Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"[Funtional Outcomes of Pediatric Trigger Digits - Outcomes of Two Centers].","authors":"Martin Vlach, David Máška, Alena Schmoranzová, Eliška Kšírová, Vojtěch Havlas","doi":"10.55095/achot2024/058","DOIUrl":"10.55095/achot2024/058","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The study evaluates the functional outcomes of the treatment of pediatric trigger digits in two centers and compares them with data from the available literature. The secondary objective is to verify the possibilities of collecting data on patients' health status through questionnaire surveys using remote communication via a web interface.</p><p><strong>Material and methods: </strong>Patients operated on at the Hand and Plastic Surgery Institute in Vysoké nad Jizerou (ÚCHRaPCH) and the Motol University Hospital, Department of Orthopaedics (FNM) between 2018 and 2021 were evaluated. An analysis of demographic data, affected digits, and an assessment of functional outcomes using the Quick-DASH questionnaire were performed. The data were collected through Google Forms and then statistically analyzed. The subgroups were compared using the chi-square test and two-tailed unpaired t-test and logistic regression with Firth's correction was used to compare the obtained Quick-DASH scores.</p><p><strong>Results: </strong>A total of 124 trigger digits in 102 patients were evaluated, including 113 thumbs and 11 fingers; bilateral findings were observed in 20.6% of patients. The mean age at the time of surgery was 3.7 years. The questionnaire was completed by 57.8% of patients treated at ÚCHRaPCH and 57.9% at FNM. The median Quick-DASH score was 0.0, indicating no disability or hand function limitation. The average Quick-DASH score was 1.7. No significant differences were found between the centers in demographic parameters or achieved scores. The prevalence of a non-zero Quick-DASH score was 24%.</p><p><strong>Discussion: </strong>Our results, in line with global literature, confirm that surgical release of the A1 pulley is an effective method for treating pediatric trigger thumb or fingers with minimal complications. The online questionnaire survey proved beneficial for data collection. The limitation is the low response rate and the unavailability of suitable validated questionnaires for the given age group. The relatively high risk of a non-zero Quick-DASH score may be influenced by the inappropriate choice of questionnaire given the age of the subjects. An advantage of the data collection method used is the ability to require full completion of the questionnaire before submission, thereby eliminating the need to discard incomplete questionnaires.</p><p><strong>Conclusions: </strong>Surgical treatment of pediatric trigger digits provides excellent outcomes, and the use of online questionnaires is suitable for health data collection. Further research is needed to validate questionnaires for pediatric age categories and subsequently to expand the concept of web-based data collection.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 3","pages":"147-152"},"PeriodicalIF":0.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938355","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":"Effects of General Anesthesia in Combination with Saphenous Nerve Block-Tibial Nerve Block on Analgesia for Total Knee Arthroplasty and Hemodynamic Indexes.","authors":"Danfeng Liu, Yong Wang, Wei Tang","doi":"10.55095/achot2024/064","DOIUrl":"10.55095/achot2024/064","url":null,"abstract":"<p><strong>Purpose of the study: </strong>We aimed to assess the effects of general anesthesia (GA) plus saphenous nerve block-tibial nerve block (SNB-TNB) on analgesia for total knee arthroplasty (TKA) and hemodynamic indexes.</p><p><strong>Material and methods: </strong>A control group and an observation group were set for equal allocation of 106 patients with knee osteoarthritis (KOA) treated with TKA during November 2021 and November 2023 through a random number table. GA was used for the control group, and GA plus SNB-TNB was performed for the observation group. Clinical indexes, analgesic effect, joint motion range, hemodynamic indexes and safety were compared between the two groups.</p><p><strong>Results: </strong>The observation group had decreased fentanyl dosage, patient-controlled intravenous analgesia pump pressing times, morphine dosage, extubation time, and recovery time compared with those of the control group (P<0.05). The static and dynamic Visual Analog Scale scores at different time points were lower in the observation group than in the control group (P<0.05). The observation group had higher maximum flexion degree than that of the control group at different time points (P<0.05). The incidence rate of adverse reactions in the observation group was lower than that of the control group (P<0.05).