Could temporary external fixation after reduction of displaced acetabular fractures prevent posttraumatic heterotopic ossification?

Objectives: To recommend appropriate immobilization after the initial reduction of acetabular displaced fractures in order to minimize the risk of heterotopic ossification formation.

Design: Retrospective study of patients treated in our surgical department during the years 2005-2018.

Materials And Methods: There were 94 patients included in statistical analysis.

[Descending Thoracic Aortic Injury in Flail Chest].

The authors present a case of 74-year-old female patient who suffered a flail chest in motor vehicle accident. First day after injury a descending thoracic aorta was injured, most likely during manipulation with the patient. This injury was verified by operation, which was indicated 26 hours after the hospital admission, because of a sudden decrease of blood pressure with blood loss over 600 ml through the chest tube.

[Surgical Treatment of Clavicle Midshaft Fractures - Prospective Randomized Trial].

PURPOSE OF THE STUDY Comparison of the outcomes of clavicle midshaft fractures using two different surgical techniques, namely intramedullar osteosynthesis using elastic stable intramedullary nailing (ESIN) with medial cap and extramedullar plate osteosynthesis. MATERIAL AND METHODS The prospective randomized trial was conducted at the Department of Trauma Surgery of the Department of Surgery of the University Hospital Hradec Králové in the Czech Republic at the Level I Trauma Center between 2014 and 2018 and compared two types of osteosynthesis of clavicle midshaft fractures. 60 patients were enrolled in the study and were randomly assigned to one of the two groups.

Initial chest X-ray in multiple trauma patients: Still works!

Objective: Blunt thoracic aortic injury is life-threatening injury. High suspicion on this clinical condition can be made by initial chest X-ray on emergency department. The aim of study was to detect which other signs, except widened mediastinum, are specific for rupture of the thoracic aorta.

[Role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to Save Life in Bleeding in a Patient with a Pelvic Ring Injury].

The author presents a case study of the use of resuscitative endovascular balloon occlusion (REBOA) as a suitable alternative to thoracotomy and clamping of the descending aorta to control retroperitoneal bleeding in a patient with a pelvic injury. The patient who suffered multiple trauma after car accident, type C pelvic injury and retroperitoneal bleeding among other things, was following the pre-hospital ambulance care transported to the department of emergency medicine, with catecholamine infusion to support the blood flow. After the primary survey following the ATLS principles, the patient was taken for a CT scan.

Deceleration thoracic aortic ruptures in trauma center level I areas: a 6-year retrospective study.

Objectives: This retrospective study aimed to analyze the trend of mortality due to thoracic aortic ruptures caused by deceleration injuries that occurred within the catchment area of Hradec Kralove University Hospital.

Materials And Methods: The study sample comprised 175 patients who had sustained thoracic aortic ruptures caused by deceleration injuries and were transported to Hradec Kralove University Hospital in 2009-2014. The small proportion of patients enrolled in this retrospective study were diagnosed and treated at the emergency department (ED).

[Extracapsular Proximal Femoral Fractures - Retrospective Evaluation of a Group of Patients with a Focus on Complications of Treatment].

PURPOSE OF THE STUDY The purpose of this study is to retrospectively evaluate the treatment and the complications in patients with extracapsular proximal femoral fractures. MATERIAL AND METHODS The evaluation focused on a group of patients who underwent a surgery at the authors department in the period from 1 January 2011 to 31 December 2013. The inclusion criteria were a simple fall and a monotrauma.

Fibular Strut Graft for Posterior Pelvic Ring Nonunion - a Case Report.

Posttraumatic pelvic nonunions in combination with malposition are uncommon in the present-day era of modern pelvic surgery. The case describes a new surgical technique for treatment of the nonunion localized to iliosacral joint. A 42-year-old polytraumatized male presented with a pelvic fracture (type 61-C2.

[Impaired Healing after Surgery for Femoral Fractures].

Purpose Of The Study: The aim of the study was to analyse causes of impaired bone healing in femoral fractures and to present options of their management.

Material And Methods: This is a retrospective study of the data on complications prospectively collected between 2008 and 2013. The patients admitted for primary treatment at the Trauma Centre of the Faculty of Medicine in Hradec Kralove from January 2008 to December 2013 included 1186 patients with injury severity scores (ISS) > 15 and 1340 patients with new injury severity scores (NISS) >15, all older than 16 years.

Crossover external fixator for acetabular fractures: a cadaver study.

Background: Dislocated acetabular fractures in polytraumatized patients are very challenging cases to deal with. Temporary stabilization by skeletal traction is difficult in these patients. A more effective solution can be an external fixation.

[Surgical treatment of ischial apophysis avulsion. Case report].

The optimal management of ischial apophysis avulsion, especially indications for surgery, is not well defined. The authors present the case of a 16-year-old man who sustained an avulsion fracture of the ischial apophysis during his athlete training programme. The avulsion was diagnosed by X-ray.

[Surgical treatment of humeral diaphyseal fractures].

Purpose Of The Study: The aim of the study was to compare two surgical methods of treating diaphyseal fractures of the humerus.

