Diagnostic Performance of Artificial Intelligence (AI) Chatbot Compared to Orthopedic Trauma Surgeons in Evaluating Indication for Surgery for Isolated Lateral Malleolar Fractures: a Retrospective Study

Maria Oulianski, Rami Mosheiff, Dana Avraham, Omer Ben Yehuda, Yoram Weil, Mahmoud Jammal

Acta Chir Orthop Traumatol Cech. 2026; 93(3):133-139 | DOI: 10.55095/achot2026/027  

The indication for surgery for isolated lateral malleolar fracture (AO/OTA 44B1) is debatable and in many cases, relies upon radiographic assessment of fracture stability. Artificial intelligence chatbots with visual analysis capabilities offer a potential attribute for radiographic assessment. This study compared the diagnostic performance of a commercially available AI chatbot with that of three fellowship-trained orthopedic trauma surgeons in evaluating equivocal isolated lateral malleolar fractures. A retrospective study. 50 patients with isolated lateral malleolar injury at the level of the syndesmosis (AO/OTA 44B1) were evaluated by three blinded...

Three-Dimensional Surgical Correction of Scoliotic Curves Monitored Using the EOS Imaging

MARTIN REPKO, MICHAL GALKO, ANDREA ŠPRLÁKOVÁ-PUKOVÁ, MARTIN PRÝMEK, DOMINIK PARÍŽEK, MILAN FILIPOVIČ

Acta Chir Orthop Traumatol Cech. 2026; 93(3):140-148 | DOI: 10.55095/achot2026/029  

Structural scoliosis is a three-dimensional deformity that adversely affects the frontal, sagittal, and axial planes. Surgical correction of scoliotic deformities in children requires effective correction of all three planes, with restoration of a balanced position of the spine and the entire trunk. Using modern surgical instruments and targeted intraoperative maneuvers, we achieve this comprehensive 3D correction. The EOS Imaging System enables effective preoperative planning and postoperative verification of outcomes based on software processing of the acquired X-ray images. The aim of the study was to objectively assess the achieved surgical outcomes...

Adjacent Segment Disease in Lumbar Spine and Lumbosacral Junction Stabilisation: Systematic Review

JAN ZEMÁNEK, JAN ŠTULÍK, ZDENĚK KLÉZL

Acta Chir Orthop Traumatol Cech. 2026; 93(3):149-155 | DOI: 10.55095/achot2026/014  

This paper aims to analyse available scientific sources related to adjacent segment disease after the surgical stabilisation of lumbar spine. To be specific, to the incidence, risk factors, gender and age of patients, correlation between the length of the instrumentation and ASD development, and the effects of suboptimal sagittal spine stability. A systematic review was elaborated in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guideline. A literature search in PubMed database was conducted in January 2025. The papers included in the systematic review were published between 2004 and 2023. The search...

Percutaneous Stabilization of the Thoracolumbar Spine: Indications, Limitations and Cohort Analysis

JAKUB JEŽEK, JAN ŠVEC, MARTIN KAPOUNEK, JIŘÍ SKÁLA-ROSENBAUM

Acta Chir Orthop Traumatol Cech. 2026; 93(3):156-161 | DOI: 10.55095/achot2026/022  

Percutaneous stabilization of the thoracolumbar spine represents a minimally invasive alternative to open posterior fixation. The aim of this study was to evaluate the indications, perioperative parameters, and limitations of this method in a single-center patient cohort. A retrospective analysis of 65 consecutive patients treated with percutaneous transpedicular stabilization of the thoracolumbar spine between 2021 and 2025 was performed. All procedures were carried out using an intraoperative CT-based navigation system (O-arm). Demographic data, primary diagnosis, extent of instrumentation, additional procedures, operative time, blood loss, length...