</p><p><strong>Discussion: </strong>SNB-TNB can comprehensively intervene with the tissues surrounding the knee joint, and nerve block techniques are capable of intercepting harmful inputs in a targeted manner, elevating pain threshold, inhibiting signaling transmission from nerve endings, and thus terminating the pain perception ability of the cortex. Nerve block mainly depends on local anesthesia, and is helpful for lowering the additional dose of opioids and maintaining the hemodynamic stability.</p><p><strong>Conclusions: </strong>Compared with simple GA, GA plus SNB-TNB applied in TKA is more conducive to accelerating the recovery of patients, reducing the anesthetic dosage, enhancing the analgesic effect, with more stable hemodynamics and higher safety.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"85-91"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938343","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":"[Acute Pancreatitis as a Result of Supramesocolic Ischemia after Scoliosis Surgery].","authors":"Josef Včelák, Jan Štulík, Michal Barna, Andrea Špeldová","doi":"10.55095/achot2024/050","DOIUrl":"https://doi.org/10.55095/achot2024/050","url":null,"abstract":"<p><p>Ischemic complications in the supramesocolic anatomical region with the development of acute pancreatitis due to compression of the celiac artery or superior mesenteric artery are rare but potentially serious complications after major spine surgery. A case report of two patients with idiopathic scoliosis who underwent posterior instrumented correction and fusion with subsequent development of acute pancreatitis due to vascular compression of the retroperitoneum is presented. The manifestation of an acute abdomen within 24 hours after the surgery with elevation of pancreatic obstruction enzymes and confirmation of acute pancreatitis on CT angiography with abdominal pain, gastrectasia, and ileus clinical findings. In both cases, due to the clinical progression, acute revision spinal surgery was performed with release of the original deformity correction. Subsequently, in combination with conservative treatment of the acute abdomen, both patients achieved full clinical recovery.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"106-113"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938348","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":"[Predictors of Knee Replacement Following Meniscal Tear Arthroscopy: a 7-Year Risk Prediction Model].","authors":"Erik Fidler, Matúš Sloviak, Kateřina Langová, Jiří Gallo","doi":"10.55095/achot2024/066","DOIUrl":"https://doi.org/10.55095/achot2024/066","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The aim of this study was to analyze the outcomes of knee arthroscopy (KA) for degenerative meniscal tears in relation to early total knee arthroplasty (TKA) in the elderly population. The study focused on identifying the factors that influence the need for TKA within seven years after previous arthroscopic partial meniscectomy (APM).</p><p><strong>Material and methods: </strong>A total of 526 patients older than 64 years who underwent APM between January 1, 2010, and December 31, 2015, were included in the study. The patients were divided into three groups according to age. Specific patient data were extracted from the hospital information system. Preoperative, intraoperative, and postoperative data were collected according to a predefined protocol.</p><p><strong>Results: </strong>A total of 118 patients (22.4%) underwent TKA within seven years after KA, with a mean time to TKA of 35.5 months. Notably, up to 30% of patients required TKA within one year of their initial KA. The mean age at the time of TKA was 72.2 years. Women had a higher risk than men (24.4% vs. 19.2% men; p = 0.195). When all factors were analyzed, postoperative pain (OR = 4.17; 95% CI: 2.03-8.553), varus knee alignment (OR = 2.45; 95% CI: 1.20-5.01), and BMI (OR = 1.11; 95% CI: 0.02-1.20) were significant predictors of TKA. When considering only preoperative factors, varus alignment on radiographs (OR = 2.39; 95% CI: 1.21-4.71), a higher radiographic grade of knee osteoarthritis (OR = 1.85; 95% CI: 1.12-3.07), and BMI (OR = 1.09; 95% CI: 1.01-1.17) were the strongest predictors of early TKA. Among intraoperative/postoperative findings, the presence of medial chondropathy confirmed during KA (OR = 2.07; 95%CI: 1.52-2.83) and postoperative pain (OR = 5.02; 95% CI: 2.75-9.17) were the only significant predictors.