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Elastic bundle nailing is a method for simple humeral mid-shaft fracture osteosynthesis. The aim of our subsequent numerical simulations was to find out torsional and bending stiffness of an elastic bundle nailed humerus. Parametrical 3D numerical model was developed. The diameter of nails was the varying parameter of 1.8, 2.5, 3 and 4 mm. From our results can be seen that the bending stiffness in bundle nailing technique does not depend on nail diameter. On the contrary the torsional stiffness does highly depend on nail diameter. The dependency of the maximal stress on a nail diameter during bending and torsion of the humerus is non-linear. It can be seen that the higher diameter is used the higher stress occurs. Achieved results allow us for the recommendation of optimal nail diameter for this method, which lies between 2 and 3 mm.

PURPOSE OF THE STUDYWe aimed to determine the incidence of pressure sores and their effect on survival in patients older than 70 years who underwent surgery for hip fracture, and to identify the factors which were associated with an increased risk of pressure sores.

PURPOSE OF THE STUDYThe aim was to determine indication criteria for use of arthroscopy in the treatment of post-traumatic changes in the elbow joint, to present the surgical technique and to evaluate the results of a prospective study involving early follow-up of functional and radiographic outcomes of this treatment. MATERIAL AnD METHODSBetween February 2010 and February 2013, arthroscopic surgery was carried out on 14 elbows in 14 patients at the Clinic of traumatology of Masaryk hospital in Ústí nad Labem. The group comprised seven men and seven women, with an average age of 40 years (range, 20 to 67 years). The indications for elbow arthroscopy included conditions after intraarticular fractures in five, elbow dislocation in one, severe elbow contusion in four and complex injury to the elbow joint in four patients. Arthroscopic surgery was performed at an average of 11 months after the primary injury. The prospective follow-up lasted for an average of 12 months (range, 6 to 25).The outcomes of surgery were evaluated on the basis of radiograms and multiplanar reconstructions of CT images, elbow function was assessed using two rating systems, i.e., the Mayo Elbow Performance Score (MEPS) and Hospital for Special Surgery (HSS) score. RESULTSThe average active range of motion (ROM) at the elbow joint was 118°/33° (145°-90°/60°-5°) before surgery and improved to 131°/5° (150°-90°/15°-0°), i.e., by 13°/28° (150°-90°/60°-0°) intra-operatively. The average final value of elbow ROM after functional stabilization was 126°/16° (145°-90°/70°-0°), which means improvement by 8°/17° (45°-0°/50°-0°) or a total of 25°. On post-operative radiograms, the findings were stable in 11 (79%) patients; elbows in three patients (21%) showed progression of degenerative changes (osteophyte formation and periarticular ossification). The final functional scores, as assessed using the MEPS and HSS score systems, were 88.93 (55-100) and 88.29 (50-100) points (average/ range), respectively. DISCUSSIOnThe study showed, in agreement with other authors' reports, that the degree of improvement in active range of motion and functional performance of the elbow is directly related to the severity of post-traumatic conditions. A certain residual ROM restriction usually remains. The outcome was poorer in patients with complex injuries of the elbow or in those with displaced intra-articular fractures of the joint and was also related to the severity of joint injury. Patients who were treated after a longer injury-to-surgery period and who suffered a more serious joint injury had more advanced arthritis, higher degree of joint contracture, worse pre-operative functional scores and less improvement in post-operative ROM of the elbow joint. COnCLUSIOnSFrom the results of early functional assessments and radiographic findings it can be concluded that the elbow joint arthroscopy is a safe and reliable technique to treat post-traumatic conditions caused by intrinsic factors in mild and moderate elbow stiffness. However, this method cannot be recommended in ...