PŮVODNÍ PRÁCE ORIGINAL PAPERzmiňuje Cotterill (4). Termín "hallux limitus" použil pro lehčí stádia v roce 1959 DuVries. V literatuře je uváděna velká řada klasifikací hallux rigidus. Beeson a kol. v roce 2008 prošel dostupnou literaturu a kriticky zhodnotil využití klasifikací pro klinickou praxi. Klasifikace Coughlina a Surnase z roku 2003 je nejblíže tzv."zlatému standardu" (3) a v současnosti je i nejpoužívanější. Vychází s klasifikace Easleho publikované v roce 1999 (9). Klasifikace Coughlina a Surnase je vodítkem k volbě typu operačního výkonu (6). Samozřejmě musíme přihlédnout k potížím a přáním pacienta, k přidruženým statickým deformitám, příp. i artrotickému ÚVODAutoři ve svém článku hodnotí soubor pacientů po artrodéze I. metatarzofalangeálního kloubu. K artrodéze byla ve všech případech použita úhlově stabilní dlaha. Cílem práce je prezentace výsledků, vyzdvihnutí výhod pro pacienta i důvodů volby této metody oproti jiným způsobům fixace. Indikace Hallux rigidusJako první onemocnění popsal v roce 1887 Davies--Colley (7). Ve svém článku použil označení "hallux flexus". Ve stejném roce termín "hallux rigidus" poprvé
PURPOSE OF THE STUDYTo give a description of the patient group, risk factors, classification, therapeutic procedures and treatment outcomes in periprosthetic femoral fractures after total hip arthroplasty treated in the Trauma Hospital in Brno. MATERIAL AND METHODSThis retrospective study comprised of 51 patients treated for a periprosthetic femoral fracture between 2003 and 2013. This included 19 (37%) intra-operative and 32 (63%) post-operative fractures. According to the Vancouver classification, the types of fractures were as follows: 9 patients A; 21 B1; 9 B2; 6 B3 and 6 with type C. RESULTSType A fractures were treated conservatively. Although pseudoarthrosis of the greater trochanter occurred, the patients had no clinical problems. The intra-operative type B1 fractures were managed by cerclage tapes in nine patients and the post-operative B1 fractures were treated by plate osteosynthesis in 10 patients and femoral stem reimplantation in two patients. All post-operative type B2 and type B3 fractures were managed by reimplantation of the femoral stem and type C fractures were treated by plate osteosynthesis. Serious complications requiring revision surgery were recorded in five patients; they included plate failure in two B1 fractures, dislocation of a B2 fracture, a dislocation with femoral component rotation in a B3 fracture and failure of the plate in a type C fracture. CONCLUSIONSThe treatment of a periprosthetic fracture can affect the patient's life. In view of the fracture type, implant type, general health of the patient and all risk factors, the authors prefer one-stage surgical treatment. The Vancouver classification is a guidleine for the therapeutic plan. Osteosynthesis as a single procedure is indicated only if the femoral component is stable and well fixed. When the stem in B2 and B3 fractures is loose, revision surgery with stem replacement is necessary.
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