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The hip fracture register, optimalization of hip hemiarthroplasty position
Skála - Rosenbaum, Jiří ; Bartoníček, Jan (advisor) ; Chomiak, Jiří (referee) ; Janeček, Miloš (referee)
The study examines the monocentric epidemiological data of patients with hip fractures from 1997-2007. Adult patients treated for hip fracture between the years 1997-2007 were included in the study. Retrospective statistical assessment of continually gathered data focused on epidemiology and demographics. The second part of the study was concerned on risk factors on protrusion of hemiarthroplasty into the acetabulum. The goal was to specify exact indication, proper operative technique and selection of the implant. The study involved 3 683 patients (2 678 women, 1 005 men). Patients older than 70 years accounted for 82 % of all cases. There was an increase in the number of hip fractures resulting in a significant increase in pertrochanteric fractures (AO-31A1+2) (p<0.001). The ratio of trochanteric to neck hip fractures increased from 0.99 to 1.53. Continual monitoring of patients with hip fracture offers data which allows comparisons between regions and countries. The importace of a continual increase in the number of hip fractures has its importance in macroeconomical planning in traumatology. Hemiarthroplasty was conversed to total hip arthroplasty in 12 patients in our department. The indication, time period to conversion and hemiarthroplasty position were retrospectively assessed. The direction of...
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Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif
Báča, Václav ; Stingl, Josef (advisor) ; Koudela, Karel (referee) ; Chomiak, Jiří (referee) ; Laichman, Stanislav (referee)
AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons...
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Spondylodiscitis - Surgical Treatment
Včelák, Josef ; Chomiak, Jiří (advisor) ; Chaloupka, Richard (referee) ; Štulík, Jan (referee)
Introduction: (Experimental part). Hypothesis evaluates the quasi-static risk of transpedicular fixation failure in the spinal cadaver with anterior column defect due to the fixation extension and defines the risk of transpedicular fixation failure due to screw convergence in cyclic loading. (Clinical part). Hypothesis evaluates the risk of isolated dorsal approach to ventral lumbar spondylodiscitis due to clinic and radiopraphic results and the risk of anterior radical debridement due to using titanium implant in the site of bone infection. Methods: (Experimental part). Four anatomically preparated spinal cadavers with anterior spinal column defect transpediculary instrumented were quasi-statically tested on MTS 858,2 Mini-Bionix. Concept of cyclic loading part were based on ASTM standard F1717. (Clinical part). The group A consisting of 23 patients was treated only by dorsal transmuscular approach and the second group B consisting of 8 patients was treated by two-stage postero- anterior surgery in lumbar spondylodiscitis. Results: (Experimental part). There were progress in all assessed parametres with considerable asymmetry direction in extension to flexion and duction in spinal column loading with anterior defect during quasi-static loading. The rod deformation decrease with extent of...
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Spondylodiscitis - Surgical Treatment
Včelák, Josef ; Chomiak, Jiří (advisor) ; Chaloupka, Richard (referee) ; Štulík, Jan (referee)
Introduction: (Experimental part). Hypothesis evaluates the quasi-static risk of transpedicular fixation failure in the spinal cadaver with anterior column defect due to the fixation extension and defines the risk of transpedicular fixation failure due to screw convergence in cyclic loading. (Clinical part). Hypothesis evaluates the risk of isolated dorsal approach to ventral lumbar spondylodiscitis due to clinic and radiopraphic results and the risk of anterior radical debridement due to using titanium implant in the site of bone infection. Methods: (Experimental part). Four anatomically preparated spinal cadavers with anterior spinal column defect transpediculary instrumented were quasi-statically tested on MTS 858,2 Mini-Bionix. Concept of cyclic loading part were based on ASTM standard F1717. (Clinical part). The group A consisting of 23 patients was treated only by dorsal transmuscular approach and the second group B consisting of 8 patients was treated by two-stage postero- anterior surgery in lumbar spondylodiscitis. Results: (Experimental part). There were progress in all assessed parametres with considerable asymmetry direction in extension to flexion and duction in spinal column loading with anterior defect during quasi-static loading. The rod deformation decrease with extent of...
