In the present study, the outcome of the surgically treated Weber type B fractures caused by supination external rotation injury was comparable in both groups. The antiglide plate fixation showed no signs of peroneal tendinopathy, low rate of complications. We believe this technique is safe and a good method of fixation as well as traditional lateral plating.

Background. Non-displaced femoral neck fractures are mostly treated with internal fixation, while in dis­placed fractures this surgical option is under debate and the benefits are still not clear. The purpose of this study was to identify the factors that affect the treatment of non-displaced and displaced hip fractures using a head-preserving plate. Material and methods. From August 2011 to May 2015, we reviewed eighty-two adult patients who had sustained undisplaced and displaced intracapsular femoral neck fracture treated with a locking plate system with telescoping sliding screws. Fracture reduction, healing rate and implant related complications were primary objectives. Other complications (e.g. avascular necrosis, nonunion, hematoma, infection) and revision surgery were recorded as well. Results. According to the Garden classification system, a total of 51.2% fractures were classified as non-displaced (type 1 and 2) and 48.8% were displaced fractures (type 3 and 4). Anatomic reduction was achieved in 58.5% and valgus in 41.5% of patients and it did not influence the healing. Varus reduction was not observed in any case. The total average complication rate was 18.1%, where screw cutout was the most frequent complication (8.5%). The timing of surgery did not affect the healing of femoral neck fractures. Age over 60 years combined with a displaced fracture was associated with impaired healing potential and a higher complication rate. Revision surgery was performed in 17.1% of patients, mainly those with displaced fractures. Conclusions. 1. The use of a locking plate system with telescoping sliding screws was associated with lower rates of postoperative complications in undisplaced, but also in displaced femoral neck fractures in patients younger 60 years. 2. Patients over 60 years with displaced fractures were more likely to have healing problems and implant failure.

PURPOSE OF THE STUDYThe aim of this pilot study was to evaluate the clinical and functional outcomes of total hip arthroplasty (THA) in patients with acetabular fractures due to a low-energy injury. Acute primary THA included an antiprotrusion cage and autologous bone grafting of the acetabulum. This prospective study was carried out between 1998 and 2004. MATERIALTen patients, of whom six were men, (average age, 71 years; range, 60 to 83 years) with acetabular fractures were treated by THA. Two patients had type A2, two had type B1, three had type B2 and three had type B3 fractures, as assessed by the AO classification. X-ray showed osteoporosis due to decreased bone mass in all patients, and dislocations of the fragments in the weight-bearing area of the joint exceeded 1 cm. The average follow-up was 36 months. METHODSIndications for primary THA included, in addition to higher age, displacement in the fracture line exceeding 1 cm, a fracture line extending to the weight-bearing part of the acetabulum, presence of hip arthritis, cartilage injury, defects of the weight-bearing area of either the femoral head or acetabulum, and Pipkin type IV injury. The interval between accident and surgery ranged from 6 to 12 days (average, 9.5). Three surgical techniques were used, namely, cemented THA with a polyethylene cup cemented into an acetabulum-stabilizing cage; reconstruction with a cementless RSC acetabular component; internal fixation using screws and a cemented cup. Bone grafting of the acetabulum was used in all patients. Evaluated were basic operative parameters, complications, X-ray findings, ability to walk and Merle d'Aubigne scores. RESULTSThe average operative time was 100 min, the average blood loss was 1000 ml. Hip motion showed the following average values: flexion, 110°; extension, 10°; rotation, 30°-0°-30°; adduction, 25°; abduction, 35°. All patients returned to their preoperative range of motion. X-ray examination showed good reduction, bone graft was completely incorporated in the acetabulum, and no displacement or signs of loosening or graft migration were recorded. Two patients had Brooker type I heterotropic ossification. The final evaluation of function at 36 months on the basis of the Merle d'Aubigne classification showed excellent and good results in four (57 %) and three (43 %) patients, respectively. The remaining three patients had a shorter follow-up, but were fully mobile with no complications observed. DISCUSSIONIt has been reported that bony union of acetabular fracture after open reduction and internal fixation (ORIF) was achieved in 74 % patients younger than 60 years, but in only 44 % of the patients older than 60 years. Secondary THA following ORIF is a demanding technique. Due to adhesions and a frequent malposition of the acetabulum, THA is associated with and increased risk of infection, tendency to develop para-articular ossifications, and a higher risk of early component loosening than in the standard procedure. One of the options is to perform acetabular stabilization and prima...

An ankle bone consisting of several fragments is a rare anatomical variant of the talus, in the literature described as talus partitus or frontal split. On radiographs or CT scans it presents as two or more relatively large fragments. The term talus partitus is sometimes incorrectly used for an accessory bone that occasionally develops behind the ankle bone and is called os trigonum.Talus partitus is an unusual developmental anomaly in which the talus is partitioned although it ossifies from a single centre. The cause of its split has not been explained although this may also be due to a previous unrecognized injury. In the Slovak medical literature no report of this anomaly has been found.Here we resent the case of a 30-year-old man in whom the ankle bone split was an incidental finding. This patient also had ipsilateral developmental dysplasia of the hip. This is the first report of a patient with the two concurrently found anomalies.

In patients with defect bone growth and dwarfism, fractures of the weight bearing skeleton are relatively rare due to their reduced mobility. When they do occur, their treatment and potential surgery are complicated. The commonly used therapeutic procedures are not applicable, the available implants are not suitable, if a surgery is necessary. An individual approach and often times also improvisation is needed. It is important to realize that these patients do not suffer from an intellectual disability and are fully aware of their physical impairment, which we must not make worse without an effort for adequate treatment. This case study presents our solution of a supracondylar femoral fracture in a patient with achondroplasia and extreme obesity. A proximal humeral nail was used for distal femoral fracture osteosynthesis by a retrograde approach. To the knowledge of authors, this study reports on the first case of supracondylar femoral fracture surgery in patients with achondroplasia.