TIBIAL TUBERCLE AVULSION FRACTURE IN A MALE ADOLESCENT.

Tibial tuberosity fractures are rare in childhood, most frequently due to excessive quadriceps muscle contraction. On performing long jump, a 15-year-old boy sustained tibial tuberosity avulsion fracture type II according to Watson-Jones. The patient was treated operatively with fragment repositioning and screw fixation.

A correlation of peak height velocity and olecranon apophysis ossification assessed by ultrasound.

Peak height velocity (PHV) is defined as the period of the fastest growth during puberty. An ability to predict annual growth and the timing of PHV may provide an opportunity to modify treatment of many diseases and conditions of the skeletal system such as scoliosis and kyphosis, slipped capital femoral epiphysis, leg length inequality and adolescent Blount's disease. There is a good correlation of peak height velocity and skeletal age determined from the radiographic assessment ofolecranon.

A validity of ultrasound subdivision of Risser grade 4 in assessment of skeletal maturity.

In the treatment of adolescent idiopathic scoliosis, one of the most frequently used technique to determine skeletal maturity is the method described by Risser. The ossification of iliac apophysis progresses from ventral to caudal through the four zones and the fusion of the iliac apophysis to the iliac crest (Risser grade 5) indicated vertebral growth completion, therefore the termination of scoliotic deformity progression. The main disadvantages of Risser method are exposure to radiation and the questionable reliability, so there are efforts to examine iliac apohysis by ultrasound.

Detection of coxarthrosis in femoral head radiographic images seems limited mainly to vertically oriented pattern features.

Out of 120 conventional hip joint X-rays, two indepenendent examiners have chosen 27 healthy and 62 coxarthrotic joints. Central parts of femoral head images were digitalized (300 points/inch) and pixel density values analysed. Two methods were applied separately to horizontal rows and to vertical columns: variance coefficient calculation and power coefficients of Fourier harmonics.

Significance of the pepsin from the saliva in the diagnosis and treatment of laryngopharyngeal reflux disease.

Etiopathogenesis of the laryngopharyngeal reflux has not been sufficiently clarified. It is believed that damage to the lining of laryngopharynx in laryngopharyngeal disease occurs in the use of acid and pepsin. The diagnosis of reflux acidic 24-hour Dual probe pH-metry is considered the gold standard.

Clinical importance of changes to femoral bone mineral density around the hip endoprosthesis.

The implanting of a hip endoprosthesis changes the mechanical loading in a hip. The changing in loading causes bone remodeling. The loss of loading leads to bone atrophy, whereas an increase in loading leads to hypertrophy of the bones.

Results of the surgical reconstruction of the anterior cruciate ligament.

Results of the surgical reconstruction of the anterior cruciate ligament (ACL), using as a graft fourfold hamstring tendons (gracilis and semitendinosus) and middle third of the patellar ligament, were compared. In all patients that were participating in this study clinical examination and magnetic resonance showed ACL rupture, and apart from the choice of the graft, surgical technique was identical. We evaluated 112 patients with implemented patellar ligament graft and fourfold hamstring tendons graft six months after the procedure.

Spontaneous regression of intervertebral disc herniation--case reports.

Lumbar disc hernia (LDH) is a common cause of low back pain and radicular leg pain. It is well known that the majority of LDH patients recover spontaneously. Since the advent of MRI, a spontaneous regression of fragment size of disc hernia occurs, as well as mitigation of subjective difficulties and neurological disorders.

Influence of surgery onto the appearance of the hip joint periarticular calcification in patients with the acetabular fracture.

The intention of this study was to investigate the influence of surgery onto the appearance of the hip joint periarticular calcification in different groups of patients who suffered the acetabular fracture. A series of 103 patients with the acetabular fracture was analysed in a retrospective case-control study during a seven-year period. The patients were divided into two groups.

Transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular fixation.

TLIF (transforaminal lumbar interbody fusion) is a method of interbody fusion, which is alternative to other vertebral fusion wherein, with an approach through intervertebral foramen, through lateral segment of intervertebral space, complications occurring with other methods are reduced. Today, there are numerous versions of this method in terms of implants and transplants. At our Department patients with axial pain resistant to conservative treatment of minimum six months underwent TLIF method with unilateral transpendicular fixation with polyaxial screws, CAGE filled with autologous transplant obtained by lamina resection, and posteromedial contralateral fusion.

Numerical analysis of standard and modified osteosynthesis in long bone fractures treatment.

The fundamental problem in osteoporotic fracture treatment is significant decrease in bone mass and bone tissue density resulting in decreased firmness and elasticity of osteoporotic bone. Application of standard implants and standard surgical techniques in osteoporotic bone fracture treatment makes it almost impossible to achieve stable osteosynthesis sufficient for early mobility, verticalization and load. Taking into account the form and the size of the contact surface as well as distribution of forces between the osteosynthetic materials and the bone tissue numerical analysis showed advantages of modified osteosynthesis with bone cement filling in the screw bed.

Advantages of modified osteosynthesis in treatment of osteoporotic long bones fractures--experimental model.

In surgery of fractured long bones, a patient suffering from osteoporosis represents constant challenge to a surgeon and applied material and instruments that need to destroy as little as possible of an already damaged bone. One potential way of increasing the contact surface between the implants and osteoporotic bone is injection of bone cement (methyl-metacrilat, Palakos) into a prepared screw bed. This method of osteosynthesis was therefore subjected to experimental research to prove that application of modified osteosynthesis using bone cement in treatment of fractures in osteoporotic patients has advantage over the standard method of osteosynthesis because this modified method enables significantly greater firmness and stability of the osteosynthesis, which is the essential precondition of a successful fracture healing.

The main biomechanical risk factors for the prevalence of the left hip joint traumatic and degenerative changes.

The aim of this paper is to examine characteristic biomechanical features leading to the acetabular fracture and hip joint arthrosis, and to explain the prevalence of the left side traumatic and degenerative pelvic pathology that is usually seen in diverse groups of patients. A total of 253 patients were analyzed in a retrospective case-control study during a six-year period. The patients were divided into the case group of 103 patients suffering traumatic acetabular fractures and into the control group of 150 patients with hip joint arthrosis, where operative aloarthroplasty was not yet performed.

Open total talar dislocation with extrusion (missing talus).

Open total dislocation of a talus with extrusion (missing talus) is an extremely rare injury. We present a case of a 63-year-old male who sustained an open total lateral dislocation of the right talus with extrusion and without a concomitant fracture after a fall from a small height. Tibiocalcaneonavicular arthrodesis was performed.

The analysis of the unstable tibia fracture treatment applying internal stabilization method.

The study included 51 patients with tibia fractures, who underwent percutaneous bone reposition and stabilization with unrimed tibial locking nail. The results obtained using this method were compared with those obtained by standard fracture treatment where flat and anatomic plates were applied (n = 64). In patients who had osteosynthetic material implanted percutaneously (using unrimed tibial locking nail) there was no incidence of post surgical osteitis or any pseudarthrosis.

Functional status of hip joint after surgical and conservative treatment of acetabular fracture.

Both conservative and surgical treatment of acetabular fractures alter biomechanical conditions in the hip joint resulting in various degenerative changes in the acetabulum and the femur head. These changes may progress to secondary coxarthrosis, causing dysfunction of the hip joint. The aim of this paper is to compare the outcomes of both conservative and surgical treatments in different types of acetabular fractures, so that clear indications for either conservative or surgical treatment could be determined.