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Surgical treatment of calcaneal fractures. Optimalization of the position of a sustentacular screw
Pazour, Jan ; Džupa, Valér (advisor) ; Krtička, Milan (referee) ; Obruba, Petr (referee)
The present study focuses on the operative treatment of intraarticular calcaneal fractures. Oste- osynthesis of calcaneal fractures through an extensile lateral approach accompanies an incre- ased risk of wound healing complications. The less invasive surgical approaches reduce these risks but achieving a fracture reduction is harder. Another problem is a technically demanding placement of a sustentacular screw. The incorrect placement of a sustentacular screw is followed by an increased risk of the screw penetration into the talocalcaneal joint. A too-long screw can threaten the anatomical structures around sustentaculum tali. Finally, the malposition of the screw can negatively influence the stability of the osteosynthesis. The purpose of the study was to compare the results of the treatment of calcaneal fractures using a plate osteo- synthesis through an extensile lateral approach and the less invasive intramedullary fixation with C-nail using a sinus tarsi approach from the perspective of the incidence of wound healing complications, stability of the osteosynthesis and the functional results. Furthermore, the impact of various positions of the sustentacular screw on the stability of osteosynthesis was also ana- lyzed. The thesis consists of two sections - clinical and experimental. In the...
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Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Obruba, Petr ; Džupa, Valér (advisor) ; Horák, Zdeněk (referee) ; Paša, Libor (referee)
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...
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Treatment of humeral diaphyseal fractures using Hackethals retrograde elastic nailing - a clinical and experimental verification of this method in contemporary traumatology
Obruba, Petr ; Džupa, Valér (advisor) ; Horák, Zdeněk (referee) ; Paša, Libor (referee)
Hackethal's bundle nailing of diaphyseal humeral fractures was historically reliable and cheap method, used for stabilization of simple humeral shaft fractures. After arrival of solid nails, this technique was successively abandoned, initially in Germany, followed by countries of Central Europe. Several cliniques are at present still using this technique successfully. Goal of this work was to establish, whether the declared stability of this technique is comparable to those of more evolved methods, whether this technique does not cause higher amount of complications, and to describe how the stability of nails bundle depends on number and diameter of used implants. The cost efficiency of different modern osteosynthetic methods used for stabilization of humeral shaft fractures was also analyzed. For verification of determined hypotheses, two clinical and one experimental studies were developed. First clinical study was focused on success rate of osteosynthesis and it's complications. In studied population of 50 patients, 4 of them (8%) developed a non-union, which was in all cases caused by wrong indication or technical error during implantation. Superficial infection was observed once, no deep infection had developed. Nine patients (18%) have healed in rotational or axial malalingement that had no...
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