Comparison of the results and complications of palmar and dorsal miniinvasive approaches in the surgery of scaphoid fractures. A prospective randomized study.

Aims: To compare the functional results and complications associated with palmar percutaneous and dorsal limited approaches in the surgical treatment of nondisplaced or minimally displaced scaphoid fractures type B2.

Methods: A total of 76 patients with acute nondisplaced or minimally displaced type B2 scaphoid fractures were included in a prospective randomised study. The assignment patients to groups according to type of operative approach was based on systematic sampling.

[A Palmar percutaneous volar versus a dorsal limited approach for the treatment of non- and minimally-displaced scaphoid waist fractures: an assessment of functional outcomes and complications].

Purpose Of The Study: Non-displaced or minimally displaced scaphoid waist fractures can be surgically treated using either the percutaneous volar or the limited dorsal approach.These techniques provide a possibility of early wrist physiotherapy throughout the healing period, better functional outcomes and a shorter sick leave duration.Many reports cite low complication rates.

[Proximal row carpectomy in the treatment of degenerative arthritis of the wrist].

Purpose Of The Study: To evaluate the outcome in patients treated by proximal row carpectomy at a follow-up of at least 12 months.

Material: A total of 28 patients were treated by proximal row carpectomy for degenerative arthritis of the wrist due to previous trauma to the wrist or avascular necrosis of the lunate. Of them, 24 underwent a follow-up examination at least 12 months post-operatively.

Spontaneous consolidation of scaphoid nonunion in a child.

Background: Scaphoid nonunion is very rare in childhood.

Case Report: A 14 year old boy with scaphoid nonunion confirmed with CT did not past scheduled surgery. In spite of the short period of immobilisation union occurred and two years after the injury he was completely asymptomatic.

Azygos vein injury in blunt chest trauma.

Injuries to the azygos vein in a blunt chest trauma are uncommon and have previously been described in only 21 cases. The diagnosis is crucially based on massive right haemothorax with signs of shock, hypotension and altered mental status. The severity of the trauma, speed of transport and surgical intervention are often decisive for the survival of the patient.

Distal scaphoid resection arthroplasty for scaphoid nonunion with radioscaphoid arthritis.

The authors compare the functional outcome of 8 patients treated by distal scaphoid resection arthroplasty for scaphoid nonunion with symptomatic wrist arthritis before surgery and after a minimum follow-up of 6 months. There was a significantly better range of radial deviation and grip strength at the time of re-examination. Significantly fewer patients complained of resting pain.

Percutaneous osteosynthesis versus cast immobilisation for the treatment of minimally and non-displaced scaphoid fractures. Functional outcomes after a follow-up of at least 12 month.

The authors compare the functional outcome of 26 patients successfully treated by percutaneous osteosynthesis and 24 patients successfully treated by a short-arm thumb cast for the acute scaphoid fracture after a follow-up of at least 12 months. The patients treated by percutaneous osteosynthesis showed a significantly better range of wrist motion at the time of re-examination. Differences in persistent complaints and in grip strength compared to the uninjured wrist between both groups were statistically insignificant yet slightly in favour of the surgically treated patients.

[Non-union in os scaphoideum and its surgical treatment: overview of literature].

Authors present an overview of surgical methods used for the treatment of os scaphoideum with a focus on currently most frequent operations. In the period between January 1998 and March 2004, the authors performed 100 operations on the scaphoid bone, of this 54times primary fixation and 46times surgery for non-union in 42 patients. The most frequent method was resection of non-union, implantation of tri-cortical bone graft and internal fixation (17times).

[Percutaneous osteosynthesis of scaphoid fractures: preliminary results].

Purpose Of The Study: To evaluate the results of percutaneous osteosynthesis of scaphoid fractures and to verify whether this approach is more effective than conservative treatment.

Material: A total of 25 patients were treated by percutaneous osteosynthesis at the Emergency and Accident Department of the University Hospital in Olomouc from March 1, 2002, till March 31, 2003. According to the Herbert classification, five had type A2 fractures, four had type B1 and 16 had type B2 fractures.

[Fractures of the sternum].

Purpose Of The Study: Assessment of the authors' group of patients with a fracture of sternum and comparison with available literary findings.

Material And Methods: In a group of 188 patients with a blunt injury of chest who were hospitalised in the Faculty Hospital in Olomouc in the period of 1996-1999 there were 7 cases with the diagnosis of the fracture of sternum. In this group of patients we observed the cause of injury, occurrence of associated injuries, the potential of diagnostic methods, method of treatment and duration of hospitalization.

[Non-penetrating thoracic injuries].

The authors compare the causes and severity of non-penetrating chest injuries during two three-year periods: 1986-1989 and 1996-1999. Within the 10-year interval the incidence of blunt chest injuries increased by almost 124%, the mean age of the casualties reduce by five years and the most frequent cause were road accidents. Chest injuries are in more than half the casualties part of multiple injuries or polytraumatism.

Axillary artery injury in closed fracture of the humeral neck.

A case of atherosclerotic axillary artery rupture in closed fracture of the proximal part of the humerus is described. It demonstrates a possible serious arterial injury in elderly persons even in case the fracture of the humeral neck is not dislocated. If there are signs of disturbed circulation in these injuries, angiography is indicated irrespective of the type of fracture and mechanism of injury.

[Is treatment of acromioclavicular dislocation with coraco-clavicular cerclage justified?].

The authors analyze the results of treatment of AC luxation by the method of coracoclavicular cerclage at the First Surgical Clinical of the Faculty Hospital and Policlinic in Olomouc in 1968-1988. A total of 18 patients were examined after an average period of 12.5 years following operation.