Rozhledy v Chirurgii最新文献_第7页

Current treatment strategy for proximal humerus fractures. 目前肱骨近端骨折的治疗策略。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.33699/PIS.2024.103.5.147-157

M Kloub, M Doležalová Hrubá, T Zídek

{"title":"Current treatment strategy for proximal humerus fractures.","authors":"M Kloub, M Doležalová Hrubá, T Zídek","doi":"10.33699/PIS.2024.103.5.147-157","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.5.147-157","url":null,"abstract":"Fractures of the proximal humerus present a unique challenge in orthopedic practice due to the complex anatomy and biomechanical complexity of this region. The spectrum of injuries occurring here ranges from nondisplaced stable fractures to complex displaced fractures or fracture-dislocations. Historically, the treatment of these fractures has been the subject of much debate and treatment modalities have mainly involved a conservative approach, with surgical management being relatively rare. In recent decades, there has been a paradigm shift in the treatment of proximal humerus fractures not only due to advances in surgical techniques, but especially with the development of new types of angular-stable implants and modern total arthroplasties. The development and availability of high-quality imaging techniques have enabled better understanding of the nature of fractures and precise planning of surgical interventions. The main goals of treatment include restoration of function, pain relief and prevention of complications such as prolonged healing or non-healing and avascular necrosis. An individualized approach to each individual patient, considering all factors that affect the final outcome, appears to be essential in the choice of treatment. The aim of this review article is to provide an up-to-date overview of the current concept of treatment of proximal humerus fractures. Trends in nonoperative and operative treatment strategies, indications for each type of treatment, operative techniques, outcomes, and complications associated with each approach are summarized.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"147-159"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early cholecystectomy. 早期胆囊切除术。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.48095/ccrvch2024294

L Martínek, J Hoch

引用次数: 0

Volkmann's ischaemic contracture of the upper extremity - raising a red flag in the setting of developing countries. 沃尔克曼氏上肢缺血性挛缩症--在发展中国家的环境中引起警惕。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.33699/PIS.2024.103.6.219-223

S Shrestha, P Obruba, V Kunc, V Kunc

{"title":"Volkmann's ischaemic contracture of the upper extremity - raising a red flag in the setting of developing countries.","authors":"S Shrestha, P Obruba, V Kunc, V Kunc","doi":"10.33699/PIS.2024.103.6.219-223","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.6.219-223","url":null,"abstract":"Introduction: Volkmann's ischaemic contracture (VIC) is a disabling condition resulting from tissue necrosis due to impaired vascular supply to the limb. Over the years VIC has become rare in developed countries with many different aetiologies described. It was alarming to have high incidence of established VIC in our practice in Nepal. A detailed analysis was conducted to accurately describe this issue.Methods: We collected 47 cases of VIC over six years and noted the age, sex, district of origin and cause of VIC, duration of injury to presentation, and the grade of VIC. Then we compared these characteristics of VIC of each Nepal province and created a map to show the problematic regions.Results: Out of 47 patients, 46 could have been prevented by an early treatment. The most common cause was a tight cast in 25 patients (53.19%), followed by unintentionally self-caused VIC by applying tight bandages in 21 patients (44.68%). Most cases came from province 6 (29.78%). Our group included three mild (6.4%), 35 moderate (74.5%) and nine severe (19.1%) cases of VIC. Only 14 cases (29.78%) had a timely fasciotomy in the past.Conclusion: VIC is an irreversible complication of the compartment syndrome which is an easily preventable condition in the setting of developing countries. Our focus should, therefore, aim at preventing such disastrous conditions as 97.87% of cases we encountered could have been avoided by proper primary care. In the case of Nepal most cases came from province 6 and province 3.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 6","pages":"219-223"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conservative therapy for acromioclavicular joint dislocation - Rockwood III: a cohort analysis. 肩锁关节脱位的保守治疗- Rockwood III：队列分析。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.33699/PIS.2024.103.5.181-186

J Kovařík, M Krtička, D Ira, P Dráč, K Benešová, P Korpa

{"title":"Conservative therapy for acromioclavicular joint dislocation - Rockwood III: a cohort analysis.","authors":"J Kovařík, M Krtička, D Ira, P Dráč, K Benešová, P Korpa","doi":"10.33699/PIS.2024.103.5.181-186","DOIUrl":"https://doi.org/10.33699/PIS.2024.103.5.181-186","url":null,"abstract":"Introduction: Acromioclavicular joint dislocation (AC) - Rockwood III (RIII) is a controversial topic with a wide range of therapeutic approaches. Operative therapy offers dozens of stabilization methods, which only confirms the absence of a \"gold standard\". The currently available literature tends to favor conservative therapy, involving several consecutive phases of physiotherapeutic care after the pain has subsided. The aim is to gradually improve the mobility of the shoulder and subsequently strengthen and stabilize the entire shoulder girdle.Methods: A study was conducted between 01/2014 and 12/2017 in patients with Rockwood III type AC joint injury. Each patient was educated in detail about the surgical and conservative treatment options and expected outcomes. Patients who opted for conservative therapy were invited to evaluate the results of the therapy at a minimum of one year after the injury. Each patient was clinically examined. Coracoclavicular (CC) distances were measured, and the presence of arthrosis and calcifications was assessed on follow-up comparison scans of both shoulders. The Constant Score (CS) and the American Shoulder and Elbow Surgeons (ASES) score were evaluated in the patients. The results were statistically processed and compared to each other and/or to the healthy shoulder.Results: A total of 37 patients were evaluated with a mean CS of 96.1 and a mean ASES score of 92.02. Lateral clavicle instability was found in 64% of the patients (n=24). The mean difference of the CC interval versus the healthy side was 8.6 mm. There was no statistically significant difference between the CS of the injured and healthy shoulder. No statistically significant association was found between CS and lateral clavicle prominence, AC joint stability, and workload, or between return to work and workload.Conclusion: Conservative therapy of AC joint dislocation - type RIII provides good functional outcomes.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 5","pages":"181-186"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep neck space infections - basic facts and our experience. 颈部深空感染-基本事实和我们的经验。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.48095/ccrvch2024494