Material And Methods: A prospective randomised study on the surgical treatment of humeral diaphyseal fractures was carried out between September 2009 and January 2013. The patients indicated for surgical treatment fell into two groups according to the technique used as follows: minimally invasive plate osteosynthesis (MIPO) with a locking compression plate (LCP; Synthes, Switzerland); depending on the fracture type and course of fracture line, either a straight narrow or a Philos or a metaphyseal LCP was used (group 1); and intramedullary nailing (EHN, Synthes, Switzerland) (group 2).

Reamed versus unreamed nail in the treatment of tibia shaft fractures.

Purpose: The aim of the prospective randomized study was to compare the results of the treatment of tibia shaft fractures (TSF) by reamed or unreamed intramedullar nail.

Methods: There were 103 patients with 104 TSF enrolled in the study within the period from December 2005 to June 2010. Seven patients were excluded from the study.

Percutaneous iliosacral screw placement using a radiolucent drive.

Percutaneous iliosacral screw placement is a standard stabilisation technique for pelvic fractures. It is a demanding operative technique. Various methods of guidance are currently available.

[True/Flex intramedullary nailing for forearm shaft fractures. Long-term results].

Purpose Of The Study: Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures.

Material And Methods: Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).

[Surgical treatment for proximal humerus fracture].

Purpose Of The Study: The aim of the study was to compare the medical aspects of alternative surgical methods for treatment of proximal humerus fractures in specific indications (two- and three- fragment fractures).

Material And Methods: A prospective randomised study on surgical treatment of two- and three-fragment fractures of the proximal humerus was carried out at the Department of Surgery, University Hospital in Hradec Králové, from January 2006 till January 2010. The study comprised patients with proximal humerus fractures indicated for surgical treatment.

[Surgical repair of bladder rupture associated with the pelvic fracture without suprapubic tube--a case report].

The authors are presenting a case of 42-year-old polytraumatized man with pelvic fracture associated with extraperitoneal urinary bladder rupture. This was verified by intraoperative retrograde cystography and treated with suture without making suprapubic tube drainage. Urinary draining was assured with a transurethral permanent urinary catheter.

[Radial nerve palsy caused by a nonunion of the humeral shaft--a case report].

This is a case of late-onset radial nerve palsy associated with the nonunion of the humeral shaft. Nonunion formation was caused by insufficient osteosynthesis and lack of proper biomechanical conditions for fracture healing. A good final outcome was achieved by simultaneous surgical treatment both nonunion of the humerus and radial nerve palsy.

[Case report: fat embolism syndrome--grave handicap after traumatic long-bones fractures].

Embolism of fat and bone marrow tissue is quite often due to bone fractures but it is seldom with signs of systemic involvement as a fat embolism syndrome. The main forming factor is late stabilization of fractures and hypovolemia too. Clinical image of fat embolism syndrome results from lung and systemic microembolism which leads to activation of inflammatory and thrombogenic cascades.

[Expert Tibial Nail (ETN) for treatment of diaphyseal tibial fractures in current and extended indications: technique and clinical results].

Purpose Of The Study: To present the authors' technical experience with the use of the Expert Tibial Nail (ETN) technique and its clinical results.

Material And Methods: Between December 2005 and the end of 2007, the ETN technique was used in 41 patients to treat 41 diaphyseal tibial fractures. All patients were followed-up prospectively.

[Percutaneous fixation of anterior column acetabular fractures--first experience].

Purpose Of The Study: Percutaneous fluoroscopy-assisted fixation of acetabular fractures is not a widely used technique. Its advantage lies particularly in percutaneous placement of screws in the anterior column of the acetabulum. The operative procedure is described and the first experience of the authors with this minimally invasive technique at their department is reported.

[Minimally invasive plate osteosynthesis (MIPO) in the humeral diaphysis fractures].

Introduction: Most of the humeral shaft fractures can be successfully treated conservatively. Due to increasing number of multiple and high-energy injuries, necessity of patient's compliance and restriction of his selfcare is conservative treatment in background. Humeral shaft fractures indicated to operation treatment are mostly solved by closed reposition and internal fixation with intramedullar nail (CRIF) or open reposition and internal fixation (ORIF).

[Operation treatment of the humeral shaft fractures].

Introduction: Nowadays the humeral shaft fractures represent about 4% of all fractures. Most of them can be treated conservatively. In this type of treatment the cooperation of the patient is necessary, treatment is long lasting and needs the extremity to be immobilized.

[Surgical management of proximal humeral fractures using the Hackethal (Zifko) method--a case review].

Background: Fractures of the proximal humerus actually represent 5% of all fractures and 45% of all humeral fractures with the highest incidence in women over 60 years of age. The outcomes of the greatest concern at these patients (pain, function of the shoulder and activities of daily living) get worse with age, osteoporosis, grading of fracture type and of initial fracture displacement. According to the literature (Evidence Based Medicine--EBM level II-III) operative treatment of displaced fractures reduces pain and need for assistance in activities of daily living, but open reduction with internal fixation by conventional screws and plates was connected with implant loosening, infection and avascular necrosis, whereas closed reduction with different methods of miniinvasive percutaneous stabilisation is threatened by primary malreduction.