Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"[Usability of Ultrasonography in the Diagnosis of Pediatric Fractures].","authors":"Jakub Krutský, Šimon Kubov, Martin Čepelík, Petr Havránek, Tomáš Pešl","doi":"10.55095/achot2026/002","DOIUrl":"https://doi.org/10.55095/achot2026/002","url":null,"abstract":"<p><p>The study aims to evaluate the usability of ultrasonography in the diagnosis of pediatric fractures. Ultrasound examination of patients with fractures diagnosed using radiography at the Clinic of Pediatric and Trauma Surgery, Third Faculty of Medicine, Charles University and UTH between 27 May 2024 and 31 December 2024. We identified a total of 11 areas to be examined - clavicle, proximal humerus, elbow, forearm, metacarpal bones, fingers of the upper limb, sternum, femur, tibia, ankle, and metatarsal bones. The examination was performed independently by a surgeon and a radiologist, who selected the patients randomly during their treatment at the clinic. The entire bone was examined by ultrasound in all available projections, and signs of skeletal trauma (cortical bumping, cortical disruption, offset of bone fragments, chimney effect, or indirect signs such as joint effusion) were sought. A total of 61 patients were examined, of whom 24 girls (39%) and 37 boys (61%). The mean age of patients was 10 years (1-17 years). The overall agreement between ultrasound and radiologic examinations is 94%. Ultrasonography failed to visualize two fractures, namely a nondisplaced SH type II fracture of the distal fibula epiphysis and a nondisplaced SH type III fracture of the distal phalanx epiphysis. Two suspected fractures of the distal forearm detected by radiography were not observed by ultrasonography. The fracture was ruled out by a follow-up radiography, and the sonographic finding was found to be correct. Ultrasonography is a usable diagnostic method for skeletal trauma. The estimated sensitivity of this examination is around 97%. Our results indicate greater specificity of ultrasound in the forearm region. In agreement with literature, ultrasound can be considered usable for the diagnosis of fractures in all examined areas. In certain locations, it can also be used to measure displacement. The weak point of the study is the limited number of patients, therefore further investigation into these matters is necessary. Ultrasonography appears to be a useful screening method for skeletal trauma in children, serving as a basis for indication for radiography. This could help reduce the number of radiologic examinations performed by up to two-thirds, thereby reducing the radiation exposure in pediatric patients. Further research on these matters is needed, and diagnostic reliability indicators shall be defined. In the phase two of the study, we plan to determine the sensitivity, specificity, positive and negative predictive values for all anatomical regions. The secondary objective is to evaluate the results achieved by the surgeon and the radiologist, the painfulness of the examination, and the usability of portable ultrasound devices.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"40-46"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Ultrasound-Guided Injection of the Thoracolumbar Fascia in the Treatment of Low Back Pain: Methodological Approach and Anatomical Study].","authors":"Tomáš Novotný, Ondřej Naňka, Daniel Nalos, Kamal Mezian","doi":"10.55095/achot2025/036","DOIUrl":"https://doi.org/10.55095/achot2025/036","url":null,"abstract":"<p><strong>Purpose of the study: </strong>To develop an anatomically verified protocol for ultrasound-guided analgesic interventions targeting the thoracolumbar fascia region for the treatment of both acute and chronic back pain.</p><p><strong>Material and methods: </strong>One cadaver was embalmed using the Fix-4-Life method, which preserves tissue properties suitable for subsequent ultrasound visualization. Under ultrasound guidance, a needle was inserted to the thoracolumbar fascia at the level of the transverse process of the fourth lumbar vertebra. Upon contact with the transverse process, 5 ml of diluted red latex dye was injected. The distribution of the injected fluid was then observed through anatomical dissection.</p><p><strong>Results: </strong>This cadaveric study confirmed that ultrasound-guided injection into the middle layer of the thoracolumbar fascia is both accurate and technically feasible. The dye demonstrated substantial potential to spread within the targeted area, distributing mediolaterally among the structures of the m. erector trunci and cranio-caudally over a range exceeding 10 cm, encompassing nearly four spinal segments.</p><p><strong>Discussion: </strong>Back pain of various etiologies remains a major interdisciplinary challenge. Refining therapeutic techniques may improve the outcomes. The thoracolumbar fascia represents a promising target for delivering local anesthetics, depot corticosteroids, and next-generation hyaluronic acid derivatives.