Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"A Systemic Review of Primary Malignant Long Bone Tumors in Children and Adolescents.","authors":"M Khan, R Patel, M Youssef, R Banerjee, A Pardiwala, C Belen","doi":"10.55095/ACHOT2024/010","DOIUrl":"10.55095/ACHOT2024/010","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Managing bone tumours is complex, relying on limited evidence, expert opinions, and retrospective reviews. Multidisciplinary approaches and early diagnosis are crucial for better outcomes, especially in young patients with growing skeletons. The aim of this systemic review and meta-analysis is to give a comprehensive review of common malignant tumors affecting long bones in children and adolescents.</p><p><strong>Material and methods: </strong>A PubMed/Medline search for \"primary malignant long bone tumours in children\" initially retrieved 1120 papers, which were subsequently narrowed down to 110 articles based on inclusion and exclusion criteria. These articles were reviewed, focusing on clinical presentation, diagnostic workup, treatment options, surgical planning, and variations in presentation, including rare tumours. The two most commonly reported tumours were osteosarcoma and Ewing sarcoma, leading to the division of studies into five groups. The inclusion criteria encompassed malignancies in patients aged 2-25 years, work-up, imaging, surgical treatment, rare tumour case reports, and surgical management principles, resulting in a heterogeneous group of articles. To enhance categorisation, it was clarified that studies with 10 or more cases were considered retrospective reviews.</p><p><strong>Results: </strong>Reviewing of results thus demonstrate that the two likely tumours in children under consideration were osteosarcoma and Ewing sarcoma. Their presentation findings and clinical features were discussed in detail in the review. It is worth noting here that in case of differential diagnosis this should be the first on the list.</p><p><strong>Discussion and conclusions: </strong>Although focus of literature is more on the two most common tumours. However, rare tumours should be considered as they can mimic these common tumors.</p><p><strong>Key words: </strong>primary, malignant, bone tumors, children, adolescent.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 2","pages":"77-87"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157407","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":"[Arthrodesis of the Distal Interphalangeal Joint of the Finger Using an Intramedullary Implant].","authors":"P Barabas, R Pavličný","doi":"10.55095/ACHOT2024/047","DOIUrl":"https://doi.org/10.55095/ACHOT2024/047","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;Osteoarthritis (OA) of the joints of the hand is one of the most common musculoskeletal disorders in the elderly population. It is a complex, degenerative disease affecting all components of the joint. Surgical treatment is indicated when conservative therapy fails. The ultimate solution is arthrodesis of the distal interphalangeal (DIP) joint. Various methods of arthrodesis have been described, ranging from the use of K-wires or compression screw to different types of intra-articular (intramedullary) implants. The aim of this study is to evaluate the surgical outcomes of arthrodesis of the distal interphalangeal (DIP) joint of the fingers using intramedullary implants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Since 2011, arthrodesis of the distal interphalangeal joint using an intramedullary implant has been performed at our department 97 times in total, in 59 patients. 9 patients (15 cases of arthrodesis) were excluded from the study group due to their failure to complete the questionnaire, 1 female patient died. In the final group, 82 cases of arthrodesis in 49 patients (47 women, 2 men) were evaluated. In 72% of cases, the surgery was performed on the dominant hand. The mean age at the time of surgery was 58 years (median 59 years). The patients were indicated for surgery after the failure of all conservative treatment options. In addition to radiographs, also the hand function and pain were assessed based on the preand postoperative DASH score questionnaires.