INTRODUCTION: No comprehensive treatise on the early history of fractures of posterior malleolus (PM) has yet been published, and many substantial discoveries have fallen into oblivion-particularly if not having been published in English originally. MATERIALS AND METHODS: Literature search was performed in original publications and historical sources. RESULTS: Early history of PM fractures from their first description up to the beginnings of their operative treatment may be divided into three basic periods, covering the era between 1828 and 1940. In the pre-radiological period (1828-1895), description of PM injuries was based merely on the autopsy findings in deceased patients. The first mentions of this injury were published by the British authors. In the radiologic period (1899-1916), the x-ray examination started a revolution also in diagnostics of ankle fractures, with the first radiographs performed as early as in 1899. Radiographic examination had subsequently become an integral part of the diagnostics of these injuries and initiated a number of significant studies of PM fractures. The first detailed mention of a PM injury may be found in the French and German literature. The period of early operative treatment (1918-1940), i.e., open reduction and internal fixation of PM, was started by the younger post-WWI generation, primarily the French surgeons, represented by Gaston Picot. His operative technique and the first six cases treated operatively between 1918 and 1921 were described in 1921 by Edouard Huc. Picot himself published his technique in great detail in 1923. CONCLUSION: The early history of diagnostics and treatment of PM fractures witnesses the remarkable body of knowledge gathered about that topic by numerous visionary surgeons predominantly French and German surgeons immediately before and after World War I. They substantially contributed to the radiological examination and operative treatment of this injury.

• MeSH
• History, 19th Century MeSH
• History, 20th Century MeSH
• Ankle Fractures * history   surgery   diagnosis   MeSH
• Humans MeSH
• Radiography methods   MeSH
• Fracture Fixation, Internal history   methods   MeSH
• Check Tag
• History, 19th Century MeSH
• History, 20th Century MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH
• Historical Article MeSH
• Review MeSH

Hallux extensus is a persistent dorsiflexion of the first metatarsophalangeal joint. Apart from many other causes, it can also be caused by contracture of the extensor hallucis longus muscle, in our case resulting from surgical treatment of crural fracture. The authors present the case of a 17-year-old soccer player who sustained a fracture of both shin and calf bone during a soccer match and underwent surgical treatment with intramedullary nailing. While compartment syndrome wasn't observed, a postoperative complication in the form of progressive development of a dynamic type of hallux extensus was reported. The reason behind this complication was later found to be the interaction of the osteosynthesis material with the extensor hallucis longus muscle, which led to its scarring and shortening. A Z-lengthening of the musculus extensor hallucis longus tendon was indicated and performed with a good clinical outcome. During surgery, an anatomical variation in the course of the extensor hallucis longus was observed, which had to be taken into account to achieve a successful surgical outcome. Key words: cock-up big toe deformity, musculus extensor hallucis longus contracture, Z-lengthening tenotomy, crural fracture complication.

• MeSH
• Soccer injuries   MeSH
• Fractures, Bone surgery   complications   MeSH
• Fracture Fixation, Intramedullary adverse effects   methods   MeSH
• Humans MeSH
• Adolescent MeSH
• Hallux * surgery   MeSH
• Postoperative Complications etiology   MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Case Reports MeSH

PURPOSE OF THE STUDY: Intertrochanteric hip fractures in elderly patients are a significant cause of morbidity and mortality, with increasing incidence due to the aging population. Despite advancements in intramedullary nailing (IMN) technology, fixation failure remains a concern. This study aims to evaluate pre-and postoperative radiographic risk factors for varus collapse in geriatric intertrochanteric fractures treated with twin interlocking derotation and compression screw cephalomedullary nail (InterTAN, Smith & Nephew). MATERIAL AND METHODS: This retrospective study included patients over 60 years with AO 31A1 and 31A2 intertrochanteric femur fractures treated with InterTAN at a tertiary referral center from August 2012 to August 2017. Patients with high-energy fractures, AO 31A3 fractures, or those requiring open reduction were excluded. Data on demographics, fracture classification, implant sizes, imaging studies, and follow-up were collected. Radiographic assessments included Chang's medial cortical support concept, tip-apex distance (TAD), calcar-referenced TAD (CalTAD), neck-shaft angles (NSA), and screw placement according to Cleveland zones. Varus collapse was defined as a >5° change in NSA within three months postoperatively. Multivariate logistic regression analysis was used to identify risk factors for varus collapse. RESULTS: The study included 136 patients with a mean age of 79.8 years, of whom 38.2% were male. The early postoperative tipapex distance (TAD) averaged 21.9mm, with 30.1% of patients experiencing varus collapse greater than 5°. Positive medial cortical support (PMCS) or neutral position (NP) type reduction was highly protective against varus collapse (p < 0.001), as well as TAD less than 25mm (p < 0.001). Additionally, the placement of screws in the central-central or central-inferior zones provided a protective effect against varus collapse (p = 0.031). Conversely, having an OTA/AO type A2.2 or A2.3 fracture significantly increased the risk of varus collapse (p = 0.030). Other factors, such as CalTAD and the nail width to medullary canal ratio, did not significantly predict varus collapse (p = 0.831 and p = 0.952, respectively). DISCUSSION: Our findings align with previous studies highlighting TAD and screw placement as critical factors in preventing fixation failure. The protective effect of PMCS or NP reduction and the increased risk associated with OTA/AO type A2.2 and A2.3 fractures are noteworthy. Unlike previous studies, CalTAD was not significantly associated with varus collapse in our cohort. The study underscores the importance of surgical technique and radiographic parameters in optimizing outcomes for elderly patients with intertrochanteric fractures. CONCLUSIONS: In elderly patients treated with InterTAN nails, varus collapse is influenced by fracture type, TAD, reduction quality, and screw placement. Ensuring a TAD <25mm, achieving PMCS or NP reduction, and placing screws in central-central or central-inferior zones are crucial for minimizing varus collapse. These findings highlight the importance of meticulous surgical technique and radiographic assessment in managing intertrochanteric fractures in the elderly. KEY WORDS: hip fractures, intertrochanteric fractures, internal Fixation, geriatrics, cephalomedullary nail.