</p><p><strong>Conclusions: </strong>This study confirms the accuracy and feasibility of ultrasound-guided interventions targeting the thoracolumbar fascia.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"15-21"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dry Needle Arthroscopy of the Elbow with a 1.9 mm Chip-on-Tip System: a Cadaveric Study.","authors":"Daniel Reiser, Lars Adolfsson, Ásgerdur Thórdardóttir, Marcus Sagerfors","doi":"10.55095/achot2025/042","DOIUrl":"https://doi.org/10.55095/achot2025/042","url":null,"abstract":"<p><p>Arthroscopy has evolved significantly with advancements in instrumentation and surgical techniques. The introduction of needle arthroscopy represents a promising minimally invasive alternative and, has for the wrist proven to offer a reduced soft tissue trauma with still maintained diagnostic and therapeutic efficacy. The purpose of this study was to evaluate the safety and visualization capabilities of needle arthroscopy of the elbow using cadaveric specimens. Six fresh-frozen cadaveric elbows (three right, three left) were examined using a needle arthroscope, followed by dissection to assess portal safety and proximity to neurovascular structures. The arthroscopic portals evaluated included the proximal anteromedial (PAMP), anteromedial (AMP), mid-anterolateral (MALP), postero-lateral (PLP), direct lateral, and direct posterior portals. The visualization quality of the needle arthroscope was found satisfactory and the smaller diameter (1.9 mm), allowed enhanced maneuverability. Needle arthroscopy offers improved access and acceptable visualization, potential risks remain, particularly concerning neurovascular structures. Notably, the anteromedial portal was in close proximity to the median nerve and medial antebrachial cutaneous nerve (MABCN), with one documented case of PBMACN (Posterior Branch of the MABCN) injury. Our results support the use of the needle arthroscope for elbow arthroscopy. However, caution is required to minimize neurovascular injury. Further studies are needed to establish standardized protocols and confirm the long-term safety and efficacy of needle arthroscopy in clinical practice.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"9-14"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Usability of Sagittal Plane Parameters with Baumann Angle in Radiological Imaging of Supracondylar Humerus Fractures.","authors":"Nuri Koray Ülgen, Batuhan Gencer, Özgür Doğan","doi":"10.55095/achot2025/030","DOIUrl":"https://doi.org/10.55095/achot2025/030","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Radiological studies in supracondylar humerus fractures (SCHF) often focus on coronal plane imaging. In our study, we focused on the measurements used in elbow sagittal plane imaging. We investigated the role of humeral shaft condylar angle (SCA) and lateral capitellohumeral angle (LCHA) in determining the reduction quality by comparing them with Baumann angle (BA). İnvestigated its effectiveness in assessing the reduction of the teardrop figure and in the follow-up period.</p><p><strong>Material and methods: </strong>Eighty-eight patients with SCHF were included in the study. BA, SCA and LCHA measurements were taken on the non-fractured contralateral elbow. The same measurements were made on the post-reduction radiographs of the fractured side and the two groups were compared. Angular measurements were performed on 98 healthy children to determine the normal values of SCA and LCHA. Teardrop figure was evaluated and compared as present or absent in the pre-fracture, post-reduction and 3-month control radiographs of 88 surgically treated patients.</p><p><strong>Results: </strong>SCA and LCHA were found to be statistically different between the two groups (p = 0.002 and p < 0.001). BA was statistically consistent in both groups (p = 0.160). The reformation of the teardrop figure compared to post-fracture; when compared in post-reduction and postoperative 3rd-month radiographs, was statistically significant (p = 0.027, p < 0.001).</p><p><strong>Conclusions: </strong>BA is an important parameter for evaluating reduction. SCA and LCHA were found to be unsuccessful in evaluating reduction. Additionally, evaluating the teardrop figure after reduction and in follow-ups is important in terms of assessing reduction quality and monitoring healing.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"47-52"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There Is No Clinical and Radiological Difference between Suspensory and Cortical Button Fixation at the Treatment of Medial Meniscus Posterior Root Tear.","authors":"Güneş Sarikaya, Ahmet Emre Paksoy, Ömer Karaşahin, Mehmet Köse, Matthie P Ollivier, Bariş Kocaoğlu","doi":"10.55095/achot2026/001","DOIUrl":"https://doi.org/10.55095/achot2026/001","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The purpose of this prospective study was to compare the two surgical techniques; (Transosseous Fixation with the Suspensory Fixation System technique and Pull Out Suture Repair) for clinical and radiologic scores and to investigate the effects on meniscal extrusion in Medial Meniscus Posterior Root Tear (MMPRT).