Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"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":"[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":"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}

{"title":"Evaluation of the Diagnostic Accuracy of Percutaneous Core Needle Biopsy in Bone and Soft Tissue Tumors.","authors":"T Cengiz, A Yurtbay, O Muslu, Ş Aydin Şimşek, A B Özbalci, H S Coşkun, Y S Bariş, N Dabak","doi":"10.55095/ACHOT2024/042","DOIUrl":"https://doi.org/10.55095/ACHOT2024/042","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Open (incisional) biopsies have long been accepted as the gold standard in diagnosing bone and soft tissue tumors. However, the main disadvantage of this method is that it can lead to increased contamination, hematoma, infection, and pathological fracture. Compared to open biopsies, percutaneous core needle biopsies are less invasive, do not require hospitalization, have low costs and low complication rates, and there is no need for wound healing in cases that require radiotherapy. This study evaluated the diagnostic accuracy and reliability of percutaneous core needle biopsy.</p><p><strong>Material and methods: </strong>The study included the results of 250 percutaneous core needle biopsies of 244 patients who presented at the tertiary university hospital between September 2012 - September 2022 and were diagnosed with a bone or soft tissue tumor using the percutaneous core needle biopsy method and then underwent surgical excision in the Orthopaedics and Traumatology Clinic. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy rates were calculated for the percutaneous core needle biopsy method according to the compatibility of the results.</p><p><strong>Results: </strong>A fluoroscopy-guided percutaneous Jamshidi needle biopsy performed by an orthopedist for lesions originating from the bone has a diagnostic accuracy of 96%. CT-guided percutaneous Jamshidi needle biopsy performed by a radiologist for lesions originating from the bone has a diagnostic accuracy of 88.9%. Percutaneous Tru-cut needle biopsy performed by an orthopedist without imaging guidance for lesions originating from soft tissue has a diagnostic accuracy of 92%. USGguided percutaneous Tru-cut needle biopsy performed by a radiologist for lesions originating from soft tissue has a diagnostic accuracy of 96,7% (p<0.001).</p><p><strong>Discussion: </strong>The diagnostic accuracy of open biopsies ranges from 91% to 99% in the literature. Additionally, the diagnostic accuracy of core needle biopsies in recent studies ranges from 76% to 99%. Compared to the literature, our study has shown that biopsies performed by orthopedic specialists have a high diagnostic power (96% for bone-derived lesions; 92% for soft tissue-derived lesions).</p><p><strong>Conclusions: </strong>Percutaneous core needle biopsy is highly effective and reliable in diagnosing bone and soft tissue tumors. Managing patients by a team using a multidisciplinary approach will increase diagnostic success.</p><p><strong>Key words: </strong>core needle biopsy, percutaneous, diagnostic accuracy, radiology guided biopsy, bone and soft tissue tumors.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 6","pages":"376-384"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942395","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":"Lisfranc Injury: a Comprehensive Analysis of LongTerm Outcomes - the Oswestry Experience.","authors":"R Patel, M S Cheruvu, A Daoub, R A Singh, R Banerjee, S Hill","doi":"10.55095/ACHOT2024/037","DOIUrl":"https://doi.org/10.55095/ACHOT2024/037","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Lisfranc is a challenging injury both diagnostically and surgically, with sparse long-term literature evidence of surgical practice. We aim to review our long-term specialist orthopaedic institutional experience of Lisfranc injuries and the surgical management of this complex injury, specifically considering surgical outcomes as per radiological and clinical assessment.</p><p><strong>Material and methods: </strong>We present data from a prospectively maintained institutional database, reviewing patients who underwent operative fixation for Lisfranc injury between April 2014 and August 2020. Patients were referred to our institution from hospitals across the country. We included all operatively managed Lisfranc injuries, primary procedures, and patients over the age of 16. Revision procedures, open injuries, polytrauma patients, patients under the age of 16, and those with multiple foot injuries were excluded. We assessed post-operative results as per the Wilpulla radiographic and clinical criteria.</p><p><strong>Results: </strong>We treated 27 patients across the study period, of mean age 37.5 (SD 18.3), 55% male and 45% female. 33.3% of our patients were obese as defined by body mass index >30. As per the Myerson classification, we had 2 category A, 24 category B, and 1 category C injuries. Time to operation was median 14 days (range 0-116), with 2 delayed presentations following failure of conservative treatment. Our median length of stay was 1 day (range 0-16). We had 3 complications: 2 wound infections and 1 re-operation for non-union. Post-operative assessment as per Wilpulla demonstrated 74% of good, 18.5% fair and 7% poor fixation results.</p><p><strong>Conclusions: </strong>In our institutional experience, partial congruity lateral displacement injuries were the majority of surgical referrals. Surgical treatment through open reduction and internal fixation delivers good clinical and radiographically anatomical results. Further to conventional mechanisms of injury, we propose obesity to be an important risk factor for indirect, low-energy injuries that may help identify this injury.</p><p><strong>Key words: </strong>Lisfranc injury, long-term, orthopaedic surgery, obesity.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 6","pages":"369-375"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942398","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":"Three-Dimensional Computed Tomography Image Reformation for Comparison of Foraminal Cross-Sectional Dimension in Patients Who Have Undergone Laminoplasty and Laminectomy with Fusion.","authors":"S-J Lee, H-J Lee, Y-M Lee, M F Deslivia, W-K Min","doi":"10.55095/ACHOT2024/011","DOIUrl":"https://doi.org/10.55095/ACHOT2024/011","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Laminectomy with fusion (LF) is commonly performed with laminoplasty (LP) for cervical myelopathy. Foraminal stenosis is important in the surgical treatment of cervical myelopathy. LF and LP can affect foraminal size in different ways. This study aimed to compare foraminal dimensions after LF and LP using a medical computer-assisted design (CAD) program.</p><p><strong>Material and methods: </strong>Computed tomography (CT) scans of the cervical vertebrae of 16 patients with cervical myelopathy were retrospectively viewed in the Digital Imaging and Communications in Medicine format on a CAD program. CT images were reformatted in an oblique plane perpendicular to the long axis of each foramen from C2-C3 to C6-C7. The narrowest foraminal crosssectional dimension (FCD) was measured and compared between the LF and LP groups at the operated, non-operated, and C4-C5 levels. The difference between the preoperative and postoperative FCDs was also calculated and compared between the operated and C4-C5 levels. Intra- and interobserver reliabilities for FCD measurements were evaluated using intraclass correlation coefficients.</p><p><strong>Results and discussion: </strong>At the operated spinal levels, the LF and LP groups showed decreased and increased mean FCDs, respectively. At the adjacent non-operated levels, the mean FCD slightly increased in both the groups. In the LF group, the difference between the preoperative and postoperative FCDs in the C4-C5 levels was larger than that in the other operated levels, but this difference was insignificant.</p><p><strong>Conclusions: </strong>LF and LP showed contrary results for FCD. Therefore, FCD and kyphosis should be considered for LF and LP.</p><p><strong>Key words: </strong>three-dimensional, foraminal cross-sectional dimension, laminoplasty, laminectomy fusion, computer-aided design, drafting system, preoperative-postoperative comparison.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 2","pages":"103-108"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157410","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}