Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca最新文献

{"title":"[Sagittal Profi le of the Spine in Patients after Lumbar Stabilisation Surgeries].","authors":"J Pešek, M Repko, L Ryba, D Matejička","doi":"10.55095/achot2024/001","DOIUrl":"10.55095/achot2024/001","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Spine stabilization surgery is nowadays one of the most common spinal surgical procedures. Spinopelvic alignment is considered to be an important factor impacting the patients' preoperative diffi culties as well as the outcome of surgery. In our study, the outcomes of stabilization surgeries in patients with lumbar spine disorders were evaluated - especially in those with stenosis and spondylolisthesis, in whom the importance of sagittal parameters were assessed with respect to the patients' clinical outcomes and diffi culties.</p><p><strong>Material and methods: </strong>The study included 50 patients with lumbar spine disorders who had undergone a spine stabilization surgery for a degenerative disease - lumbar spinal stenosis, spondylolisthesis between 2015 and 2017. Spino-pelvic radiological parameters and clinical parameters were evaluated using the nonparametric Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests.</p><p><strong>Results: </strong>In 38 of 50 patients, who at the end of the follow-up period did not have the PI-LL (pelvic incidence-lumbar lordosis) mismatch, i.e. PI-LL was ≤10°, a statistically signifi cant difference in pelvic tilt (p=0.049) and sagittal vertical axis (p<0.001) was reported, which was not the case in the remaining patients of the study population. Claudication and OSWESTRY (ODI) showed no statistically signifi cant difference. We have also compared the differences in the number of fused vertebrae and type of stabilization. A signifi cant change was seen in the claudication parameter at 12 and 24 months after surgery (p=0.007, p=0.005), with better outcomes achieved by 360° lumbar fusion compared to posterior lumbar fusion. The improvement of VAS and ODI scores in both the groups over time (from 6.1 to 3.6 or from 6.3 to 3.5 in VAS and from 62 to 32, or from 62 to 30 in ODI) was also statistically signifi cant (p<0.001 in both groups), while when comparing the groups against each other it was statistically insignifi cant.</p><p><strong>Discussion: </strong>The authors confi rmed signifi cant improvement in the studied clinical parameters in all groups of patients (VAS, ODI, claudication), which is consistent with the results of recently published papers. The authors also established the correlation between different radiological parameters in the studied groups. The results do not confi rm the importance of the length or type of instrumentation for the clinical outcomes. This is consistent with the fi ndings of other published manuscripts. The authors failed to confi rm a signifi cant change in clinical parameters in dependence on the matching relationship between the pelvic incidence and lumbar lordosis.</p><p><strong>Conclusions: </strong>Proper spinopelvic balance in patients after spinal surgery is a very important indicator of postoperative development and condition, but our cohort showed no statistically signifi cant difference in the clinical outcomes of patients wh","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"17-23"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048473","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":"Results of Allografts and Synthetic Grafts in Humeral Simple Bone Cysts.","authors":"M A Şahin, E Özkul, S Elçi","doi":"10.55095/achot2024/005","DOIUrl":"10.55095/achot2024/005","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Simple bone cysts (SBCs) are the most common benign bone lesions in childhood. There are many different methods in the treatment of SBCs. There is no consensus on which method to use in the treatment. In this study, we compared the results of allogeneic bone graft or synthetic bone graft in addition to fl exible intramedullary nail (FIN) for SBC located in the humerus.</p><p><strong>Material and methods: </strong>This retrospective study comparing the data of 19 (group 1: 8 curettage, allograft and FIN; group 2: 11 curettage, synthetic graft and FIN) patients with a mean age of 11.4 (6 to 26; seven female, twelve male) who were surgically treated in our hospital for humeral SBC between April 2014 and January 2020. Patient data included age, sex, anatomical side, stage of the cyst, pathological fracture, previous treatments and complications.</p><p><strong>Results: </strong>The mean follow-up period was 33.7 months (12 to 61). The average last follow-up Musculoskeletal Tumor Society functional scores for groups 1 and 2 were 27.8 (20 to 30) and 28.6 (21 to 30) (P > 0.05). Complete or signifi cant partial radiographic healing rates were achieved in group 1 (75%) compared with group 2 (81.9%). The reoperation rates for groups 1 and 2 were 62.5% (5/8; three for nails removed, two for recurrence) and 36.3% (4/11; two for nails removed, two for recurrence). One patient in group 2 had a 15° varus deformity due to recurrence. No other complications were observed.</p><p><strong>Conclusions: </strong>The combination of curettage-grafonage FIN is a common treatment method in recent years, as it provides early cyst healing and limb mobilization in SBCs located in the upper extremity. For defects after curettage of the bone cysts, allogeneic or synthetic grafts (granule b-tricalcium phospate) which have similar results in terms of healing can be used as an alternative to each other.