</p><p><strong>Discussion and conclusions: </strong>This study highlights the risk of TKA in elderly patients undergoing APM. Previous studies have cautioned against performing this procedure in older patients, yet the optimal treatment for symptomatic knees with degenerative meniscal tears remains uncertain. Several factors may influence the progression of knee osteoarthritis in these patients, with knee biomechanics and pre-existing osteoarthritis being the most critical. Both can potentially be addressed with appropriate knee osteotomy, a procedure that has recently been shown to be effective in patients with knee osteoarthritis. Interestingly, age itself did not increase the risk of TKA in our study. In conclusion, our retrospective analysis showed that more than one-fifth of patients undergoing KA for degenerative meniscal tears may require TKA within seven years. In addition, preoperative varus knee alignment, advanced knee osteoarthritis, and higher BMI were identified as the strongest risk factors, suggesting that KA should be indicated with caution in such patients.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"67-76"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938371","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":"[Preoperative Incidence of Deep Venous Thrombosis and Its Risk Factors in Older Patients with Hip Fracture].","authors":"Tingming Pan, Dong Zhong, Hongjie Zhang, Jinchao Xu, Jianwei Guan, Xiang Peng","doi":"10.55095/achot2024/062","DOIUrl":"https://doi.org/10.55095/achot2024/062","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Hip fractures in the elderly are commonly complicated by deep venous thrombosis (DVT), particularly in the preoperative phase. This retrospective study aimed to determine the preoperative incidence of DVT and identify its risk factors in older patients with hip fractures.</p><p><strong>Material and methods: </strong>This single-center retrospective study enrolled 278 patients (aged ≥ 60 years) with unilateral hip fracture, who underwent color Doppler ultrasonography of the lower extremity veins on the day of surgery at the Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine between 1st January 2015 and 31st December 2020. Demographic data, clinical characteristics, and surgical history were analyzed. Multivariate logistic regression was used to identify independent risk factors for preoperative DVT.</p><p><strong>Results: </strong>The incidence of DVT was 15.5%, including peripheral venous thrombosis at 18.6% and central venous thrombosis at 5.4%. Univariate analysis showed no significant differences in gender, age, and type of fracture. However, delayed admission, longer time from admission to surgery, and atrial fibrillation were significant risk factors. Multivariate logistic regression analysis identified delayed admission (OR = 2.597, 95% CI 1.275-5.290, P = .009), prolonged time from admission to surgery (OR = 1.166, 95% CI 1.034-1.314, P = .012), and atrial fibrillation (OR = 2.848, 95% CI 1.115-7.275, P = .029) as significant independent risk factors for DVT.</p><p><strong>Conclusions: </strong>Early admission and prompt surgery of elderly patients with hip fractures are critical to prevent the occurrence of DVT. Atrial fibrillation remains a significant risk factor that requires close attention. Prospective studies are warranted to validate these findings and optimize prophylactic strategies.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"92-97"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938303","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 Outcomes of Treatment of the Mallet Finger with a Bone Fragment Using the Ishiguro Extension].","authors":"Martin Vlach, Dominik Krejčí, Vojtěch Havlas","doi":"10.55095/achot2024/059","DOIUrl":"https://doi.org/10.55095/achot2024/059","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The study aims to evaluate the mid-term functional and subjective outcomes of treatment of the mallet finger with a bone fragment using the Ishiguro extension block pinning. The hypothesis was that this technique provides reliable and high-quality outcomes with a low complication rate.</p><p><strong>Material and methods: </strong>The study included 54 patients aged 7-17 years who underwent surgery at our department between 2017 and 2022. The inclusion criteria were the diagnosis of the mallet finger with a Doyle type IVa and IVb bone fragment, subluxation of the distal interphalangeal joint, fracture fragment size greater than 30% of the articular surface on lateral view radiographs, and fragment dislocation greater than 2 mm. The surgeries were performed in line with the original description of the Ishiguro technique, with reduction and closed osteosynthesis of the fragment using Kirschner wires. The surgery was followed by fixation with a plaster cast for 4 weeks on average, and rehabilitation was recommended after pin removal. The outcomes were assessed using the QuickDASH questionnaire and the Crawford criteria.