CURRENT TREATMENT OPTIONS OF DUPUYTREN´S DISEASE.

Dupuytren's disease (fibromatosis of the palmar fascia, benign neoplastic fibromatosis, Dupuytren's contracture) is a disease characterized by growth and successive contracture of single parts of the palmar aponeurosis. This condition is known and has been treated for several centuries. In the advanced stages of the disease, it leads to significant limitation of hand function, resulting in reduced quality of life of the patient.

Management of infected tibial fractures and chronic tibial osteomyelitis by muscle flap transfer: a comparison of two series of patients.

Objective: The goal of this work is to compare therapeutic results of two groups of patients with an infected fracture or chronic osteomyelitis of the lower leg and ankle joint treated by the method of radical debridement followed by free flap transfer or muscle transposition.

Patients: In the period between 1 January 2002 and 30 September 2007 the authors used this method in the treatment of 52 patients (10 females and 42 males) with the average age of 44 years (ages ranged from 10 to 67). The observed group of patients was divided into retrospective and prospective subgroups.

[Reccurent tibial osteomyelitis after the segmental bone transport: a radical interdisciplinary treatment].

Long-term or recurrent osteomyelitis results in the deterioration of soft tissue quality at the site of an infectious process. An insufficient perfusion of the scar tissue contributes to difficult treatment of osteomyelitis. A local transpositional or free muscle flap used to replace the vulnerable scar tissue will enhance perfusion of the affected bone and will help to control osteomyelitis.

[Plastic and reconstructive surgery and orthopaedics interdisciplinary cooperation in the management of extremity injuries. Review].

Gradual particularization of medicine, as witnessed during the second half of the 20th century, resulted in a detailed development of individual subspecializations. Association of therapeutic options resulting from enormous development of these subspecialization brought a new dimension to the treatment of formerly unmanageable conditions. The closest cooperation between a plastic surgeon and a traumatologist is required in the management of patients with serious extremitiy injuries.

[Muscle flap transfer of the treatment of infected tibial and malleolar fractures and chronic osteomyelitis of the tibia].

Purpose Of The Study: The aim of the study was to evaluate the results of treatment in patients with infected fractures or chronic osteomyelitis in the tibial and ankle regions by radical debridement of skeletal and soft tissues and coverage of the defect, using free flap transfer or muscle flap transposition.

Material: Between January 1, 2002 and December 31, 2004, 26 patients were treated by this method; 13 had infected tibial or ankle fractures and 13 showed osteomyelitis of the tibia. All patients, in the case of failure, would have been indicated for below-knee amputation.

Breast reconstruction using free tram flap transfer--ten years experience.

Over the course of ten years, 119 breast reconstruction procedures using a free TRAM flap transfer were performed in our department. In the present review, the authors explain the indication pattern for breast reconstruction. The age of patients undergoing breast reconstruction is given, as well as a description of the time interval between mastectomy and breast reconstruction, which recipient vessels were used, the general and local complications and the complications relating to the anastomosis.

Evaluation of results of replantations at the Department of Plastic Surgery, University Hospital Královské Vinohrady, during the period 1994-1999.

During the period from 1994-1999, 226 patients were treated, incl. 91 replantations and 135 revascularizations. The group included 199 men and 27 women.

Treatment of chronic osteomyelitis of the lower extremity using free flap transfer.

Between 1987 and 1995, 25 patients with chronic osteomyelitis of the lower extremity were treated by transfer of muscle or musculocutaneous flap. The subsequent follow-up extended over more than three years. Five patients developed a recurrence.

Effect of primary repositioning of the nasal septum on facial growth in unilateral cleft lip and palate.

Objective: The objective of this study is to evaluate whether manipulation of the nasal septum, its release, and changing of its abnormal position in infancy has an impact on maxillary growth and facial development in patients with unilateral cleft lip and palate.

Design: Roentgencephalometric investigation.

Setting: Cleft Centre at the Clinic of Plastic Surgery, Prague.

Penile replantation--a case report.

The authors submit a successful case of penile replantation. They discuss the course of the procedure and document the immediate and long-term result of this procedure.

Changes in craniofacial development due to modifications of the treatment of unilateral cleft lip and palate.

Objective: The objective of this study was to evaluate the craniofacial morphology of children with unilateral cleft lip and palate (UCLP) resulting from differing management protocols practiced in Prague from 1945 to 1976.

Design: The craniofacial morphologies of four groups of patients were compared. Two groups were assessed retrospectively (individuals born from 1945 to 1963), and two groups were followed on a longitudinal basis (individuals born from 1966 to 1976).

[Melorheostosis (case history).].