</p><p><strong>Key words: </strong>allografts, bone cysts, bone nails, synthetic grafts, humerus.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"62-68"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048502","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":"Analysis of Punch Injuries: Clinical Characteristics, Management and Outcomes.","authors":"Y Ağirdil, Y Şahbat","doi":"10.55095/ACHOT2024/029","DOIUrl":"https://doi.org/10.55095/ACHOT2024/029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;The aim of this study is to describe injury patterns, characteristics, treatment modalities and functional outcomes after punching related injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;Retrospective data of cases admitted to emergency department following punch injury between January 1, 2012, and December 31, 2022. was collected. Patient's demographic data, the dominant and injured upper extremity side, punched object, a time of patient admission were recorded. Smoking habit and blood ethanol level were documented. Trauma mechanism, diagnosis (1: dermabrasions: skin, 2: lacerations: neurovascular structures or tendons and 3: osseous pathologies), treatment modalities were analyzed. Outcomes were assessed using the DASH questionnaire (Disabilities of the Arm, Shoulder, and Hand) at the last follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1052 patients (male=968 (92%), female=84 (8%)) with mean age 24.6 ± 7.2 included this study. Six hundred and twenty-one (59%) patients punched a solid object and 675 (64%) had osseous pathology. The most commonly fractured bone, injured tendon, injured nerve, and injured artery were 5th metacarpal, extensor digitorum communis (EDC), ulnar nerve, and ulnar artery, respectively. The majority of the patients, (73%) were smokers while 15% of the patients had high level of blood ethanol concentration on admission (82±12.3 mg/100 ml). A comparison between smokers and non-smokers did not reveal any significant differences (p=0.425) in terms of diagnosis whereas 74% of alcoholic patients admitted with lacerations which was statistically significant (p=0.023). Injuries of 321 (30.5%) patients required surgery in the operating room, while 711(67.5 %) patients received interventions in the emergency room setting. The average DASH score differed between subgroups, with significantly higher scores in patients with laceration type injuries (7.2 SD), indicating more disability (p=0.001) DISCUSSION. The study reveales a high prevalence of hand injuries among individuals aged 18 to 40, with the dominant hand being most affected, primarily due to physical violence and self-harming behaviors. Primary contributing factors to this pattern are the escalated incidents of physical violence and self-harming behaviors arising from an inability to manage anger impulses. Punching solid objects, especially during late afternoon and evening periods often associated with alcohol use, was a common cause, resulting in metacarpal fractures being the most reported injury. Multiple tendon and nerve injuries were frequent, highlighting the severity and complexity of these traumas, often necessitating surgical intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings highlight the several key aspects, including demographic characteristics of the patient population, common causes and types of injuries observed, and the association between alcohol use as well as the specific injury profiles","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"222-228"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339053","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":"Is Extensor Indicis Proprius Tendon Transfer an Innocent Surgical Procedure for the Restoration of Extensor Pollicis Longus Function?","authors":"K Uzel, F Aydin, Z M Asfuroğlu, E Gümüşoğlu, M M Eskandari","doi":"10.55095/ACHOT2024/039","DOIUrl":"https://doi.org/10.55095/ACHOT2024/039","url":null,"abstract":"<p><strong>Purpose of the study: </strong>The aim of this study to evaluate the subjective and objective results of Extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfer with an emphasis on donor site morbidity.</p><p><strong>Material and methods: </strong>17 patients (59% men, 41% women) who underwent EIP-EPL transfer were retrospectively analyzed. The mean age was 43 (9-64) years, and the mean follow-up was 72 (19-124) months. The extensor strengths were measured according to the Medical Research Council (MRC) scoring system. Nail tip-table surface distance (NTD) was measured to evaluate extension loss, and pulp-palm distance (PPD) to evaluate thumb flexion-adduction limitation. Grip and key pinch strengths were measured and corrected regarding the dominance and compared with those of the non-operated side. Quick Disability of Arm, Shoulder, and Hand (QDASH) and satisfaction scores of the patients were evaluated.</p><p><strong>Results: </strong>Donor site morbidity was detected in 6 patients (35%). The extension strength of the index finger was found to be significantly lower than the non-operative side (p<0.05). Thumb mean NTD and PPD values were 6.8 (0-50) and 2.9 (0-20) mm, respectively. The index finger mean NTD was 0.6 (0-10) mm. The grip strength was 86% (43%-100%) and the pinch strength was 82% (31-100%) of the expected strengths. Compared to the preoperative period, there was a significant decrease in the QDASH score (p <0.05). Postoperative QDASH scores of patients with donor site morbidity were significantly higher than those without (p <0.05).