Avascular Necrosis of the Femoral Head after Hodgkin Lymphoma Treatment: Analysis of Risk Factors and Mid-Term Outcomes after Total Hip Replacement

MARTIN SALÁŠEK, JANA MARKOVÁ, KAROLÍNA BAREŠOVÁ, RICHARD ČESKÝ, HEIDI MÓCIKOVÁ, MICHAL ZÍDKA, VALÉR DŽUPA

Acta Chir Orthop Traumatol Cech. 2026; 93(3):162-169 | DOI: 10.55095/achot2026/015  

Treatment of classical Hodgkin lymphoma (cHL) can be eventually complicated by avascular necrosis of the femoral head (AVN FH). Stages 1 and 2 of AVN FH can be treated conservatively, but stages 3 and 4 are indicated for surgery. In adults, total hip replacement (THR) is the preferred method. The goal of our study was to analyze the risk factors for AVN FH and functional results after THR. This is a single-center retrospective observational longitudinal study. Patients with AVN FH after previous cHL treatment were included. Basic epidemiological data, time to AVN FH and THR, and complications of hemato-oncological treatment and THRs were recorded....

Bacteriophage Therapy in Orthopaedics and Trauma:

RADEK BARTOŠKA, VLADISLAV BARTÁK, JIŘÍ GALLO, DAVID MUSIL

Acta Chir Orthop Traumatol Cech. 2026; 93(3):170-177 | DOI: 10.55095/achot2026/018  

Sternal Fracture as a Risk Factor for Blunt Cardiac InjuryZlomenina hrudní kosti jako rizikový faktor tupého poranění srdce

BARBORA VYHNÁNKOVÁ, VALÉR DŽUPA, ZDENĚK ŠUBRT

Acta Chir Orthop Traumatol Cech. 2026; 93(3):178-188 | DOI: 10.55095/achot2025/044  

Motor vehicle collisions are the leading cause of blunt chest trauma, including blunt cardiac injury (BCI) and sternal fracture (SF). Blunt cardiac injury occurs in about 20% of blunt chest trauma reaching to 76% in polytrauma patients. Reported SF rates range from 1.6% to 42%. This review evaluates the link between SF and BCI with focus on incidence, diagnosis and implications for patient management. A systematic search of the scientific literature in online databases over the past 15 years was conducted. The final set included 31 studies, predominantly retrospective, which were subsequently analyzed with emphasis on the definition of BCI, its occurrence...

Blood Loss in Open Spine Surgeries - Preoperative Estimate vs Reality

JIŘÍ SKÁLA-ROSENBAUM, JAKUB JEŽEK, PETR KAFKA

Acta Chir Orthop Traumatol Cech. 2026; 93(3):189-193 | DOI: 10.55095/achot2026/030  

Intraoperative blood loss represents a critical challenge in spinal surgery, with the potential to increase morbidity, mortality, and healthcare costs. Significant blood loss is associated with postoperative complications such as respiratory failure, infections, and hematomas. This paper evaluates current methods of estimating blood loss and highlights the discrepancy between intraoperative clinical estimates and the actual total blood loss, with a specific focus on the phenomenon of hidden blood loss (HBL). The concept of Total Blood Loss (TBL) is analyzed as the sum of Visible Blood Loss (VBL), consisting of blood in suction canisters, sponges, and...

Osteoid Osteoma in S2: Percutaneous CT Guided Resection of a Double Nidus

JIŘÍ SKÁLA-ROSENBAUM, JAKUB JEŽEK

Acta Chir Orthop Traumatol Cech. 2026; 93(3):194-197 | DOI: 10.55095/achot2026/031  

The case report describes the option of percutaneous CT-guided ablation of osteoid osteoma with a double nidus to combine minimally invasive approach and CT(O-arm)-guided technique. Following X-ray, CT and MRI examinations, osteoid osteoma was diagnosed in the body of the second sacral vertebra (S2) in a 31-year-old female patient. CT reconstructions detected a double nidus with a defective, sclerotic rim. MRI demonstrated reaction in the surrounding tissue and edema in the nerve root. In consideration of the anatomic location of the osteoid osteoma and vicinity of the irritated S2 root percutaneous CT-guided intralesional resection of a double nidus...