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The surgical outcomes for all implants are satisfactory. In all 82 patients, the surgical wounds healed per primam. In one case, implant extraction was performed due to infection. Another complication was an unhealed fusion and formation of a non-union with minimum pathological mobility (the patient is satisfied with the outcome). In three patients, a fracture at the base of the distal phalanx was observed on postoperative radiographs, which fully healed within 3 months after surgery. The mean DASH score decreased from 41.95 preoperatively to 14.93 postoperatively. The mean time to healing of the arthrodesis observed on radiographs was 9.1 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Currently, there are many different types of arthrodesis of the distal interphalangeal joint of the hand. Each method has its pros and cons. Arthrodesis using an intramedullary implant has the advantages of the older methods while minimizing postoperative complications. Our results are comparable to those reported in the foreign literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Based on the evaluated outcomes, arthrodesis of the distal interphalangeal joint using an intramedullary implant can be considered valid. It definitely deserves to be included in the portfolio of surgical treatment of osteoarthritis of the DIP joints of the hand. According to our observation, the differences between various types of implants are minimal and thei","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 5","pages":"282-288"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574891","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 Subtalar Distraction Arthrodesis in Post-Traumatic Indications].","authors":"V Rak, J Šrámek, D Ira, M Krtička","doi":"10.55095/achot2024/002","DOIUrl":"10.55095/achot2024/002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;This manuscript aims to present the method of arthroscopic assisted subtalar arthrodesis and to evaluate the benefi ts of this surgery on our study population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;In the period from 9/2007 to 1/2020, a total of 33 subtalar arthrodesis were performed in 31 patients aged 19-66 years (mean 48 years, median 50 years). The indication for arthrodesis was subtalar arthritis causing pain and gait disorders, or hindfoot deformities (most commonly after a calcaneus bone fracture). The arthroscopic assisted subtalar arthrodesis was performed with autologous tricortical bone block graft harvesting from the pelvis, supplemented by autologous cancellous bone graft. Stabilization was achieved by cannulated screws inserted in neutral ankle position. Patients in our retrospective study were followed up for a mean of 48 months (range, 24-130 months). The patients were evaluated preoperatively and at 2 years after surgery. The hindfoot angles and height (TCA - talocalcaneal angle, CIA - calcaneal inclination angle, TCH - talocalcaneal height) were evaluated on radiographs, bone union was assessed on radiographs and CT scans. The clinical assessment was performed using the ankle-hindfoot scale (AHS) of AOFAS (AOFAS score).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The preoperative AOFAS score was 35-68 points (mean 52, median 54), the postoperative AOFAS score at 2 years after arthrodesis was 58-94 points (mean 82, median 82). Both the mean and median values of AOFAS score showed a signifi - cant progress from the poor result to the good and excellent result. After 2 years the TCA value decreased in 18 patients (56%) by no more than 3°. The CIA decrease observed in 21 patients (64%) was by 1° on average. The TCH decrease of 1-5 mm after 2 years since the surgery was seen in 16 patients. In 2 patients incomplete healing of arthrodesis was observed, manifested as a clinically asymptomatic non-union. No deep infection was reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;In agreement with the current literature, the arthroscopic subtalar arthrodesis has been confi rmed to be a safe method for the management of consequences of hindfoot fractures, with minimum complications and leading to accelerated bone fusion. Differences can be found in the approach, position, use of cancellous bone graft and surgical techniques. In recent years, prone position, posterior approaches, use of cancellous bone graft, distraction and fi xation with 2-3 screws divergently inserted into the bone prevail. The degree of healing of the bone fusion is generally an important factor. In our study population, non-healing was recorded in 2 patients, namely in the form of a clinically silent non-union. Neurological or early complications and/or osteosynthesis material failure occurred in up to a maximum of 10% of cases. The conclusive results of minimally invasive arthrodesis based on the AOFAS score have been confi rmed by us as w","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"34-43"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048472","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":"[Total Hip Arthroplasty Using the AMIS Method: Surgical Technique, Suitability of This Method for Obese Patients, Evaluation of the Study Population].","authors":"P Palásek, P Mašát, V Řeháček","doi":"10.55095/achot2024/008","DOIUrl":"10.55095/achot2024/008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;This manuscript aims to introduce our surgical technique, with an emphasis on the latest recommendations. The AMIS technique is discussed in more detail in patients with Class II and Class III obesity. We seek to prove the premise claiming that the anteversion and inclination values observed in this group of patients do not differ signifi cantly from those observed in patients with the recommended BMI index. We will also compare the risk of neurovascular bundle injury and postoperative complication rate regarding the surgical wound.