P Klail, L Hauer, J Šafránek, T Kostlivý, D Slouka

引用次数: 0

Descending necrotizing mediastinitis - a surgical view. 下行坏死性纵隔炎-外科观察。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.48095/ccrvch2024502

J Šafránek

引用次数: 0

Pathoanatomy and pathomechanics of pertrochanteric fractures - an MRI study. 股骨粗隆上骨折的病理解剖学和病理力学--磁共振成像研究。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.48095/ccrvch2024299

R Bartoška, J Bartoníček, J Alt, M Tuček

{"title":"Pathoanatomy and pathomechanics of pertrochanteric fractures - an MRI study.","authors":"R Bartoška, J Bartoníček, J Alt, M Tuček","doi":"10.48095/ccrvch2024299","DOIUrl":"10.48095/ccrvch2024299","url":null,"abstract":"Background and study aims: Magnetic resonance imaging (MRI) has been used for more than 20 years in the region of the proximal femur to diagnose occult, or incomplete, fractures of the femoral neck and the trochanteric segment. MRI has also potential to contribute to the understanding of the pathogenesis and pathoanatomy of trochanteric fractures.Methods: The group including 13 patients was examined by MRI for a suspected, or incomplete, fracture of the trochanteric segment within 24 hours post-injury. In all cases, this was the first injury to the hip joint, with the other hip joint remaining intact.Results: The coronal scans showed a marked fracture line which, in the region of the intertrochanteric line, extended from the base of the greater trochanter (GT) medially and distally and involved the medial cortex. This inclination, however, was gradually changing posteriorwards and close before the posterior cortex. The fracture line was passing vertically along the lateral trochanteric wall as far as the level of the lesser trochanter (LT). Then the fracture line changed its course and ran horizontally to the cortex of the LT. Sagittal scans showed clearly the primary fracture line originating in the greater trochanter, extending medially and starting to separate the posterior cortex.Conclusion: Analysis of MRI findings has documented that the primary fracture line in pertrochanteric fractures originates in the GT and extends distally, medially and anteriorly towards the anterior cortex, the intertrochanteric line and the LT. Thus, the GT presents a rather vulnerable site and is always broken into more fragments than shown by a radiograph.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 8","pages":"299-304"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intranodal embolization for lymphocele after revascularization procedure in the groin. 腹股沟血管再通术后淋巴结栓塞术。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.33699/PIS.2024.103.6.228-231

D Janák, R Pavlík, T Meliš, Š Černý

引用次数: 0

Incarceration of Bochdalek hernia in an adult - case report. 成人波赫达勒克疝嵌顿--病例报告。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.33699/PIS.2024.103.3.100-103

V Přibáň, P Pták

引用次数: 0

Skin pigmented lesions in the hands of an ambulatory surgeon. 门诊外科医生手上的皮肤色素损伤。

Rozhledy v Chirurgii Pub Date : 2024-01-01 DOI: 10.48095/ccrvch2024381

Ondřej Troup, A Růžičková, A Koy, Vlastimil Woznica, Inka Třešková

{"title":"Skin pigmented lesions in the hands of an ambulatory surgeon.","authors":"Ondřej Troup, A Růžičková, A Koy, Vlastimil Woznica, Inka Třešková","doi":"10.48095/ccrvch2024381","DOIUrl":"10.48095/ccrvch2024381","url":null,"abstract":"The ambulatory surgeon deals daily with patients who come for various pigmented skin lesions. A number of patients come on the recommendation of a dermatologist, but for the majority of patients, the primary visit is directly to the surgical clinic. The reason for removing a pigmented lesion may be an unsatisfactory cosmetic appearance or frequent irritation due to inappropriate location of the lesion, but also the fear of the development of malignancy. Pigmented lesions of the skin are a very hetero-geneous group represented from benign nevi to malignant melanoma. They occur in all age groups. Congenital nevi and hemangiomas are most often treated at an early age, and the incidence of skin malignancies increases in older patients. The ambulatory surgeon is often faced with the decision whether and how radically the pigmented lesion needs to be removed. Skin lesions such as lentigo solaris do not need to be treated surgically. Other lesions, such as basal cell carcinoma, require radical excision and subsequent professional dispensary. However, the treatment of melanoma is complex, it is led by specialists in dermato-oncology centers and therefore interdisciplinary approach is neces-sary. Every ambulatory surgeon should be knowledgeable and experienced enough to be able to decide on the need for removal of pigmented lesions and, in case of uncertainty, refer the patient to a skin specialist. This article provides a brief overview and specifics of basic skin pigment manifestations and criteria for their surgical removal.","PeriodicalId":52413,"journal":{"name":"Rozhledy v Chirurgii","volume":"103 10","pages":"381-386"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0