• MeSH
• Hip Fractures * surgery   MeSH
• Fracture Fixation, Intramedullary * methods   instrumentation   adverse effects   MeSH
• Bone Nails * MeSH
• Bone Screws * adverse effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Postoperative Complications etiology   epidemiology   MeSH
• Retrospective Studies MeSH
• Risk Factors MeSH
• Prosthesis Failure MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

The bone transport technique uses the principle of distraction-osteogenesis and fill bone defects with the aid of an external fixator. In order to evaluate the clinical effect of femoral internal fixation with Ortho-Bridge System after bone transport, 4 patients after femoral bone transport from October 2020 to October 2022 are studied in this paper. Among them, 3 patients ran refracture of femur after removal of the Limb reconstruction system, 1 patient just finish femoral bone transport and request internal fixation. The surgery results show that Ortho-Bridge System can be used in the situation that conventional Locking compression plate and intramedullary nail are not suitable due to anatomical variation after femoral bone transport. Key words: femoral fracture; Ortho-Bridge System; bone transport; postoperative complications of bone transport.

• MeSH
• Adult MeSH
• External Fixators MeSH
• Femur surgery   MeSH
• Femoral Fractures * surgery   MeSH
• Middle Aged MeSH
• Humans MeSH
• Osteogenesis, Distraction methods   instrumentation   MeSH
• Postoperative Complications etiology   MeSH
• Fracture Fixation, Internal methods   instrumentation   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Significant malrotation of the femur after osteosynthesis is a serious complication of treatment and has a number of consequences for the patients and causes deterioration of their quality of life. Therefore, it is necessary to be familiar with intraoperative techniques to control the correct rotation, mostly clinical and radiological, which give us the possibility to minimize rotational errors. In the postoperative period, with even a slight suspicion of malrotation, it is necessary to proceed to its exact verification and, in indicated cases, to perform necessary correction. We recommend one of the CT techniques as a very reliable method, however in younger patients we prefer to use MRI. Early diagnosis of the rotational error and especially its size is essential from the point of view of potential reconstructive surgery, which is then chosen also with regard to the location of the original lesion. Key words: femoral osteosynthesis, limb malrotation, methods of measuring.

• MeSH
• Femur surgery   diagnostic imaging   MeSH
• Femoral Fractures * surgery   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Tomography, X-Ray Computed MeSH
• Postoperative Complications diagnosis   etiology   MeSH
• Fracture Fixation, Internal * adverse effects   methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• English Abstract MeSH
• Journal Article MeSH
• Review MeSH

První úspěšnou osteosyntézu u pacienta s otevřenou zlomeninou bérce v předaseptickém období provedl pomocí zlatého drátu vlámský chirurg Dominique Le Roy v roce 1796 v Antverpách. V první polovině 19. století našel řadu následovníků, mezi nimi i Achille-Cléophase Flauberta, otce spisovatele Gustava Flauberta, kteří ošetřili otevřenou operací jak akutní zlomeniny, tak paklouby. Prakticky ve všech případech došlo ke hnisání, u některých pacientů se kost přesto zhojila, jiné případy skončily amputací nebo dokonce smrtí. Přes řadu neúspěchů byly jednotlivé operace inspirací pro další generaci chirurgů. Trvalo však dalších 40 let, než byly belgickým chirurgem Albinem Lambottem položeny základy moderní osteosyntézy.