</p><p><strong>Material and methods: </strong>This was a prospective single-center study. Patients undergoing MMPRT were divided into two groups. Group 1 patients were repaired with Transosseous Fixation with The Suspensory Fixation System technique while Group 2 patients were repaired with Pull Out Suture Repair with Cortical Button. Lysholm and Tegner Score, Visual Analog Scale (VAS), meniscus extrusion on magnetic resonance imaging (MRI) and K-L grade were recorded preop and postop at minimum one year follow-up.</p><p><strong>Results: </strong>Meniscal extrusion on MRI increased in both groups at 12 months postoperatively compared to preoperative evaluation, but this increase was not statistically significant in both methods (Group 1: p = 0.670, Group 2: p = 0.211). There was no statistically significant difference in the pre-postoperative change in Lysholm knee score, Tegner activity score and meniscal extrusion on MRI in Group 1 compared to Group 2 (p = 0.575, p = 0.257 and, p = 0.141 respectively). Both Lysholm Knee Score (Group 1: p = 0.001, Group 2: p = 0.001) and Tegner Activity Score (Group 1: p = 0.008, Group 2: p < 0.001) increased statistically significantly at 12 months postoperatively compared to preoperative evaluation in Group 1 and Group 2. No patient in either group underwent total knee arthroplasty(TKA) at one-year follow-up.</p><p><strong>Conclusions: </strong>The Suspensory Fixation System technique in MMPRT repair has been shown to be a feasible treatment method with similar functional and radiologic results compared to Pull Out Suture Repair with Cortical Button. At short-term follow-up, the addition of a suspensory device to the conventional transtibial pullout repair did not result in a statistical difference on meniscal extrusion on MRI.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"53-58"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of MRI of Paraspinal Muscles in Patients after Open and Minimally Invasive Percutaneous Stabilisation of Thoracic and Lumbar Spine Fractures].","authors":"Tomáš Matějka, Jiří Matějka, Jaroslav Zeman, Jaroslav Belatka, Martin Salášek","doi":"10.55095/achot2025/033","DOIUrl":"https://doi.org/10.55095/achot2025/033","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Magnetic resonance imaging (MRI) was used to evaluate paraspinal muscle damage after classic open surgery (OPEN) and minimally invasive spine surgery (MISS) after injury. In a randomised prospective study, we evaluated our hypothesis that MISS would result in a lower extent of atrophy and fibrosis as detected by MRI.</p><p><strong>Material and methods: </strong>MRI was performed after the injury and not earlier than 3 months after the removal of implants. 16 OPEN and 16 MISS patients underwent the final follow-up. Both atrophy and muscle fibrosis were assessed based on the progression of the condition after the surgery from the pre-operative state. Atrophy was assessed using T2-weighted axial scans based on the progression of fat tissue growth in the muscle and muscle tissue regression, while muscle fibrosis was assessed using T1-weighted scans before and after the administration of a contrast agent.</p><p><strong>Results: </strong>Mean fibrotic changes were found to be higher in the OPEN group than in the MISS group, but insignificantly (p = 0.1100). Muscular atrophy was higher in the MISS group (p = 0.2099). Occurrence of fibrosis correlated positively with muscular atrophy only in the MISS group (R = 0.617 (0.174-0.852), p = 0.0094).</p><p><strong>Discussion: </strong>Minimally invasive percutaneous methods of spinal stabilization and other types of less invasive spinal surgeries are more gentle to the paraspinal muscles than standard OPEN approaches. Their importance is clear despite certain disadvantages such as longer duration of surgery and higher radiation exposure (in case of insertion without robotic assistance or 3D CT guidance). The condition of the paraspinal muscles is more suitable for the follow-up physiotherapy, enabling easier and quicker recovery. In the long term, the muscles are more capable of maintaining spinal balance and allowing for a wider range of movement, despite in this study is a mild controversy in the higher percentage of muscle atrophy in MISS procedures.</p><p><strong>Conclusions: </strong>MISS procedures are more gentle to the paraspinal muscles than OPEN procedures. The condition of muscles is better for physiotherapy, enabling easier and quicker recovery.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"22-28"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric Analysis of Lumbar Vertebral Pedicles According to Age and Gender.","authors":"Zehra Seznur Kasar, Göksel Tuzcu","doi":"10.55095/achot2025/037","DOIUrl":"https://doi.org/10.55095/achot2025/037","url":null,"abstract":"<p><strong>Purpose of the study: </strong>A thorough understanding of pedicle morphometrics is crucial for selecting suitable pedicle screws and their optimal trajectory in spinal stabilization. This study aims to provide a detailed morphometric analysis of lumbar pedicles in a Turkish population from the Aegean region, considering gender and age based on CT scans.</p><p><strong>Material and methods: </strong>This retrospective study analyzed CT scans of 500 lumbar vertebrae from 100 healthy individuals (50 females, 50 males) residing in the Aegean region of Turkey.</p><p><strong>Results: </strong>Our study found that pedicule axial length (PAL), pedicle width (PW), pedicle height (PH), and foramen vertebra transverse diameter (FTD) parameters were significantly higher in males than in females (p < 0.05). In both genders, from L1 to L5, there was an increase in PW (left and right), FTD, pedicle transverse angle (PTA) (left and right), and a decrease in pedicle length (PL) (left and right) and foramen vertebra sagittal diameter (FSD). PTA right values were significantly lower than PTA left values at L1 and L2 levels in females and at L2 and L3 levels in males (p < 0.05). However, there were no statistically significant differences between the left and right mean measurements for the remaining parameters in both genders (p > 0.05).</p><p><strong>Discussion: </strong>Recent studies indicate significant racial and gender variations in pedicle morphometry, making gender a crucial factor in screw size selection. Our study found notable gender-based differences in PAL, PH, PW, PTA, and PSA. Prior research showed no significant asymmetry in left and right pedicle dimensions. Consistent with these findings, our study observed symmetrical left-right pedicle measurements in both genders, with the exception of PTA.</p><p><strong>Conclusions: </strong>Gender and race differences had a significant impact on the characteristics of pedicle morphometry. This study demonstrates significant gender-based differences in lumbar vertebral morphometric parameters, independent of age. The presented morphometric data provide valuable reference information for the local population and contribute to the expanding body of knowledge in the field.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"93 1","pages":"29-39"},"PeriodicalIF":0.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparative Analysis of First Metatarsophalangeal Arthrodesis: Implant Survival, Failure Modes, and Functional Outcomes across Three Fixation Techniques].","authors":"Jakub Jindra, Vasileios Apostolopoulos, Jakub Rapi, Marián Kubíček, Luboš Nachtnebl, Tomáš Tomáš","doi":"10.55095/achot2025/027","DOIUrl":"https://doi.org/10.55095/achot2025/027","url":null,"abstract":"<p><strong>Purpose of the study: </strong>First metatarsophalangeal (I. MTP) arthrodesis is a well-established surgical procedure for treating hallux rigidus. Despite its widespread use, the optimal fixation method remains debated. This study compares implant survival, failure modes, and functional outcomes across three fixation techniques: two crossed screws, dorsal plate fixation, and dorsal plate fixation with a lag screw.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 83 patients (89 fusions) who underwent I. MTP arthrodesis between January 2014 and October 2023. Patients were categorized into three groups based on the fixation method: Group A (two crossed screws, n=31), Group B (dorsal plate, n=29), and Group C (dorsal plate with a lag screw, n=29). Implant survival, failure rates, hardware removal, and clinical outcomes were evaluated using radiographic assessment and the American Orthopedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal (AOFAS-HMI) scoring system.</p><p><strong>Results: </strong>The overall implant survival rate was 96.54% at one year and 93.98% at ten years. No significant differences in implant survival rates were observed among the three groups. Group C had the highest union rate (93.1%). Asymptomatic pseudoarthrosis was most common in Group B (17.24%). The hardware removal rate was higher in the plate groups (10.34%) compared to the two-screw group (3.1%). The mean AOFAS score was 83.30 (±9.29), with no statistically significant differences between groups. Patient satisfaction was highest in Group C (96.6%) and lowest in Group A (87.1%).</p><p><strong>Conclusions: </strong>The long-term overall implant survival rate was excellent, with similar survival rates observed across all groups. Functional outcomes, assessed using the AOFAS score, were satisfactory and comparable among the fixation techniques. Hardware removal rates were higher in the groups that utilized plate fixation.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 6","pages":"311-319"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Minimally Invasive Osteosynthesis with Intramedullary Nail: Evaluation of Outcomes].","authors":"Martin Pompach, Martin Carda, P Boštík, David Prchal, Pavel Dráč, Marek Peml","doi":"10.55095/achot2025/038","DOIUrl":"https://doi.org/10.55095/achot2025/038","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;Fractures of the calcaneus are always very serious injuries that, due to their nature or when inadequately treated, can have permanent consequences. Minimally invasive methods, such as the C-nail, help reduce both intraoperative and postoperative risks. The aim of the study is a retrospective evaluation of a group of 260 patients with 280 calcaneus fractures treated surgically with the C-nail in the period from 2011 to 2023. The hypotheses of a lower incidence of postoperative infection, a lower risk of sural nerve injury, and a higher AOFAS functional score need to be confirmed or disproved. Thanks to the higher biomechanical stability of the C-nail and the minimally invasive approach, a lower incidence of postoperative complications is expected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;In the period 2011-2023, 304 patients with 324 calcaneus fractures were operated on using the C-nail. A total of 260 patients were followed up at 12 months after surgery. The values ​​of Böhler's angle and incongruence of the posterior articular surface of the calcaneus were recorded from X-ray and CT documentation immediately after the injury, postoperatively, and 12 months after surgery. Furthermore, complications were monitored, namely the development of infection, neurological symptoms (sural nerve injury), presence of osteoarthritis, and the non-union formation. The functional outcome was assessed 12 months after surgery using the AOFAS (American Orthopaedic Foot and Ankle Society) scoring system. Data from the available medical literature were used as a control set.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patients in the study group underwent surgery at the age between 17 and 75 years. Men represented 88.5% of cases, women 11.5% of cases. A total of 48.0% of patients were smokers and 8.2% were patients with diabetes. The patients were classified based on the CT scan as type I (n=19), type II (n=175), type III (n=62) and type IV (n=24) according to Sanders classification. Eight patients in the group sustained an open calcaneus fractures. The mean Böhler angle measured preoperatively was 7.9°, the Böhler angle measured immediately after surgery was 30.9° on average. A slight decrease to the mean value of 28.6°was observed one year after surgery. Based on the CT scan, the mean preoperative step-off was 6.0mm, while the mean postoperative step-off was 0.9mm. The mean AOFAS score at 12 months after surgery was 91.9 points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;When analyzing both surgical methods, the study confirmed that the calcaneal nailing method has comparable functional outcomes compared to the open lateral approach and the use of a locking plate. Comparative studies prove higher biomechanical resistance of the calcaneal nail and lower incidence of soft tissue damage than the use of calcaneal plates. Osteosynthesis with a C-nail can be indicated for all types of intra-articular calcaneal fractures. This method can als","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 6","pages":"326-335"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Simultaneous Ruptures of All Four Extensor Mechanism Tendons in Both Knees: a Rare and Challenging Case in a Chronic Kidney Disease Patient].","authors":"Ali Can Koluman, Suleyman Emre Salmanoglu, Cemal Kural","doi":"10.55095/achot2025/040","DOIUrl":"https://doi.org/10.55095/achot2025/040","url":null,"abstract":"<p><p>We report a rare and remarkable case of simultaneous bilateral injuries to all four extensor mechanism tendons in a 39-year-old male with a history of diabetes and chronic kidney disease. Physical examination revealed pronounced swelling, palpable gaps above and below both patellae, and complete loss of active knee extension. Imaging confirmed complete ruptures of the right quadriceps and left patellar tendons, alongside partial ruptures of the left quadriceps and right patellar tendons. Surgical repair was performed using suture anchors to ensure secure tendon reattachment. Postoperatively, both knees were immobilized with hinged braces for six weeks, followed by a structured rehabilitation program. At the 12-month follow-up, the patient demonstrated full recovery, with complete restoration of knee range of motion and muscle strength.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 6","pages":"362-366"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}