</p><p><strong>Conclusions: </strong>Although patients are generally satisfied with the EIP-EPL transfer results, the permanent morbidity rate in the index finger is high. Therefore, alternatives other than EIP should be considered for transfer to EPL in individuals whose occupation requires complete and strong index finger extension.</p><p><strong>Key words: </strong>extensor pollicis longus, neglected tendon laceration, extensor indicis proprius, tendon transfer, donor site morbidity.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 6","pages":"364-368"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942397","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":"Application of Ortho-Bridge System after Femoral Bone Transport.","authors":"Jinxing Yang, Shuyu Liu, Zicai Fu, Qin Xu, Jianyi Xiong, Weimin Zhu, Lijun Liu","doi":"10.55095/ACHOT2024/043","DOIUrl":"https://doi.org/10.55095/ACHOT2024/043","url":null,"abstract":"<p><p>The bone transport technique uses the principle of distraction-osteogenesis and fill bone defects with the aid of an external fixator. In order to evaluate the clinical effect of femoral internal fixation with Ortho-Bridge System after bone transport, 4 patients after femoral bone transport from October 2020 to October 2022 are studied in this paper. Among them, 3 patients ran refracture of femur after removal of the Limb reconstruction system, 1 patient just finish femoral bone transport and request internal fixation. The surgery results show that Ortho-Bridge System can be used in the situation that conventional Locking compression plate and intramedullary nail are not suitable due to anatomical variation after femoral bone transport. Key words: femoral fracture; Ortho-Bridge System; bone transport; postoperative complications of bone transport.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 5","pages":"269-275"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574947","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":"Two-Stage Treatment Protocol of Fungal Periprosthetic Hip and Knee Joint Infections: the Clinical Experience from a Single Center Experience.","authors":"J Xu, W Sun, Y Wang, H Jiang, H Ding, Q Cheng, N Bao, J Meng","doi":"10.55095/achot2024/003","DOIUrl":"10.55095/achot2024/003","url":null,"abstract":"<p><strong>Purpose of the study: </strong>To evaluate the clinical results and safety of fungal periprosthetic joint Infections (fPJIs) using two-stage treatment protocol.</p><p><strong>Material and methods: </strong>8 patients with fPJIs (3 hips and 5 knees) using two-stage revision were reviewed retrospectively and followed up at least 2 years. The preoperative demographic data, two-stage treatment protocol, results of microbiology and histologic workup and postoperative follow-up results (reimplantation success rate and infection free time) were recorded.</p><p><strong>Results: </strong>7 patients got successful reimplantation, with a 75% reimplantation success rate. Two patients got knee arthrodesis eventually. All patients were infection free with a median follow-up of 4.0 ± 2.0 years (range, 2-7 years). Of them, Candida species were found in 7 patients, while non-Candida specimen was only isolated in 1 patient with Aspergillus. Only 2 patients had coexisting bacterial infection (Methicillin-resistant coagulase-negative Staphylococci and Proteus mirabilis respectively). The average interval between the initial surgery and diagnosis of fPJIs was 21.50±34.79 months (range, 4-104 months). The mean time of spacer implantation was 7.75±2.77 months (range, 6-14 months). None serious complication or above knee amputation was found.</p><p><strong>Discussion: </strong>fPJIs are very rare and considerable challenge after total hip or knee arthroplasty. The goal of therapy is to eradicate local infection and maintain function. Candida species were the most common pathogen. The duration between spacer placement and staged reimplantation was highly variable, and generally dependent upon the results of joint aspirates and infl ammatory markers. The current study shows that the two-stage treatment protocol is recommended for fungal periprosthetic hip and knee joint infections.</p><p><strong>Conclusions: </strong>The two-stage treatment protocol is recommended for fungal periprosthetic hip and knee joint infections. The safety and effi cacy of biantibiotical impregnated (antifungal + antibiotics) cement spacer is confi rmed. Further evidence-based work is needed to determine the optimal drug dose and reimplantation time.</p><p><strong>Key words: </strong>two-stage treatment protocol, fungal periprosthetic infections, hip spacer, knee spacer.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 1","pages":"52-56"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048504","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 Quality of the Most Commonly Used New UHMWPE Articulation Inserts of the Total Knee Replacement].","authors":"D Pokorný, M Šlouf, V Gajdošová, I Šeděnková, M Vyroubalová, K Němec, P Fulín","doi":"10.55095/achot2024/026","DOIUrl":"https://doi.org/10.55095/achot2024/026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of study: &lt;/strong&gt;Total joint replacements (TJR) have become the cornerstone of modern orthopedic surgery. A great majority of TJR employs ultrahigh molecular weight polyethylene (UHMWPE) liners. TJR manufacturers use many different types of UHMWPE, which are modified by various combinations of crosslinking, thermal treatment, sterilization and/or addition of biocompatible stabilizers. The UHMWPE modifications are expected to improve the polymer's resistance to oxidative degradation and wear (release of microparticles from the polymer surface). This manuscript provides an objective, non-commercial comparison of current UHMWPE formulations currently employed in total knee replacements.