INTRODUCTION: Volkmann's ischaemic contracture (VIC) is a disabling condition resulting from tissue necrosis due to impaired vascular supply to the limb. Over the years VIC has become rare in developed countries with many different aetiologies described. It was alarming to have high incidence of established VIC in our practice in Nepal. A detailed analysis was conducted to accurately describe this issue. METHODS: We collected 47 cases of VIC over six years and noted the age, sex, district of origin and cause of VIC, duration of injury to presentation, and the grade of VIC. Then we compared these characteristics of VIC of each Nepal province and created a map to show the problematic regions. RESULTS: Out of 47 patients, 46 could have been prevented by an early treatment. The most common cause was a tight cast in 25 patients (53.19%), followed by unintentionally self-caused VIC by applying tight bandages in 21 patients (44.68%). Most cases came from province 6 (29.78%). Our group included three mild (6.4%), 35 moderate (74.5%) and nine severe (19.1%) cases of VIC. Only 14 cases (29.78%) had a timely fasciotomy in the past. CONCLUSION: VIC is an irreversible complication of the compartment syndrome which is an easily preventable condition in the setting of developing countries. Our focus should, therefore, aim at preventing such disastrous conditions as 97.87% of cases we encountered could have been avoided by proper primary care. In the case of Nepal most cases came from province 6 and province 3.

• Klíčová slova
• Volkmann’s ischaemic contracture, cast application, compartment syndrome, iatrogenic injury, paediatric orthopaedics,
• MeSH
• dítě MeSH
• dospělí MeSH
• horní končetina krevní zásobení   MeSH
• ischemická kontraktura * etiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• předškolní dítě MeSH
• rozvojové země * MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Nepál epidemiologie   MeSH

PURPOSE OF THE STUDY Extended lateral approach to calcaneus fractures is associated with a high risk of infection. Such risk can be reduced by using mini-invasive approaches. The sinus tarsi approach provides a good overview of the posterior joint facet of the calcaneus and can also be done as a mini-invasive procedure. The authors present their fi rst experience with osteosynthesis of joint depression calcaneal fractures using the anterolateral locking plate inserted through the sinus tarsi approach. MATERIAL AND METHODS During the period from 1 February 2020 to 31 January 2022, 18 patients were treated by the anterolateral locking plate in the authors' department (3 women, 15 men). Eleven fractures were classifi ed according to Sanders as IInd grade, fi ve as IIIrd grade and two fractures were classifi ed as tongue-type (as described by Essex-Lopresti). The fractures were treated by open reduction through the sinus tarsi approach and osteosynthesis by the anterolateral locking plate combined with headless screws. The following factors were examined: time from injury, duration of surgery, quality of reduction (post-op control with multiplanar CT scans), wound and technical complications, loss of reduction after treatment, substance abuse and comorbidities. The follow-up was 12-36 months (median 17). At one year after surgery, the functional outcomes were evaluated using the AOFAS Hindfoot score. RESULTS The most common negative predispositions for successful healing were smoking (9 cases), alcohol abuse, drug abuse, mild mental retardation, personality disorder, insulin-dependent diabetes and epilepsy (1 case each), hypothyreodism and bronchial asthma (2 cases each). The time from injury to surgery and duration of surgery surgery were measured. The quality of reduction was excellent in 12 patients (dislocation less than 1 mm), good in 6 patients (dislocation less than 2 mm), dislocation more than 2 mm was not present in the group. In one case, a revision surgery was performed because of screw malposition into the subtalar joint, delayed wound healing was observed in two cases. There was no case of deep surgical site infection or loss of reduction. The mean AOFAS score after one year was 85 points. The most common complaints were scar pain or discomfort. DISCUSSION The current studies on osteosynthesis of calcaneal fractures favor the sinus tarsi approach for its lower risk of wound-related complications compared to the extended lateral approach. The sinus tarsi approach requires the use of different osteosynthetic material than the conventional calcaneal plate. If a conventional locking plate is to be used, the surgical approach has to be modifi ed. In 2021, Wang et al. published an intermediate step leading to the reduction of early complications and the use of conventional locking calcaneal plate inserted through the sinus tarsi approach, with an additional incision. The sinus tarsi approach is used also when intramedullary nailing is performed, which is preferred by biomechanical studies evaluating the rigidity of osteosynthesis. However, when comparing nails and locking plates, the differences are insignifi cant. The use of anterolateral locking plates was presented by Xie et al., with results similar to those of our own group of patients. CONCLUSIONS The results of the followed-up group of patients confi rm low complication rate of the sinus tarsi approach as reported by current literature. At the same time, it provides good options for reduction even in complicated fractures. For successful osteosynthesis, the anterolateral locking plate with headless screws may be used. The incidence of post-operative complications is low even in high-risk patients. Adhesions of peroneal tendons can be treated with material removal and tissue release. They could be prevented by good physiotherapy. Key words: calcaneus, osteosynthesis, anterolateral plate, peroneal tendons, sinus tarsi approach.