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Patients who underwent surgery using the AMIS method in the period between 1/2020 and 4/2023 were assessed retrospectively. The study included 1150 implantations. The entire study population was assessed for neurovascular bundle injury and surgical wound healing complications. For this purpose, the patients were divided into two groups based on the BMI, namely BMI &lt; 35 kg/m2 (n=1042) and BMI &gt; 35 kg/m2 (n=108). In patients with the BMI ≤ 25 kg/m2 (n=280) and BMI ≥ 35 kg/m2 (n=108), the inclination and anteversion values were compared. Standard centered AP view X-rays of their operated joints were assessed. The Liaw's method was used to calculate the anteversion and inclination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In group one of patients with BMI ≤ 25 kg/m2 (208 women and 72 men), the arithmetic mean of acetabular anteversion was 25.4° (median 25°) and inclination was 38.3° (median 38°). In group two, which consisted of patients with BMI ≥ 35 kg/m2 (59 women and 49 men), the total arithmetic mean of acetabular anteversion was 25.1° (median 25) and inclination was 37.6° (median 37.5°). The anteversion and inclination were assessed using the Mann-Whitney test for equality of medians. The value of 0.05 was chosen as the level of signifi cance. The resulting p-value was 0.5359 in anteversion and 0.3763 in inclination. Since the p-value of both anteversion and inclination was greater than the chosen level of signifi cance, their medians have not been confi rmed to differ signifi cantly. A total of 6 cases of femoral nerve injury was reported, i.e. 0.5% out of 1150. Therefore, the risk of injury was 0.4% in the group with BMI &lt; 35 kg/m2 (n=1042). On the contrary, in the group of patients with BMI &gt; 35 kg/m2 (n=108), the risk was 2%. No injury to femoral artery was reported. The surgical wound healing complications were seen in a total of 87 cases (7.6%). In the group with BMI &lt; 35 kg/m2 , healing complications of the surgical wound were observed in 7.4% of cases, with the need for revision surgery in 7 patients. In the group with BMI &gt; 35 kg/ m2 , healing complications occurred in 13% of patients and wound revision was necessary in 4 cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Our results are consistent with those in the published studies that also show no signifi cant difference in anteversion and inclination of components in the compared grou","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"24-33"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048474","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":"Evaluation of the Relationship between Acromiohumeral Distance and Supraspinatus Tendon Thickness Measured by Ultrasonography and Rotator Cuff Pathologies, Pain, and Function.","authors":"B T Dede, Y P Doğan, M Oğuz, B Bulut, H Coşkun, E Aytekin","doi":"10.55095/achot2024/024","DOIUrl":"https://doi.org/10.55095/achot2024/024","url":null,"abstract":"<p><strong>Purpose of the study: </strong>In this study, we aimed to evaluate acromiohumeral distance (AHD) and supraspinatus tendon (ST) thickness measurements and their relationship with pain and function in ST pathologies.</p><p><strong>Material and methods: </strong>The study included 111 patients and 25 healthy controls (HC). Patients were divided into 3 groups according to their diagnosis: non-tear tendinopathy (NTT), partial thickness tear (PTT), and full thickness tear (FTT). The AHD and ST thickness of the participants were measured with ultrasound. The pain and functional status of the patients were evaluated with the Numeric Rating Scale (NRS), The QuickDASH shortened version of the DASH Outcome Measure - Disabilities of the Arm Shoulder and Hand (QDASH), and Simple Shoulder Test (SST).</p><p><strong>Results: </strong>The AHD value was significantly higher in the NTT group (p=0.000). The AHD value was significantly lower in the FTT group (p=0.000). ST thickness value was significantly lower in the PTT group compared to the NTT group (p=0.000). There was a positive correlation between ST thickness and BMI (r=0.553,p<0.01). There was a negative correlation between ST thickness and SST and a positive correlation between ST thickness (r=-0.223,p<0.05) and QDASH (r=0.276,p<0.05).