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;UHMWPE liners from 21 total knee replacements (TKR) were collected which represent the most implanted liners in the Czech Republic in the period 2020-2021. The UHMWPEs were characterized using several methods: infrared microspectroscopy (IR), non-instrumented and instrumented microindentation hardness testing (MH and MHI), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and solubility measurements. The above-listed methods yielded quite complete information about the structure and properties of each UHMWPE type, including its potential long-term oxidation resistance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For each UHMWPE liner, IR yielded information about immediate oxidative degradation (in the form of oxidation index, OI), level of crosslinking (trans-vinylene index, VI) and crystallinity (CI). The MH and MHI testing gave information about the impact of structure changes on mechanical properties. The remaining methods (DSC, TGA, and solubility measurements) provided additional information regarding the structure changes and resistance to long-term oxidative degradation. Statistical evaluation showed significant differences among the samples as well as interesting correlations among the UHMWPE modifications, structural changes, and mechanical performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Surprisingly enough, UHMWPE materials from different manufacturers showed quite different properties, including the resistance against the long-term oxidative degradation, which is regarded as one of the main reasons of TJR failures. The most promising UHMWPE types were crosslinked materials with biocompatible stabilizers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Current UHMWPE liners from different manufactures used in total knee replacements exhibit significantly different structure and properties. From the point of view of clinical practice, the traditional UHMWPE types, which contained residual radicals from irradiation and/or gamma sterilization, showed inferior resistance to oxidative degradation and should be avoided. The best properties were observed in modern UHMWPE types, which combined crosslinking, biocompatible stabilizers, and sterilization by ethylenoxide or gas plasma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;K","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"207-216"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339047","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":"[Mid Term Results of Treatment of Unstable Slips of Proximal Femoral Epiphysis by Closed Reduction].","authors":"J Chomiak, M Ošťádal, P Dungl","doi":"10.55095/achot2024/025","DOIUrl":"https://doi.org/10.55095/achot2024/025","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose of the study: &lt;/strong&gt;The study aimed to evaluate the results of closed reduction and epiphyseodesis of unstable slips of the proximal femoral epiphysis. The hypothesis was that the clinical and radiological results of this method and incidence of avascular necrosis are comparable to the results of closed reduction and open reduction using surgical hip dislocation reported by literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material and methods: &lt;/strong&gt;In the period 2013-2023, 20 patients were treated for unstable slips in one institution. Whereas the boys were older (mean age of 13.4 years) than girls (mean age of 11.6 years), the gender distribution was equal. Acute on chronic slips prevailed over the acute slips (ratio 3:1). The slips were treated using the closed reduction, transphyseal fixation and capsular decompression at 6 to 240 hours after slip (81 hours on average). All patients were treated concurrently on the contralateral side as the prevention of the slip or to treat the grade I slips (two patients). The follow-up ranged from 7 months to 7 years. Clinical results were evaluated according to two scores: 1) own score (Bulovka University Hopspital score) based on the reduction of ROM, shortening of extremity and limitations of activities; 2) D'Aubigne-Postel score. In the radiological evaluation, correction of slip angle, alpha-angle, avascular necrosis (AVN) and the prominence of the anterior margin of the femoral neck on axial radiographs were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;According to the Bulovka University Hospital score, there were 10 excellent results (50%) with no limitation of activity, including sport, in tree cases the results were very good (15%) and in five cases good (25%), respectively, with some limitation of activity, and two results were unsatisfactory (10%) with severe limitation of activity due to the AVN. According to the D'Aubigne-Postel score, there were 14 excellent results (70%), four good results (20%), and two unsatisfactory results (10%). The slip reduction was as follows: under 20 deg. in five patients; under 30 deg. in 10 patients, and over 30 deg. in five patients, respectively. Alfa-angle