatment of an acute compartment syndrome is based on clinical assessment, supported by invasive monitoring. Thus, evolving compartment syndrome may require repeated pressure measurements. In suspected cases of potential compartment syndromes clinical assessment alone seems to be unreliable. The objective of this study was to investigate the feasibility of a non-invasive application estimating whole compartmental elasticity by ultrasound, which may improve accuracy of diagnostics.MATERIAL AND METHODSIn an in-vitro model, using an artificial container simulating dimensions of the human anterior tibial...

Retrograde Tibial Nail: Anatomical Implantation and Surgical Feasibility StudyOriginal papers

S. KUHN, P. APPELMANN, P. PAIRON, D. GRUSZKA, P. M. ROMMENS

Acta Chir Orthop Traumatol Cech. 2015; 82(3):203-208 | DOI: 10.55095/achot2015/030  

PURPOSE OF THE STUDYThe treatment of distal tibial fractures requires a stable fixation while minimizing the secondary trauma to the soft tissues by the surgical approach and implant. The experimental Retrograde Tibial Nail is currently investigated as a minimally invasive alternative to plating and antegrade nailing. The purpose of this study was to evaluate the surgical feasibility in a cadaver model for all distal tibial fracture types generally considered treatable by nailing.MATERIAL AND METHODSFive different fracture types (AO/OTA 43-A1/A2/A3 and 43-C1/C2) were created on separate cadaveric limbs. In simple fractures (AO/OTA 43-A1/A2/A3)...

Long-Term Results of Surgery for Cervical Spondylotic Myelopathy Using Open-Door LaminoplastyOriginal papers

L. RYBA, R. CHALOUPKA, M. REPKO, J. CIENCIALA

Acta Chir Orthop Traumatol Cech. 2015; 82(3):209-215 | DOI: 10.55095/achot2015/031  

PURPOSE OF THE STUDYCervical spondylotic myelopathy (CSM) is a serious disease which, in its advanced form, can markedly disable the patient. The aim of the present work was a prospective evaluation of a group of CSM patients treated by open-door laminoplasty.MATERIAL AND METHODSWe evaluated 89 patients (59 men and 30 women; average age, 62 years; range, 39 to 81 years) who underwent surgery in the years 2001 to 2011. The average follow-up was 76 months. The patients were examined neurologically, radiologically, by magnetic resonance imaging (MRI) or CT. All of them had quadruparetic disability and showed signs of myelopathy on MRI examination....

Kirschner Wire Transfixation of Unstable Ankle Fractures: Indication, Surgical Technique and OutcomesOriginal papers

J. MARVAN, V. DŽUPA, R. BARTOŠKA, D. KACHLÍK, M. KRBEC, V. BÁČA

Acta Chir Orthop Traumatol Cech. 2015; 82(3):216-221 | DOI: 10.55095/achot2015/032  

PURPOSE OF THE STUDYThe aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis.MATERIAL AND METHODSBetween 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive...

Intra-Articular Reinforcement of a Partially Torn Anterior Cruciate Ligament (ACL) Using Newly Developed UHMWPE Biomaterial in Combination with Hexalon ACL/PCL Screws: Ex-Vivo Mechanical Testing of an Animal Knee ModelOriginal papers

P. FEDOROVÁ, R. SRNEC, J. PĚNČÍK, M. DVOŘÁK, M. KRBEC, A. NEČAS

Acta Chir Orthop Traumatol Cech. 2015; 82(3):222-228 | DOI: 10.55095/achot2015/033  

PURPOSE OF THE STUDYRecent trends in the experimental surgical management of a partial anterior cruciate ligament (ACL) rupture in animals show repair of an ACL lesion using novel biomaterials both for biomechanical reinforcement of a partially unstable knee and as suitable scaffolds for bone marrow stem cell therapy in a partial ACL tear. The study deals with mechanical testing of the newly developed ultra-high-molecular-weight polyethylene (UHMWPE) biomaterial anchored to bone with Hexalon biodegradable ACL/PCL screws, as a new possibility of intra-articular reinforcement of a partial ACL tear.MATERIAL AND METHODSTwo groups of ex vivo...