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Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif
Báča, Václav ; Stingl, Josef (advisor) ; Koudela, Karel (referee) ; Chomiak, Jiří (referee) ; Laichman, Stanislav (referee)
AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons...
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The hip fracture register, optimalization of hip hemiarthroplasty position
Skála - Rosenbaum, Jiří ; Bartoníček, Jan (advisor) ; Chomiak, Jiří (referee) ; Janeček, Miloš (referee)
The study examines the monocentric epidemiological data of patients with hip fractures from 1997-2007. Adult patients treated for hip fracture between the years 1997-2007 were included in the study. Retrospective statistical assessment of continually gathered data focused on epidemiology and demographics. The second part of the study was concerned on risk factors on protrusion of hemiarthroplasty into the acetabulum. The goal was to specify exact indication, proper operative technique and selection of the implant. The study involved 3 683 patients (2 678 women, 1 005 men). Patients older than 70 years accounted for 82 % of all cases. There was an increase in the number of hip fractures resulting in a significant increase in pertrochanteric fractures (AO-31A1+2) (p<0.001). The ratio of trochanteric to neck hip fractures increased from 0.99 to 1.53. Continual monitoring of patients with hip fracture offers data which allows comparisons between regions and countries. The importace of a continual increase in the number of hip fractures has its importance in macroeconomical planning in traumatology. Hemiarthroplasty was conversed to total hip arthroplasty in 12 patients in our department. The indication, time period to conversion and hemiarthroplasty position were retrospectively assessed. The direction of...
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Gait analysis in cerebral Palsy
Švehlík, Martin ; Trč, Tomáš (advisor) ; Smetana, Karel (referee) ; Chomiak, Jiří (referee)
lom><luclioo G>il :wd pos"'" disrurb= :n~ ~ of m. mosl common probl"", in childrm wilh CP. lk clinical studie; pr~ItN in tbi, tMsis" br~ ~ CUlImt mowlnlg~ 00 DlO\T'!IImI .bnorm>.liTi.. in childrm witb CP aru! a!low US to bffi..- und..-stand :md drscribr m. patbopby,i"logica! tlltClwli>mS "f~ dis...-dns .Um, Srudy I - To pro'" m., bypoIbrsis th:ot ~:nt)" kntt rrrurnTioo i, C:llIsN by . dynamic ~inus <lefumlity:md lal~ ~ =-:nion i, hnkN 10 m. fixrd ~inus <leťcrmity. Sttood . im " .." to analyz~ tbr rol~ ofbamstrings in tbt ""thobiomrcbani.. ofm. knt-r =",rum Srudy 1 - To ~"alU3t~ ~ fuoction of m. tr1cq>< S\lGI~ during wa1king ,,1Ien 6tbtr dynamic lricrps """" Tighmess or fixrd rquinus cootJacrur~ is """"'" in childr<n witb CP Srudy 3 - To perf<mll' cornprehensi,,, anaJys;s of m., >bort-leml dr""", of. stan<IardizN dosr ofBorubnnm 10xin A (BTX-A) aru! sniaI casting 00 spNic N[Uinn'. Srudy 4 - To compar. noodjoV'll,ional nonnaliz:ltioo of""'D' c.,.t of walling in childrm ,,~Ih CP to chnically UsN body mass oonnali..z.atioo "'~. Srudy 5 - To ~va!ll.1~ Ibr .".olutioo of diff..-mt gail p;uamrt..-s "'''' p..-lod ar niot months rollo"'1ng cOCf"",i,,, ""ft tis"", ru:g~'Y in cbild:ren ,,;Ih CP. ~Iotbod, Ccmp.iltriz.rd bn..-mtic :wd bnrTic thr..,-<liDV'Ilsional gail analysi' togrtb..- ,,;Ih...
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