</p><p><strong>Results: </strong>The mean QuickDASH score was 3.8, the median score was 0.0. A total of 59% of patients reported no difficulty or limitations, and 37% described minimal extension deficit with no subjective difficulty. Only 4% of patients experienced more severe difficulty such as significant extension deficit or pin track infection. No secondary subluxation of the distal interphalangeal joint was observed.</p><p><strong>Discussion: </strong>The results of our study are in agreement with global literature, which also shows a predominantly excellent and good effect of the treatment of mallet finger by extension block pinning. Complications were associated with delayed treatment and patient noncompliance. The studies comparing different techniques show that the extension block pinning provides outcomes comparable to those achieved by other methods, or even better.</p><p><strong>Conclusions: </strong>The Ishiguro extension block pinning is a reliable, technically and financially undemanding technique that provides excellent outcomes in treating the mallet finger with a bone fragment. The use of this technique is also supported by the fact that it can be performed as an outpatient surgery under local anaesthesia and by its low complication rate. Nonetheless, further research is necessary to specify more accurately the indication criteria for surgical management of Doyle IVa and IVb lesions.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"77-82"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938320","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":"[Isolated Lateral Subtalar Dislocation Due to Low-Energy Trauma].","authors":"Nuri Koray Ülgen, Batuhan Gencer, Teoman Bekir Yeni, Doğan Özgür","doi":"10.55095/achot2025/001","DOIUrl":"https://doi.org/10.55095/achot2025/001","url":null,"abstract":"<p><p>Isolated subtalar dislocations constitute 1% of all dislocations and are extremely rare. They frequently occur as a result of high-energy trauma. Dislocations are classified based on the direction of the dislocation, with 80% being medial. Closed reduction under anesthesia without delay is the optimal treatment method. In our case, we present an extremely rare instance of an isolated lateral subtalar dislocation resulting from a low-energy injury. Although isolated subtalar dislocations are frequently reduced with closed reduction, open reduction was necessary in our case. The structure obstructing reduction in lateral dislocations is often reported to be the tibialis posterior tendon. During open reduction, we identified and documented the tibialis posterior tendon as the obstructing structure. We have also discussed the post-reduction follow-up protocol.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"114-117"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of the Results of Expanded Arthroscopic Debridement and 18-Gauge Percutaneous Tenotomy in Lateral Epicondylitis].","authors":"Ibrahim Faruk Adigüzel, Hünkar Cagdas Bayrak, Osman Orman, Samed Ordu","doi":"10.55095/achot2024/060","DOIUrl":"https://doi.org/10.55095/achot2024/060","url":null,"abstract":"<p><strong>Purpose of the study: </strong>This retrospective comparative study aims to evaluate the clinical outcomes, cost-effectiveness, and complication rates associated with two minimally invasive surgical techniques: extended arthroscopic debridement and 18-gauge percutaneous tenotomy.</p><p><strong>Material and methods: </strong>The study included 31 patients with resistant lateral epicondylitis who underwent either arthroscopic debridement (n=14) or percutaneous tenotomy (n=17) between January 2019 and June 2023. Outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and the Patient-Rated Tennis Elbow Evaluation (PRTEE) at preoperative, 3-month, 6-month, and 12-month intervals. Additionally, a detailed cost analysis was performed to compare the economic implications of both surgical techniques.</p><p><strong>Results: </strong>The results demonstrated significant improvements in both groups at 3 and 6 months postoperatively. However, by the 12-month follow-up, the arthroscopic group maintained stable clinical outcomes, while the percutaneous group showed a decline in MEPS and PRTEE scores, suggesting a potential regression in long-term efficacy. Despite this, the percutaneous tenotomy group benefited from a shorter procedure time, fewer complications, and a quicker return to work, making it a highly cost-effective alternative.</p><p><strong>Conclusions: </strong>In conclusion, while extended arthroscopic debridement offers sustained clinical benefits, particularly in long-term follow-up, 18-gauge percutaneous tenotomy emerges as a viable primary intervention due to its simplicity, low complication rate, and significant cost savings. Future studies with larger cohorts and longer follow-up periods are warranted to further elucidate the long-term effectiveness and patient satisfaction associated with these techniques.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 2","pages":"98-105"},"PeriodicalIF":0.