was greater than 63 degrees (range 45-88 deg.) on average. Prominence of the off-set epiphysis-femoral neck and femoroacetabular impingement (FAI) were observed in six patients. Remodelling of this prominence was seen in one patient four years after surgery. Shortening of the femoral neck over 1 cm was reported in two patients. Complete AVN with severe deformity of the hip was noted in two patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Our hypothesis was confirmed because the results of treatment of the unstable slips by closed reduction are comparable with the published results of the same method and with surgical hip dislocation. The results correspond with those of large published cohorts of patients concerning the correction as well as rate of complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;According to","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 4","pages":"199-206"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339051","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":"Viscosupplementation with High Molecular Weight Hyaluronic Acid for Hip Osteoarthritis: a Systematic Review and Meta-Analysis of Randomised Control Trials of the Efficacy on Pain, Functional Disability, and the Occurrence of Adverse Events.","authors":"R Patel, G Orfanos, W Gibson, T Banks, G McConaghie, R Banerjee","doi":"10.55095/ACHOT2024/009","DOIUrl":"10.55095/ACHOT2024/009","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Hip osteoarthritis (OA) has a prevalence of around 6.4% and is the second most commonly affected joint. This review aims to assess the clinical outcomes of intra-articular high molecular weight hyaluronic acid (HMWHA) in the management of hip osteoarthritis.</p><p><strong>Material and methods: </strong>We conducted a comprehensive search across PubMed, Google Scholar, and the Cochrane Library for randomised trials investigating the effectiveness of high molecular weight hyaluronic acid (HMWHA) in the treatment of hip osteoarthritis. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. To synthesise the data, we utilised the Standardised Mean Difference (SMD) for assessing pain relief through the Visual Analogue Scale (VAS) and the Lequesne index (LI) for evaluating functional outcomes. Risk Ratio (RR) was calculated to assess the occurrence of complications.</p><p><strong>Results: </strong>A total of four studies involving HMWHA and control groups were included. The standardised mean difference (SMD) for the Visual Analogue Scale (VAS) (SMD -0.056; 95% CI; -0.351, 0.239; p = 0.709) and the Lequesne index (SMD -0.114; 95% CI; -0.524, 0.296; p = 0.585) were not statistically significant. Analysis for complications demonstrated an overall relative risk ratio (RR) of 0.879 (95% CI; 0.527, 1.466; p = 0.622), and was not statistically significant.</p><p><strong>Discussion and conclusions: </strong>Intra-articular HMWHA in hip OA can significantly reduce pain and improve functional recovery when compared with the condition before treatment. However, there is no significant difference between HMWHA, or saline, or other therapeutic treatments. Currently, available evidence indicates that intra-articular HMWHA in hip OA would not increase the risk of adverse events.</p><p><strong>Key words: </strong>hip osteoarthritis, hyaluronic acid, intra-articular, molecular weight, viscosupplementation.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 2","pages":"109-119"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157454","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 Prevalence and the Clinical Importance of os vesalianum pedis.","authors":"C Uğuz Gençer, H Tetiker, M I Koşar, N Çullu","doi":"10.55095/ACHOT2024/053","DOIUrl":"https://doi.org/10.55095/ACHOT2024/053","url":null,"abstract":"<p><strong>Purpose of the study: </strong>Os vesalianum pedis (OVP) is a rare accessory bone of the foot located at the base of the fifth metatarsal bone. It is usually asymptomatic and incidentally seen on radiographs. When symptomatic, it manifests itself with lateral foot pain. OVP, which can become symptomatic as a result of traumatic injuries, can also be confused with fracture. The aim of this study is to determine the prevalence and morphometric characteristics of OVP in the Turkish population.</p><p><strong>Material and methods: </strong>Radiographic images of 5268 individuals aged 16 years and older (mean 39.65±17.21) who completed ossification of the fifth metatarsal bone were evaluated for OVP. Of the cases included in the study, 44.8% were female and 55.2% were male. The general and sex-based prevalence of OVP was calculated, and morphometric measurements were done.</p><p><strong>Results: </strong>OVP prevalence in the Turkish population was found to be 0.15% regardless of sex. OVP prevalence was calculated to be 0.24% in men and 0.04% in women.</p><p><strong>Conclusions: </strong>Anatomy, radiology, orthopedics and emergency medicine physicians are frequently encountered with foot disorders in clinical and educational practices. It is important to keep in mind the rare presence of OVP (0.15%), in the preliminary diagnosis.</p><p><strong>Key words: </strong>os vesalianum pedis, accessory ossicle, foot, radiography.</p>","PeriodicalId":6980,"journal":{"name":"Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca","volume":"91 5","pages":"296-300"},"PeriodicalIF":0.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574962","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}