The authors present the case of a patient with a diagnosis at the age of 10 of melorheostosis affecting the left lower extermity with the reduction of flexion in the knee joint as a dominant finding. Despite the releasing operation on the soft tissue complicated by infection in the wound and dihescence there is a continuous progress in the reduction of the range of motion in the knee causing ever greater difficulties for the patient. Authors point out some specific features of this disease the incidence of which is 1 :1 000 000 and describe the plan of further treatment.

Exposure to stress alters the effects of dynorphins in the hot plate test.

The analgesic effects of intracerebroventricularly (i.c.v.

Treatment of defects and instable skin scars on heavily exposed parts of the leg.

The authors report a series of 41 patients subjected to a transfer of the sensitive fasciocutaneous flap to a defect or to instable skin scars on the leg. Described are immediate as well as longterm surgical results in relation to the sensitivity of the transferred flap and the condition of the donnor site of the flap.

Chronic traumatic wounds of the leg.

The authors report the results of a retrospective study of the treatment of chronic defects of soft tissues and bones of the leg and foot with free muscle and musclecutaneous flaps. The study deals with the results of the use of the microsurgical techniques during the period of 11 years at the Department of Plastic Surgery of the 3rd Medical School in Prague. Discussed are the advantages and disadvantages of this technique as one the of possible therapeutic methods inclusive of the results obtained at the above mentioned department.

Internal mammary vessels as recipient vessels to the free TRAM flap.

For the reconstruction of the breast after mastectomy, it is possible to use the internal mammary artery and vein as recipient vessels. The authors consider their experience and some new knowledge gained on the basis of 53 cases. They try to promote the indisputable advantages of the use of the mentioned recipient vessels.

Free cross leg flap as a method of reconstruction of soft tissues defects.

Authors demonstrate on clinical cases the possibility of reconstruction of soft leg tissues by the use of the so called free cross flap. This method appears to be convenient in cases where there are no suitable recipient vessels within reach on the injured extremity and where the defect is of such an extent that the conventional cross flap does not provide sufficient amount of tissue.

[Reduction surgery of the breasts at the Plastic Surgery Clinic in Prague].

The authors present an account of the history of surgical treatment of hypertrophic breasts at the Clinic of Plastic Surgery in Prague. They divided the period from 1928 to the present time into stages with regard to the predominating technique. The authors emphasize also the necessity of careful selection of the surgical procedure with regard to the type and extent of the defect.

Application of free radial forearm flap in reconstruction of the face and oral cavity.

The authors have shown the possibilities of application of the free radial forearm flap in clinical cases when reconstructing defects in the region of the face and of oral cavity. This flap is particularly useful in cases where it is necessary to duplicate the flap and to reconstruct two layers at the same time.

Use of free flaps in burn trauma.

The present currently used method of treating and reconstructing injuries caused by electric current and deep thermal injuries is compared with the method of early reconstruction using free flaps. Brief summary of present experience substantiating this method is presented. The three presented clinical cases show subacute reconstruction in this type of injury by free flaps transfer.

Ten years of replantation surgery at the Department of Plastic Surgery, Charles University Hospital, Prague.

The authors present results of the ten years replantation surgery centre at the department of plastic surgery in Prague. The presented series of patients includes 393 persons operated on because of amputation or ischaemic injury to the region of the upper extremity. The number of replantations and revascularisations in the individual years is analysed, as well as the age of the patients, type of injury, mechanism of injury and operation results.

Importance of an early tissue transfer in the treatment of complicated injuries of lower extremities.

3rd degree fractures with extensive defects of soft tissues represent a major therapeutical problem. The technique of free tissue transfer makes it possible to adopt an active access to primary treatment to this injuries. Radical necrectomies may be performed without respect to the extent of the defect that will arise.

Reduction mammaplasty at the Department of Plastic surgery in Prague.

The authors present a review of the history of surgery of hypertrophic breast at the Department of Plastic Surgery in Prague. The period from 1928 to the present time was divided into stages by the dominating surgical technique. The authors emphasize the importance of careful selection of the surgical procedure with regard to the type and grade of the defect.

Sequelae of an injury from the Second World War treated by free flap transfer.

The authors present the case-history of patients with chronic osteomyelitis of the proximal third of the tibia-resulting from an injury during the Second World War. The defect of bone and soft tissues was treated by free transfer of a musculocutaneous flap. The behaviour of the flap in the osteomyelitic cavity is followed up and checked by repeated CT and NMR examinations.

[Extensive basocellular carcinoma of the abdominal wall].

A rare case of extensive invasive basilioma of the abdominal wall in a 65-year-old female patient was treated by resection of the affected wall in its entire width and reconstruction by mobilizing the peritoneum and an extended inguinal flap. In combination with a simple appliance an adequately firm wall was established for complete social rehabilitation of the patient.