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938368","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":"[Pediatric Upper Cervical Spine Injuries: a Systematic Review].","authors":"Lucie Salavcová, Jan Štulík, Ondřej Naňka","doi":"10.55095/achot2024/036","DOIUrl":"10.55095/achot2024/036","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The study aimed to systematically review the available literature focusing on upper cervical spine injuries in children, namely the age and sex of patients, epidemiology of injuries, classifications used, diagnosis and treatment methods, neurologic deficit, concomitant injuries, and potential complications.</p><p><strong>Material and methods: </strong>The systematic review was elaborated in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The studies assessing pediatric upper cervical spine injuries were searched for in the MEDLINE database in September 2023. The studies included were published between 1991 and 2022.</p><p><strong>Results: </strong>A total of 1354 studies were found through the database search. Subsequently, 53 articles were excluded as duplicates and 1217 due to irrelevant title or abstract. The full text of 84 studies was reviewed. Sixty-nine manuscripts failed to meet the predefined criteria. In the end, the systematic review was based on 15 studies. In the cohort of paediatric patients with upper cervical spine injuries, the girls accounted for 51.1% and boys for 48.9%. X-ray (64.9%) and CT (56.2%) were the most commonly used imaging for diagnosis, with MRI (51.5%) being the least used diagnostic method. Surgical procedure was opted for in treating more than a quarter of cases (27.6%). Most of the surviving patients were neurologically intact (69.2%), a fairly large number of patients (14.4%) died. The most common concomitant injury was craniocerebral trauma (39%) and the most common treatment complication was the instrumentation failure (11.3%).</p><p><strong>Discussion: </strong>Upper cervical spine injuries are rare in children and represent a relatively heterogeneous group. The literature on this topic is mostly inconsistent. Currently, there is just a few studies dealing with pediatric upper cervical spine injuries as a whole; more often the papers focus on a single type of injury. Inconsistencies also occur in defining the age limit for the pediatric spine and in defining the upper cervical spine. For these reasons, comparing the results of individual studies can be difficult.</p><p><strong>Conclusions: </strong>The mean age of pediatric patients with upper cervical spine injuries was 6.7 years, with a slight predominance of girls. The most common cause of injury was traffic accidents. X-ray and CT were the most commonly used diagnostic methods and surgical therapy was opted for in treating more than a quarter of cases. More than two-thirds of the surviving patients were neurologically intact. Instrumentation failure was the most common treatment complication and craniocerebral trauma was the most common concomitant injury.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 1","pages":"15-20"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717583","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":"[Combined Proximal Radius Reconstruction Following Resection for Oncological Indication].","authors":"Mário Malina, Matej Majerčík, Yousef Naser","doi":"10.55095/achot2024/068","DOIUrl":"10.55095/achot2024/068","url":null,"abstract":"<p><p>Early surgical treatment of giant cell tumour of the bone has very good functional outcomes with a relatively low risk of local recurrence and metastatic spread.In case of a pathologic fracture, extraosseous extension, and tumor location in an anatomically difficult area, surgical treatment may represent a big challenge with an uncertain functional outcome.Our case report presents a 35-year-old patient with a delayed diagnosis of giant cell tumor of the proximal radius of the dominant limb, with pulmonary metastases. Following neoadjuvant Denosumab therapy, with a major treatment effect on both the primary tumor and pulmonary metastases, we performed a wide resection and combined biological reconstruction with fibular autograft, radial head endoprosthesis, and comprehensive elbow ligament reconstruction.At 24 months after surgery, the patient is self-sufficient, capable of more physically demanding work, with a satisfactory functional outcome of reconstruction (MSTS 66.6%, TESS 69%), with no signs of local recurrence and regression of pulmonary metastases at 18 months after the last administration of Denosumab.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"92 1","pages":"52-57"},"PeriodicalIF":0.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717631","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}