The first successful internal fixation in the pre-aseptic period was performed by the Flemish surgeon Dominique Le Roy in 1796 in Antwerpen, using a gold wire in a patient with an open fracture of the lower leg. In the first half of 19th century, he was followed by a number of other surgeons, among them Achille-Cléophase Flaubert, father of the famous novelist Gustav Flaubert, who treated both acute fractures and non-unions. Almost all operations resulted in suppuration, however, in many patients the fracture healed, while other cases ended in amputation or even death. Despite a series of failures, individual operations inspired the next generation of surgeons. Nevertheless, it took another 40 years before the foundations of modern internal fixation were laid by the Belgian surgeon Albin Lambotte.

• MeSH
• History, 19th Century MeSH
• History of Medicine MeSH
• Fractures, Bone therapy   MeSH
• Infections MeSH
• Humans MeSH
• Fracture Fixation, Internal * history   MeSH
• Check Tag
• History, 19th Century MeSH
• Humans MeSH
• Publication type
• Historical Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Úvod: Cílem práce je pomocí analýzy vlastního souboru pacientů a aktuálních odborných publikací stanovit, v jakých případech lze zlomeniny střední části skafoidea léčit konzervativně krátkodobou sádrovou fixací s malým rizikem vzniku pakloubu. Materiál a metoda: Soubor 19 pacientů (17 mužů a 2 ženy) s průměrným věkem 31 let (rozsah 20–43, SD 7,3) se zlomeninami střední části člunkové kosti zápěstí indikovanými ke konzervativní léčbě. Diagnostika byla prováděna na základě RTG a CT vyšetření. Konzervativní terapie spočívala v přiložení sádrové fixace zápěstí a palce na dobu min. 6 týdnů u zcela nedislokovaných zlomenin (průměr 6,4 týdne, rozsah 6–10 týdnů). Ostatní zlomeniny byly imobilizovány sádrou celkem 9 týdnů. Všichni pacienti byli sledováni min. 6 měsíců. Výsledky: V odstupu 6 měsíců od úrazu uváděli 2 z pacientů mírné klidové bolesti (1× při zhojené zlomenině, 1× při pakloubu). Bolesti při pohybu nastávaly u 5 pacientů s rozvinutým pakloubem. Dobré zhojení zlomeniny v anatomickém postavení bylo pozorováno u 10 pacientů (53 %), ve 2 případech (11 %) došlo v průběhu hojení k úhlové dislokaci a v 7 případech (37 %) se rozvinul pakloub. Závěr: Konzervativní terapie je vhodná pro zlomeniny střední části skafoidea nedislokované a s dislokací kostních fragmentů do 1,5 mm. U těchto zlomenin je při konzervativní terapii nízké riziko rozvoje pakloubu. RTG zobrazení je nedostatečné. CT vyšetření je nutné zhotovit při nezachycení linie lomu na RTG snímcích při výrazném klinickém nálezu, obzvlášť ve skupině pacientů s typickým výskytem zlomeniny střední části skafoidea, tzn. u mladých mužů ve věku mezi 25. a 40. rokem. Rozhodnutí o druhu léčby musí vždy vycházet z CT vyšetření.

Introduction: The goal of this work is to determine, using the analysis of our own patient group and current professional publications, in which cases fractures of the scaphoid waist can be treated conservatively by short-term plaster fixation with a low risk of non-union developing. Material and method: A group of 19 patients (17 men and 2 women) with the mean age 31 years (range 20–43, SD 7.3) with fractures of scaphoid waist were indicated for conservative treatment. The diagnosis was made on the basis of X-ray and CT examination. Conservative therapy consisted of applying plaster fixation of the wrist and thumb for a minimum of 6 weeks in completely non-dislocated fractures (mean 6.4 weeks, range 6–10 weeks). The other fractures were immobilized with a plaster cast for a total of 9 weeks. All patients were followed for at least 6 months. Results: At 6 months after the injury, 2 of the patients reported mild pain at rest (1× with healed fracture, 1× with a non-union). Pain during movement occurred in 5 patients with a developed non-union. Good healing of the fracture in the anatomical position was observed in 10 patients (53%), in 2 cases (11%) an angular dislocation occured during healing, and in 7 patients (37%) the result of treatment was a non-union. Conclusion: Conservative therapy is suitable for fractures of the scaphoid waist without dislocation and with dislocation of bone fragments up to 1.5 mm. In these fractures, conservative therapy has a low risk of non-union developing. X-ray imaging is insufficient. In case the fracture line does not appear on the X-ray and there is a significant clinical finding, especially in the group of patients with a typical occurrence of a fracture of the scaphoid waist, i.e. in young men aged between 25 and 40 years, CT examination must be performed. The decision on the type of treatment must always be based on the CT scan.