</p><p><strong>Conclusions: </strong>We found that AHD and SST thicknesses significantly differed in the NTT, PTT, FTT, and HC groups. This difference may be important for diagnosis. In addition, the effect of obesity on ST thickness and the relationship between ST thickness and functional scores may be considered. Weight control may be effective at this point.</p><p><strong>Key words: </strong>acromiohumeral distance, supraspinatus tendon thickness, ultrasound.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 3","pages":"164-169"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533276","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":"Prepacked Take-Home Analgesia in Outpatient Hand Surgery Reduces Opioid Dispensation.","authors":"E Lundqvist, S Mousa, S Wallén, I Hurtig, D Reiser","doi":"10.55095/achot2024/018","DOIUrl":"https://doi.org/10.55095/achot2024/018","url":null,"abstract":"<p><strong>Background: </strong>Adequate postoperative pain treatment is important for quality of life, patient satisfaction, rehabilitation, function, and total opioid consumption, and might lower both the risk of chronic postoperative pain and the costs for society. Prolonged opioid consumption is a well-known risk factor for addiction. Previous studies in upper extremity surgery have shown that total opioid consumption is a third of the amount prescribed, which can be explained by package size. The aim of this study was to examine whether implementation of prepacked takehome analgesia bags reduced the quantity of prescribed and dispensed opioids.</p><p><strong>Material and methods: </strong>We introduced prepacked take-home analgesia bags for postoperative pain treatment in outpatient surgery. The bags came in two sizes, each containing paracetamol, etoricoxib, and oxycodone. The first 147 patients who received the prepacked analgesia bags were included in the study, and received a questionnaire one month after surgery covering self-assessed pain (visual analog scale of 0-10) and satisfaction (0-5), as well as opioid consumption. Prescription data after introducing the analgesia bags were compared with data before the bags were introduced.</p><p><strong>Results: </strong>Of the 147 patients included in the study, 58 responded. Compared to standard prescription (small bag group: 14 oxycodone immediate release capsules (5 mg), large bag group: additional 28 oxycodone extended release tablets (5 mg), based on the smallest available package), the patients in the small analgesia bag group received 50% less oxycodone and 67% less for the large bag group. Patients with small bags consumed a median of 0.0 mg oxycodone and those with large bags consumed a median of 25.0 mg oxycodone. The median satisfaction was 5.0 (range: 2-5) and the median pain score was acceptable at the first postoperative day. Prescription data showed a significant reduction of 60.0% in the total amount of prescribed opioids after the introduction of prepacked analgesia bags.</p><p><strong>Conclusions: </strong>The introduction of prepacked analgesia bags dramatically reduced the quantity of opioids prescribed after outpatient hand surgery. Patient satisfaction was high and the postoperative pain level was acceptable.</p><p><strong>Key words: </strong>analgesia, hand surgery, opioids, outpatint surgery, wrist surgery.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 3","pages":"182-187"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533340","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":"Alternative Surgical Treatment Method for 5th Metacarpal Neck Fractures: Comparison of Clinical Outcomes of Intramedullary and Transverse K-Wire Fixations with Additional Antirotational K-Wire.","authors":"U O Kasman, C Turemis, S Surucu, Ö Korkmaz","doi":"10.55095/ACHOT2024/030","DOIUrl":"https://doi.org/10.55095/ACHOT2024/030","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The purpose of this study was to assess the clinical outcomes and complications associated with intramedullary and transverse K-wire fixations of 5th metacarpal neck fractures.</p><p><strong>Material and methods: </strong>Patients who were operated for 5th metacarpal neck fractures between 2019 and 2022 were evaluated retrospectively. Regarding the surgical treatment methods, patients were assessed by dividing them into two groups. The first group comprised patients who underwent treatment with an intramedullary K-wire. The second group comprises patients who underwent transverse K-wire fixation.</p><p><strong>Results: </strong>The average quick DASH score of all patients was 5.6±4.7 in the intramedullary K-wire fixation group and 5.9±5.1 in the transverse K-wire fixation group. An average 5th finger metacarpophalangeal joint extension limitation was 6.2±5.7° in the intramedullary fixation group and 6.1±5.8° in the transverse K-wire group. The mean radiological union time was 4.9±0.7 weeks in the intramedullary fixation group and 5.1±0.7 weeks in the transverse K-wire group. No statistically significant difference was found between the quick DASH scores and degrees of the MCP joint extension limitation ( p=0.785). Intramedullary fixation and transverse K-wire fixations are effective surgical treatment methods for metacarpal neck fractures.</p><p><strong>Discussion: </strong>It has been reported that the intramedullary fixation method in metacarpal bone fractures is more effective than the fixation methods with cross and transverse K-wire. But our results revealed no difference in clinical outcomes between the two surgical fixation methods.</p><p><strong>Conclusions: </strong>We observed no statistically significant difference between the two fixation techniques with regard to union, clinical outcomes, or complications.</p><p><strong>Key words: </strong>intramedullary fixation; metacarpal neck fracture; transverse K-wire fixation.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"229-233"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339052","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":"The Impact of Coracoid Tip Orientation on Subscapularis Tear Incidence: an MRI-Based Study.","authors":"H Yaka, M Özer, B Sarikaya, U Kanatli","doi":"10.55095/ACHOT2024/032","DOIUrl":"https://doi.org/10.55095/ACHOT2024/032","url":null,"abstract":"<p><strong>Purpose of the study: </strong>This study investigated the relationship between the position of the tip of the coracoid process (CP) relative to the glenoid with subscapularis (Ssc) tears. We hypothesized that the coracoid tip is more inferior, lateral and posterior in patients with Ssc tear.</p><p><strong>Material and methods: </strong>This research enrolled 34 isolated Ssc tears and 44 controls. We introduced the axial central glenoid-coracoid angle (acGCA) and sagittal central glenoid-coracoid angle (scGCA) to evaluate the position of the tip of the CP relative to the glenoid center on MRI images. In both groups, acGCA, scGCA on MRI and critical shoulder angle (CSA), glenoid inclination (GI) on true anterior-posterior shoulder radiography were evaluated.</p><p><strong>Results: </strong>When both groups were compared in terms of acGCA, the acGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of acGCA for Ssc tears was 28.3°. acGCA values higher than 28.3° showed 93.3% sensitivity and 93.1% specificity for Ssc tears (likelihood ratio:13.53, AUC: 0.979, 95% CI of AUC: 0.950- 0.999). In terms of acGCA, the power analysis between Ssc tears group and control group was 99.9% between Ssc tears and the control group (effect size d=2.63). When both groups were compared in terms of scGCA, the scGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of scGCA for Ssc tears was 41.4°. Scores of scGCA greater than 41.8° showed 80% sensitivity and 89.7% specificity for Ssc tears (likelihood ratio: 7.73, AUC: 0.899 95% CI of AUC: 0.837-0.958). In terms of scGCA, the power analysis between Ssc tear and control group was 99.8% (effect size d=1.23). When both groups were compared in terms of CSA and GI; CSA and GI values in the Ssc tear group were significantly higher (p<0.001 and p<0.012, respectively).</p><p><strong>Conclusions: </strong>AcGCA values higher than 28.3° indicate that the coracoid tip is located more laterally and posteriorly; scGCA values higher than 41.8° indicate that the coracoid tip is located more inferiorly and these two new indexes are showing that more laterally, posteriorly and inferiorly coracoid tip is related to subscapularis tears.</p><p><strong>Key words: </strong>coracoid process, subscapularis tear, coracoid morphology, scapula morphology.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"239-244"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339057","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 of Length Unstable Femur Fractures in Children by Flexible Intramedullary Nails: A Systematic Review.","authors":"V Garg, A K S Gowda, A Regmi, S Barik, V K Maheshwari, V Singh","doi":"10.55095/achot2024/006","DOIUrl":"10.55095/achot2024/006","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Surgical options for paediatric femoral fractures include fl exible intramedullary nailing (FIN), plating, and external fi xators. Length unstable fractures are usually spiral, long oblique, or comminuted and are often associated with > 2 cm of shortening. The purpose of this study was to see whether FIN is effective for managing unstable femur fractures in children.</p><p><strong>Material and methods: </strong>An electronic literature search was performed up to 25 February 2022 in Cochrane Library, PubMed, and Embase databases using a combination of MeSH search terms and keywords related to the population (e.g., \"child\" AND \"diaphyses\" AND \"femur\"), and intervention (e.g., \"nail\" OR \"ESIN\"). The data extracted included the study details, Demographic data, surgical details, postoperative immobilization, complications, and outcome.</p><p><strong>Results: </strong>Eight studies with a total sample size of 369 patients were reviewed. The mean operative time, blood loss, and length of stay in the hospital were 67.62±12.32 minutes, 33.82±16.82 ml, and 4.9±1.27 days, respectively. The results were excellent in 61.92% of the patients, satisfactory in 32.61%, and poor in 5.43%. 4.54% of patients had major complications requiring reoperation and 32.46% of patients had minor complications. the most common complication was nail prominence seen in 26.30% of patients. Locked Ender's nail was associated with the least reoperation, malunion, and LLD rate compared to other types of FIN.</p><p><strong>Conclusions: </strong>FIN along with a single walking spica cast is a good choice in all forms of paediatric femoral fracture patterns allowing proper alignment and rotation. Locked Ender's nail is safe and effective for managing unstable paediatric femur fracture.</p><p><strong>Key words: </strong>pediatric femur fracture, length unstable, fl exible intramedullary nailing, submuscular plating, Flynn criterion.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"44-51"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048475","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":"Clinical Effect of Screw Internal Fixation on Fracture Healing and Ankle Alignment in Patients with Posterior Malleolar Fracture.","authors":"Jiawang Zhou, Weidong Wu, L I Sun, Feng Lv, Junjie Fan","doi":"10.55095/ACHOT2024/027","DOIUrl":"https://doi.org/10.55095/ACHOT2024/027","url":null,"abstract":"<p><strong>Purpose of the study: </strong>To examine the clinical impact of screw internal fixation on the process of fracture healing and ankle alignment in individuals diagnosed with posterior malleolar (PM) fracture, specifically those with a fracture involving less than 25% of the articular surface (ASR) area.</p><p><strong>Material and methods: </strong>A total of 120 patients diagnosed and treated for PM fracture, encompassing less than 25% of the distal tibial ASR area, were selected from our hospital's records spanning from September 2021 to June 2023. These people were subsequently divided into two groups, namely the control group (group A) and the observation group (group B), based on the distinct treatment methods employed, with each group consisting of 60 patients. The people in the group A were treated with posterior malleolus non internal fixation, while the patients in the group B were treated with posterior malleolus screw internal fixation. The visual analog scores, peak plantar pressure and AOFAS scores of the two groups were subjected to comparison.</p><p><strong>Results: </strong>The visual analog scores in the observation group at 6 months and 12 months after operation were reduced than the group A. Three months after operation, the peak plantar pressure of the affected foot (full foot, hind foot) in the group B was reduced than that of the healthy foot; There was a lack of statistically significant variation observed in the peak plantar pressure (full foot, hind foot) between the affected foot and the healthy foot 12 months after operation in the group B, and the plantar pressure tended to be balanced. Three months after operation, the peak plantar pressure of the affected foot (full foot, hind foot) in the group A was reduced than that of the healthy foot; After a period of 12 months following the surgical procedure, no notable disparity in the maximum pressure exerted on the sole of the foot was observed between the foot that underwent the operation and the unaffected foot in the group A, but the peak plantar pressure of the whole foot was reduced than that of the healthy foot, and the plantar pressure did not tend to be balanced. At the intervals of 6 months and 12 months following the surgical procedure, AOFAS ankle hind foot score in the group B was increased than the group A.</p><p><strong>Conclusions: </strong>The utilization of screw internal fixation demonstrates favorable clinical outcomes in patients presenting with PM fracture encompassing less than 25% of the articular surface area, which is conducive to promoting fracture healing, maintaining good ankle alignment, and promoting patient rehabilitation.</p><p><strong>Key words: </strong>screw internal fixation, posterior ankle fracture, articular surface of distal tibia, fracture healing, ankle joint alignment.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"217-221"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339054","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}