Use of Cultured Human Autologous Bone Marrow Stem Cells in Repair of a Rotator Cuff Tear: Preliminary Results of a Safety StudyOriginal papers

V. HAVLAS, J. KOTAŠKA, P. KONÍČEK, T. TRČ, Š. KONRÁDOVÁ, Z. KOČÍ, E. SYKOVÁ

Acta Chir Orthop Traumatol Cech. 2015; 82(3):229-234 | DOI: 10.55095/achot2015/034  

PURPOSE OF THE STUDYRotator cuff tears are one of the most frequent shoulder disorders which are often associated with pain and interfere with proper arm function. In order to evaluate the safety and effectiveness of using cultured human autologous mesenchymal stem cells (MSC) applied to the suture site during arthroscopic repair of a rotator cuff tear, a prospective clinical study was designed and started recently at the authors' department. Its primary goal was to evaluate the safety of using cultured human MSCs, the secondary goal then was to study a therapeutic effect of their application. Preliminary results of the study on a limited number...

Odontoid Bending Stiffness after Anterior Fixation with a Single Lag Screw: Biomechanical StudyOriginal papers

P. BUCHVALD, L. ČAPEK, P. BARSA

Acta Chir Orthop Traumatol Cech. 2015; 82(3):235-238 | DOI: 10.55095/achot2015/035  

PURPOSE OF THE STUDYThe aim of the experiment was to compare the bending stiffness of an intact odontoid process with bending stiffness after its simulated type II fracture was fixed with a single lag screw. The experiment was done with a desire to answer the question of whether a single osteosynthetic screw is sufficient for good fixation of a type II odontoid fracture.MATERIAL AND METHODSThe C2 vertebrae of six cadavers were used. With simultaneous measurement of odontoid bending stiffness, the occurrence of a fracture (type IIA, Grauer's modification of the Anderson- D'Alonzo classification) was simulated using action exerted by a tearing...

Radial Head Prosthesis after Radial Head and Neck Fractures - Current Literature and Quality of EvidenceCurrent concepts review

J. ZWINGMANN, G. BODE, T. HAMMER, N. P. SÜDKAMP, P. C. STROHM

Acta Chir Orthop Traumatol Cech. 2015; 82(3):177-185 | DOI: 10.55095/achot2015/026  

Due to the elbow joint's complex functional anatomy, the multifragmentary nature of many fractures and concomitant destabilizing associated injuries, dislocated fractures of the radial head and neck still present a serious challenge for the orthopedic surgeon. Thorough knowledge of the elbow's anatomy and biomechanics is essential to analyze and understand the injury and plan its treatment. The aim of a differentiated therapy approach is to restore the joint's anatomy and kinetics, stable and painless joint function, and to avoid or at least delay posttraumatic joint changes. The degree of dislocation, stability of fragments, size and number of fractured...

Continuous Passive Motion in Joint Rehabilitation after Injury and SurgeryCurrent concepts review

I. VAŘEKA, R. VAŘEKOVÁ

Acta Chir Orthop Traumatol Cech. 2015; 82(3):186-191 | DOI: 10.55095/achot2015/027  

Devices for continuous passive motion, also known as motor-driven splints, are widely used in rehabilitation therapy following injuries and surgery. They present an adjunct method substituting the physical work of a physiotherapist. The method is indicated in early post-injury or post-operative periods. It is expected to increase blood drainage and remove haemarthrosis and synovial fluid exudate which precede an undesired development of granulation and fibrous tissues. However, continuing such an intensive therapy after 3 to 4 post-operative weeks lacks its raison d'être. The only exceptions include conditions after autologous chondrocyte transplantation...

Salvage Total Hip Arthroplasty after Two Gamma 3 Nail Failures: A Case ReportCase report

Z. L. STEPANOVIC, B. M. RISTIC

Acta Chir Orthop Traumatol Cech. 2015; 82(3):239-242 | DOI: 10.55095/achot2015/036  

We report a case of 68-year-old female patient who suffered two Gamma 3 nail breakages following trochanteric fixation failure revision surgery. A patient was primarily treated with sliding hip screw. Revision surgeries of reverse trochanteric non-union were performed with short Gamma 3 nails and bone grafting. The nail failures occurred 11 and 7 months after implantation. This undesired series of events were caused by inappropriate implant selection, thus replacing the nail to a modular total hip arthroplasty was more effective as salvage surgery.

Zápis ze zasedání výboru ČSOT konaného dne 7. 4. 2015 v Parkhotelu Průhonice v restauraci TaroucaReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2015; 82(3):243

34. výroční kongres European Paediatric Orthopaedic Society (EPOS) 15. - 18. duben 2015, Marseille, FrancieReports from ČSOT

Acta Chir Orthop Traumatol Cech. 2015; 82(3):244