• MeSH
• Scaphoid Bone * diagnostic imaging   injuries   MeSH
• Adult MeSH
• Fracture Fixation MeSH
• Fractures, Bone diagnostic imaging   therapy   MeSH
• Conservative Treatment * MeSH
• Humans MeSH
• Wrist Injuries therapy   MeSH
• Pseudarthrosis diagnostic imaging   etiology   MeSH
• Casts, Surgical MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH

INTRODUCTION: German-speaking surgeons have left a deep imprint on the history of diagnostics and treatment of proximal femur fractures. Some of the studies published in German have fell into oblivion, others are cited until today, although sometimes quite inaccurately. The cause of such inaccuracies are citations from secondary sources due to unavailability of the original or inability to read it because of a language barrier. In the current literature, globally predominated by English articles, the "German history" of treatment of proximal femur fractures remains undervalued. The aim of the present article is to point out its contribution. MATERIALS AND METHODS: Literature search was performed in original publications and historical sources. RESULTS: The German-speaking surgeons have considerably contributed to the development of the treatment of proximal femur fractures. The analyzed period between 1847 and 1970 may be divided into three basic periods. In the first period (1847-1896), the German-speaking surgeons (Langenbeck, Trendelenburg, König, Heine, Dolinger) were the first worldwide to start treating the fractures of proximal femur operatively. In the second period (1897-1935), mainly in the 1930s, the initiative in Europe was taken over by surgeons publishing studies in France and in Belgium. Overseas, American surgeons were coming to the forefront. In Germany, only Pauwels developed the first biomechanical classification of femoral neck fractures. In the third period (1936-1970), mainly in the 1940s and 1950s, implants were designed (Pohl, Künstcher), based on close collaboration between German engineers and surgeons, that served as a model for a dynamic hip screw and a proximal femoral nail, which are currently the implants of choice in the treatment of trochanteric fractures. CONCLUSION: The historical contribution of German-speaking surgeons to understanding the issue of proximal femur fractures and their operative treatment is far more significant than presented in the historical studies published in English.

• MeSH
• Femur surgery   MeSH
• Femoral Neck Fractures * surgery   MeSH
• Hip Fractures * surgery   MeSH
• Proximal Femoral Fractures * MeSH
• Bone Nails MeSH
• Humans MeSH
• Fracture Fixation, Internal MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

• MeSH
• History, 18th Century MeSH
• History, 19th Century MeSH
• Patella Fracture surgery   history   MeSH
• Humeral Fractures surgery   history   MeSH
• Femoral Neck Fractures surgery   history   MeSH
• Humans MeSH
• Fracture Fixation, Internal * history   methods   MeSH
• Check Tag
• History, 18th Century MeSH
• History, 19th Century MeSH
• Humans MeSH

PURPOSE OF THE STUDY: The purpose of this study was to assess the clinical outcomes and complications associated with intramedullary and transverse K-wire fixations of 5th metacarpal neck fractures. MATERIAL AND METHODS: Patients who were operated for 5th metacarpal neck fractures between 2019 and 2022 were evaluated retrospectively. Regarding the surgical treatment methods, patients were assessed by dividing them into two groups. The first group comprised patients who underwent treatment with an intramedullary K-wire. The second group comprises patients who underwent transverse K-wire fixation. RESULTS: The average quick DASH score of all patients was 5.6±4.7 in the intramedullary K-wire fixation group and 5.9±5.1 in the transverse K-wire fixation group. An average 5th finger metacarpophalangeal joint extension limitation was 6.2±5.7° in the intramedullary fixation group and 6.1±5.8° in the transverse K-wire group. The mean radiological union time was 4.9±0.7 weeks in the intramedullary fixation group and 5.1±0.7 weeks in the transverse K-wire group. No statistically significant difference was found between the quick DASH scores and degrees of the MCP joint extension limitation ( p=0.785). Intramedullary fixation and transverse K-wire fixations are effective surgical treatment methods for metacarpal neck fractures. DISCUSSION: It has been reported that the intramedullary fixation method in metacarpal bone fractures is more effective than the fixation methods with cross and transverse K-wire. But our results revealed no difference in clinical outcomes between the two surgical fixation methods. CONCLUSIONS: We observed no statistically significant difference between the two fixation techniques with regard to union, clinical outcomes, or complications. KEY WORDS: intramedullary fixation; metacarpal neck fracture; transverse K-wire fixation.

• MeSH
• Adult MeSH
• Fractures, Bone * surgery   MeSH
• Fracture Fixation, Intramedullary * methods   instrumentation   MeSH
• Bone Wires * MeSH
• Middle Aged MeSH
• Humans MeSH
• Metacarpal Bones * injuries   surgery   MeSH
• Retrospective Studies MeSH
• Fracture Fixation, Internal methods   instrumentation   MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH