Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"[Instabilities of the Thumb Carpometacarpal Joint: Our Surgical Outcomes].","authors":"J. Pilný, D. Kachlík, P. Zeman, K. Horáčková, P. Hájek","doi":"10.55095/achot2023/004","DOIUrl":"https://doi.org/10.55095/achot2023/004","url":null,"abstract":"PURPOSE OF THE STUDY Carpometacarpal (CMC) instabilities of the thumb joint occur after injuries or due to joint overload in patients with congenital joint hypermobility. They are often undiagnosed and, if left untreated, are the basis for the development of rhizarthrosis in young individuals. The authors present the results of the Eaton-Littler technique. MATERIAL AND METHODS The authors present a set of 53 CMC joints of patients with an average age of 26.8 years (15-43 years) operated on in the years 2005-2017. Post-traumatic conditions were found in 10 patients and in 43 cases instability was caused by hyperlaxity, also demonstrated in other joints. The operation was performed from the Wagner's modified anteroradial approach. After the operation, a plaster splint was applied for 6 weeks, after which rehabilitation (magnetotherapy, warm-up) began. Patients were evaluated using the VAS (pain at rest and during exercise), DASH score in the work module, and subjective evaluation (no difficulties, difficulties not limiting normal activities, and difficulties limiting normal activities) before surgery and 36 months after surgery. RESULTS During the preoperative assessment, the average VAS value was 5.6 at rest and 8.3 during exercise. During the VAS assessment at rest, the values at 6, 12, 24 and 36 months after surgery were 5.6, 2.9, 0.9, 1, 2 and 1.1. When evaluated in the given intervals under load, the detected values were 4.1, 2, 2.2 and 2.4. The DASH score in the work module was 81.2 before surgery, 46.3 at 6 months, 15.2 at 12 months, 17.3 at 24 months, and 18.4 at 36 months after surgery. In the subjective self-assessment made at 36 months after surgery, 39 patients (74%) assessed their condition as having no difficulties, ten patients (19%) reported difficulties that did not limit normal activities, and four patients (7%) reported difficulties limiting normal activities. DISCUSSION Most authors present the results of their surgeries in patients with post-traumatic joint instability, and they report excellent results at two to six years after surgery. There is a negligible number of studies addressing instabilities in patients with instability caused by hypermobility. When using the conventional method described by the authors in 1973, our results of the evaluation performed at 36 months after surgery are comparable to those reported by other authors. We are well aware of the fact that this is a short-term follow-up and that this method does not prevent developing degenerative changes in the case of long-term follow-up, but reduces clinical difficulties and may delay the development of severe rhizarthrosis in young individuals. CONCLUSIONS CMC instability of the thumb joint is a relatively common disorder, although not all individuals experience clinical difficulties. In the case of difficulties, the instability needs to be diagnosed and treated as this is how the development of early rhizarthrosis in the predisposed individuals can be preve","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"29-33"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48343044","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":"Scapholunate Ligament Partial Tears; Tear Localization, Extrinsic Ligament Injury Association and Conservative Treatment Responses Prior to Instability: Cross-Sectional Study.","authors":"B. Karaalioglu, O. Korkmaz, K. Yilmaz, S. Sarı, B. Sener, A. Kara","doi":"10.55095/achot2023/003","DOIUrl":"https://doi.org/10.55095/achot2023/003","url":null,"abstract":"PURPOSE OF THE STUDY Scapholunate interosseous ligament (SLIOL) tears with accompanying extrinsic ligament rupture have been associated with scapholunate (SL) instability. SLIOL partial tears were examined in terms of tear localization, grade and accompanying extrinsic ligament injury. Conservative treatment responses were scrutinized according to injury types. MATERIAL AND METHODS Patients with SLIOL tear without dissociation were evaluated retrospectively. Magnetic resonance (MR) images were reexamined in terms of tear localization (volar, dorsal or combined volar and dorsal tears), grade of injury (partial or complete) and extrinsic ligament injury accompaniment (RSC, LRL, STT, DRC, DIC). Injury associations were examined with MR imaging. All patients treated conservatively were recalled at their first year for re-evaluation. Conservative treatment responses were analyzed according to pre- and post-treatment first year visual analog scale for pain (VAS), disabilities of the arm, shoulder and hand questionnaire (DASH) and Patient-Rated Wrist Evaluation (PRWE) scores. RESULTS In our cohort, 79% (n: 82/104) of patients had SLIOL tear and 44% (n: 36) of them had accompanying extrinsic ligament injury. The majority of SLIOL tears and all extrinsic ligament injuries were partial tears. In SLIOL injuries, volar SLIOL was most commonly damaged portion (45%, n: 37). DIC (n: 17) and LRL (n: 13) were most frequently torn ligaments, radiolunotriquetral (LRL) injury generally co-existed with volar tears and dorsal intercarpal ligament (DIC) with dorsal tears regardless of injury time. Extrinsic ligament injury accompaniment was associated with higher pre-treatment VAS, DASH and PRWE scores than isolated SLIOL tears. Injury grade, location and extrinsic ligament accompaniment had no significant effect on treatment responses. Test scores reversal was better in acute injuries. CONCLUSIONS On imaging SLIOL injuries, attention should be paid to the integrity of secondary stabilizers. In partial SLIOL injuries, pain reduction and functional recovery can be achieved with conservative treatment. Conservative approach can be the initial treatment option in partial injuries especially in acute cases regardless of tear localization and injury grade if secondary stabilizers are intact. Key words: scapholunate interosseous ligament, extrinsic wrist ligaments, carpal instability, MRI of wrist, wrist ligamentous injury, volar and dorsal scapholunate interosseous ligament.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"22-28"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42883335","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":"[Management Strategy and Evaluation of Surgical Outcomes in Patients with Recurrent Patellar Instability between 2010-2020].","authors":"R. Čapek, D. Musil, L. Nevšímal, P. Sadovsky, T. Trnka","doi":"10.55095/achot2023/001","DOIUrl":"https://doi.org/10.55095/achot2023/001","url":null,"abstract":"PURPOSE OF THE STUDY The study retrospectively reviews the outcomes of patella stabilisation surgeries performed at our department in the period 2010-2020. It aimed to provide a more thorough evaluation, to compare the respective types of MPFL reconstruction and to confirm the beneficial effect of tibial tubercle ventromedialization on patella height. MATERIAL AND METHODS In the period 2010-2020, a total of 72 stabilisation surgeries of patellofemoral joint in 60 patients with objective patellar instability (OPI) were performed at our department. The surgical treatment outcomes were evaluated retrospectively using a questionnaire, including the postoperative Kujala score. A comprehensive examination was carried out in 42 patients (70%) who had completed the questionnaire. In case of distal realignment, the TT-TG distance and a change in the InsallSalvati index which serve as an indication for surgery, were assessed. RESULTS Altogether 42 patients (70%) and 46 surgical interventions (64%) were evaluated. The follow-up period was 1-11 years, with the mean follow-up of 6.9 years. In the studied group of patients, only 1 case (2%) of new dislocation was seen, in 2 cases (4%) the patients reported a subluxation episode. The mean score using the school grades was 1.76. Thirty-eight patients (90%) were satisfied with the surgical outcome, 39 patients would undergo a surgery in case of identical problems with the other limb. The mean postoperative Kujala score was 76.8 points, range 28-100 points. The mean TT-TG distance in the studied group with the preoperative CT scan (33x) was 15.4 mm (12-30 mm). The mean TT-TG distance in the cases indicated for tibial tubercle transposition was 22.2 mm (15-30 mm). The mean Insall-Salvati index prior to the performance of tibial tubercle ventromedialization was 1.33 (1-1.74). Postoperatively, the index decreased by 0.11 on average (-0.00 to -0.26) to 1.22 (0.92-1.63). No infectious complications were presented in the studied group. DISCUSSION In patients with recurrent patellar dislocation, the instability is often times caused by pathomorphologic anomalies of the patellofemoral joint. In patients with clinically expressed patellar instability and physiological values of the TT-TG distance, an isolated proximal realignment is performed by medial patellofemoral ligament (MPFL) reconstruction. In the case of pathological values of the TT-TG distance, distal realignment is performed by tibial tubercle ventromedialization to achieve physiological values of the TT-TG distance. In the studied group, tibial tubercle ventromedialization helped decrease the Insall-Salvati index by 0.11 points on average. This has a positive side effect on the patella height, thus on increasing its stability in the femoral groove. In patients with both proximal and distal malalignment, a two-stage surgery is performed. In the isolated cases of severe instability or if symptoms of lateral patellar hyperpressure are present, musculus vastus med","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"9-16"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44277482","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":"High-Grade Chondrosarcoma of the Proximal Phalanx: an Unusual Case of a Rare Entity.","authors":"A. Pagnotta, V. Formica, S. Taccogna, G. Summa, C. Zoccali","doi":"10.55095/achot2023/010","DOIUrl":"https://doi.org/10.55095/achot2023/010","url":null,"abstract":"Chondrosarcoma of the hand is a rare disease, but is one of the more common malignancies of the hand. Biopsies and imaging are a fundamental step in determining correct diagnosis, grading and selection for best treatment. We describe the case of a 77-year-old male complaining of a painless swelling in the proximal phalanx of the third ray of left hand. A biopsy was performed and the histology revealed a G2 chondrosarcoma. The patient underwent III ray amputation with metacarpal bone disarticulation and sacrifice of the radial digit nerve of the fourth ray. Definitive histology revealed grade 3 CS. Eighteen months after surgery, the patient is apparently disease-free with a good functional and aesthetic outcome although with persistent paresthesia of the fourth ray. Although there is no agreement in the literature for the treatment of low-grade chondrosarcomas, wide resection or amputation can be considered the mainstay treatment for high-grade tumors. Key words: chondrosarcoma, proximal phalanx, ray amputation, surgical treatment, tumor hand.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"63-66"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49211754","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":"Functional and Radiologic Results of Posteromedial Limited Surgery in Developmental Dysplasia of the Hip.","authors":"K. Uzel, M. Gem, İ. Şahin, M. O. Ziyadanoğulları, M. Eskandari, H. Arslan","doi":"10.55095/achot2023/002","DOIUrl":"https://doi.org/10.55095/achot2023/002","url":null,"abstract":"PURPOSE OF THE STUDY In treatment algorithm of developmental dysplasia of the hip, posteromedial limited surgery is placed between closed reduction and medial open articular reduction. The aim of the present study was to assess the functional and radiologic results of this method. MATERIAL AND METHODS This retrospective study was performed in 37 Tönnis grade II and III dysplastic hips of 30 patients. The mean age of the patients at operation was 12.4 months. The mean follow-up time was 24.5 months. Posteromedial limited surgery was applied when sufficient stable concentric reduction was not achieved by closed technique. No pre-operative traction was applied. Postoperatively, human position hip spica cast was applied for 3 months. Outcomes were evaluated regarding modified McKay functional results, acetabular index and presences of residual acetabular dysplasia or avascular necrosis. RESULTS Thirty-six hips had satisfactory and one hip had poor functional result. The mean pre-operative acetabular index was 34.5 degrees. It improved to 27.7 and 23.1 degrees at the postoperative 6th month and the last control X-Rays. The change in acetabular index was statistically significant (p<0.05). At the last control, 3 hips had findings of residual acetabular dysplasia and 2 hips had avascular necrosis. CONCLUSIONS Posteromedial limited surgery for developmental dysplasia of the hip is indicated when closed reduction remains insufficient and medial open articular reduction remains unnecessarily invasive. This study, in line with the literature, provides evidences that this method might decrease the incidences of residual acetabular dysplasia and avascular necrosis of the femoral head. Key words: developmental dysplasia of the hip, posteromedial limited surgery, closed reduction, medial open reduction.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"17-21"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48908007","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":"5th Metatarsal Jones Fracture - To Treat Conservatively, or Surgically Using Headless Double-Threaded Herbert Screw?","authors":"J. Demel, L. Planka, R. Štichhauer, A. Vrtková, G. Bajor, M. Havlícek, L. Pleva","doi":"10.55095/achot2023/008","DOIUrl":"https://doi.org/10.55095/achot2023/008","url":null,"abstract":"PURPOSE OF THE STUDY Fifth metatarsal fractures, in particular so-called Jones fractures, are relatively common injuries both in the general population and athletes. Although discussions about whether the surgical or conservative solution should be preferred are ongoing for decades, there is no clear consensus. Here, we aimed to prospectively compare the results of osteosynthesis using the Herbert screw with the conservative solution in patients from our department. MATERIAL AND METHODS Patients 18-50 years presenting to our department with Jones fracture and meeting further inclusion/exclusion criteria were offered participation in the study. Those willing to participate signed informed consent and were randomized by flipping the coin into surgically and conservatively treated groups. After six and twelve weeks, X-ray was performed in each patient and AOFAS score was determined. Conservatively treated patients who showed no signs of healing and whose AOFAS was below 80 after six weeks were offered surgery again. RESULTS Of 24 patients in total, 15 were assigned to the surgically treated group and nine were treated conservatively. After six weeks, AOFAS score of all but two patients (86%) in the surgically treated group ranged between 97 and 100, while this score exceeded 90 points only in three patients (33%) from the conservatively treated group. On X-ray, successful healing after six weeks was observed in seven patients (47%) from the surgically treated group but in none of the patients from the conservatively treated group. Three out of five patients in the conservative group whose AOFAS was below 80 after six weeks opted for surgery at that time and all improved significantly by the twelfth week. DISCUSSION Although studies on surgical treatment of Jones fracture using various screws or plates are not rare, we present an uncommon method of surgical treatment of this injury - the use of the Herbert screw. The results of this method are excellent and even on a relatively small sample yielded statistically significantly better results than conservative treatment. Moreover, the surgical treatment facilitated early loading of the injured limb, which allows an earlier return of the patients to normal life. CONCLUSIONS Osteosynthesis using Herbert screw in Jones fracture yielded significantly better results than conservative treatment. Key words: Jones fracture, AOFAS, Herbert screw, 5th metatarsal fracture, surgical treatment.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"53-58"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44128075","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":"Which is the Best Solution for Achieving Maximal Interfragmentary Compression of the Scaphoid Fractures - One or Two Herbert Screws?","authors":"L. Simeonov","doi":"10.55095/achot2023/005","DOIUrl":"https://doi.org/10.55095/achot2023/005","url":null,"abstract":"PURPOSE OF THE STUDY To compare the treatment outcome of scaphoid facture fixation with one versus two Herbert screws (HBS). MATERIAL AND METHODS 72 patients underwent open reduction internal fixation (ORIF) following acute scaphoid fracture, and were followed prospectively by one surgeon. All fractures were Herbert & Fisher classification type B, the most common fracture lines being oblique (n=38) and transverse (n=34). Fractures with similar fracture lines were randomly assigned into two groups; fractures stabilized with one HBS (n=42) and fractures stabilized with two HBS (n=30). A specific methodology was developed for placement of two HBS; in the case of transverse fractures, screws were introduced perpendicular to the fracture line, for oblique fractures the first screw was placed perpendicular to the fracture line and the second screw was placed along the longitudinal axis of the scaphoid. RESULTS Patients were followed for a total 24 months, no patients were lost to follow-up. Outcome measures included bone healing, duration to bone healing, carpal geometry, range of motion (ROM), grip strength, and the Mayo Wrist Score. Patient rated outcomes were measured using DASH. Bone healing was radiographically and clinically confirmed in 70 patients. There were two non-unions after fixation with one HBS. Radiographic angles in both groups did not differ significantly from the physiological values. The mean duration to bone union was 1.8 months for one HBS and 1.5 months for two HBS. Mean grip strength was 47 kg in the group with one HBS (16-70 kg), 94 % of the unaffected hand, and 49 kg in the group with two HBS, 97% unaffected hand. The average Visual Analog Scale (VAS) score for the group with one HBS was 2.5, while for the group with two HBS was 2.0. Both groups had excellent and good results. For the group with two HBS, they are more. (100% for those fixed with two HBS and for those fixed with one HBS = 95% excellent and good and 5% bad results). DISCUSSION A review of the literature confirms that the addition of the second screw increases the stability in the scaphoid fractures by offering added resistance to torque forces. Most authors propose the parallel placing of both screws in all cases. In our study we offer an algorithm for the placement of screws depending of the type of fracture line. For transverse fractures screws are placed parallel and perpendicular to the fracture line, for oblique fractures the first screw is placed perpendicular to the fracture line, and the second screw is placed along the longitudinal axis of the scaphoid. This algorithm covers the main laboratory requirements for maximal fracture compression depending of the fracture line. CONCLUSIONS This study of 72 patients in whom patients with similar fracture geometry were separated into two groups fixed by one HBS and fixed by two HBS. Analysis of the results demonstrate that osteosynthesis with two HBS creates greater fracture stability. The proposed algorithm for","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"34-40"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47868345","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":"[First Experience with Diaphragm Pacing System in the Czech Republic].","authors":"J. Kříž, S. Jarosciakova, K. Šedivá, V. Hyšperská, K. Čadová, Z. Přikrylová","doi":"10.55095/achot2023/009","DOIUrl":"https://doi.org/10.55095/achot2023/009","url":null,"abstract":"Patients with impaired diaphragm function are dependent on long-term mechanical ventilation. It is associated with numerous health complications as well as significant economic burden. Intramuscular diaphragm stimulation through laparoscopic implantation of pacing electrodes is a safe method which enables restoring breathing using diaphragm in a considerable number of patients. The first implantation of diaphragm pacing system in the Czech Republic was performed in a thirty-four-year-old patient suffering from a high-level cervical spinal cord lesion. After eight years of mechanical ventilation support, just five months from initiation of stimulation, the patient is able to breathe spontaneously for ten hours per day on average, with expected total weaning. Once the insurance companies decide to reimburse the pacing system, a widespread use of the method even in patients with other diagnoses, including children, is expected. Key words: electrical stimulation, diaphragm, spinal cord injury, laparoscopic surgery.","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1 1","pages":"59-62"},"PeriodicalIF":0.4,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46102288","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":"Functional and Radiologic Results of Posteromedial Limited Surgery in Developmental Dysplasia of the Hip.","authors":"K Uzel,&nbsp;M Gem,&nbsp;I Şahin,&nbsp;M O Ziyadanoğullari,&nbsp;M M Eskandari,&nbsp;H Arslan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>PURPOSE OF THE STUDY In treatment algorithm of developmental dysplasia of the hip, posteromedial limited surgery is placed between closed reduction and medial open articular reduction. The aim of the present study was to assess the functional and radiologic results of this method. MATERIAL AND METHODS This retrospective study was performed in 37 Tönnis grade II and III dysplastic hips of 30 patients. The mean age of the patients at operation was 12.4 months. The mean follow-up time was 24.5 months. Posteromedial limited surgery was applied when sufficient stable concentric reduction was not achieved by closed technique. No pre-operative traction was applied. Postoperatively, human position hip spica cast was applied for 3 months. Outcomes were evaluated regarding modified McKay functional results, acetabular index and presences of residual acetabular dysplasia or avascular necrosis. RESULTS Thirty-six hips had satisfactory and one hip had poor functional result. The mean pre-operative acetabular index was 34.5 degrees. It improved to 27.7 and 23.1 degrees at the postoperative 6th month and the last control X-Rays. The change in acetabular index was statistically significant (p<0.05). At the last control, 3 hips had findings of residual acetabular dysplasia and 2 hips had avascular necrosis. CONCLUSIONS Posteromedial limited surgery for developmental dysplasia of the hip is indicated when closed reduction remains insufficient and medial open articular reduction remains unnecessarily invasive. This study, in line with the literature, provides evidences that this method might decrease the incidences of residual acetabular dysplasia and avascular necrosis of the femoral head. Key words: developmental dysplasia of the hip, posteromedial limited surgery, closed reduction, medial open reduction.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 1","pages":"17-21"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9155201","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":"[Arthroscopic Superior Capsule Reconstruction with a Long Head of the Biceps Tendon Autograft: One-Year Follow-up Results].","authors":"R Kalina, P Neoral, M Sigmund, J Gallo","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;Superior Capsule Reconstruction (SCR) of the shoulder joint has recently been included in the portfolio of interventions as a solution to irreparable rotator cuff tears. One of the options is to use a long head of the biceps tendon (LHBT) autograft. This paper presents the fi rst clinical outcomes of the SCR of the shoulder joint using the LHBT autograft. MATERIAL AND METHODS It is a prospective non-randomised study in which 14 patients were included, namely 7 men and 7 women. The patients were evaluated using the pain VAS, UCLA (The University of California at Los Angeles) Shoulder Rating Scale and ASES (The American Shoulder and Elbow Surgeons) Shoulder Score. The minimum follow-up was 12 months after surgery. The measured values were analysed using the standard statistical methods. RESULTS From August 2020 to January 2022, a total of 14 SCR with biceps tendon autograph were performed at our department. The mean age of the patients was 62 years (40-72). The mean value of the UCLA Shoulder Score was 12.36 ± 2.92 points preoperatively, while after surgery the obtained values increased to the mean value of 28.86 ± 3.08 points. The ASES score was 25.48 ± 3.89 points preoperatively and 82.41 ± 7.95 points at one year after surgery. The preoperative mean VAS score was 6.14 ± 1.10 points and 1.36 ± 0.93 points at one year after surgery. The mean active shoulder fl exion measured preoperatively was 140 degrees, whereas at one year after surgery it was 171 degrees. The mean active abduction reached 123 degrees before surgery and 169 degrees after surgery. The mean active external rotation of the shoulder joint was 59 degrees preoperatively and 52 degrees postoperatively. The mean active external rotation at 90 degrees of abduction was 52 degrees preoperatively and 60 degrees postoperatively. Whereas the improvement as against the preoperative status measured by the UCLA, ASES and pain VAS was signifi cant, the differences in the range of motion were signifi cant in the case of active fl exion and abduction only. DISCUSSION Painful irreparable rotator cuff tear constitutes an indication for SCR. The reconstruction is performed using autografts, allografts and xenografts. In literature, several SCR surgical techniques using a long head of the biceps tendon have been presented. In most of these techniques the supraglenoid insertion of the LHBT was left intact. Our study showed a signifi - cant relief from problems and good functional outcomes at 1 year after surgery when the biceps tendon had been used. Similar results are reported also by other studies using the biceps tendon for SCR. When comparing this study and the other study we published earlier on SCR with xenografts, there is no signifi cant difference in the clinical outcomes between these two techniques. On the very contrary, they are slightly better in some parameters. CONCLUSIONS Arthroscopic SCR of the shoulder joint with the biceps tendon reports good","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"90 6","pages":"391-399"},"PeriodicalIF":0.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139401395","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}