• MeSH
• fraktury kostí * chirurgie   MeSH
• intraartikulární fraktury * chirurgie   MeSH
• kostní destičky MeSH
• kostní šrouby MeSH
• lidé MeSH
• patní kost * chirurgie   zranění   MeSH
• počítačová rentgenová tomografie MeSH
• poranění kolena * MeSH
• poranění kotníku * MeSH
• vnitřní fixace fraktury metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

Fractures of the surgical neck of the scapula combined with a fracture of the coracoid base constitute a specific and rare type of a fracture pattern. When displaced, they present a severe, completely unstable type of surgical neck fracture, requiring a precise CT diagnosis, open reduction and stable internal fixation of the fracture via the Judet approach. The aim of this study is to describe our four cases and discuss three others reported to date.

• Klíčová slova
• Judet approach, coracoid process, scapula, scapular fractures, scapular neck,
• MeSH
• artrodéza MeSH
• fraktury kostí * diagnostické zobrazování   chirurgie   MeSH
• fraktury páteře * MeSH
• lidé MeSH
• lopatka diagnostické zobrazování   zranění   chirurgie   MeSH
• vnitřní fixace fraktury MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY The study aims to evaluate and compare the results of conservative and operative treatment of individual types of distal ulna fractures associated with distal radius fracture treated by plate osteosynthesis and to verify the conclusions of the other authors regarding the recommended therapeutic procedures in these fractures. MATERIAL AND METHODS In the period from 08/2013 to 09/2015, a total of 81 patients participated in the prospective randomised study, with the mean follow-up period of 24 months (6-36). All the fractures of distal two thirds of ulnar styloid process were treated conservatively. The patients with the other types of ulnar fractures (fractures of the proximal third of ulnar styloid process, ulnar head fractures, subcapital fractures) were systematically divided into two cohorts, based on which the subsequent (conservative vs. operative) treatment of distal ulna fractures was indicated. The operative treatment of all the types of distal ulna fractures was performed by plate osteosynthesis using LCP Distal Ulna Plate implant so that a uniform method is applied. RESULTS In the post-operative follow-up not a single patient with tip fracture of ulnar styloid process in the cohort showed a posttraumatic instability or disorder of distal radioulnar joint (DRUJ) biomechanics (ROM 96.6% (91-100), MWS 61.3 points (75-100), QDASH 2.9 points (0-6.8)). The patients with a fracture of the proximal third of ulnar styloid process, a fracture of ulnar head and a subcapital fracture, treated operatively, achieved better early radiographic and functional outcome (ROM 95.7% (60-100), MWS 91.2 points (75-100), QDASH 3.5 points (0-11.4)) than patients treated conservatively (ROM 89.6% (64-100), MWS 70.4 points (35-85), QDASH 18.4 points (0-52.3)). DISCUSSION The study confirms the conclusions drawn by the other authors that tip fractures of ulna do not cause posttraumatic DRUJ instability and do not require operative treatment. Conservative treatment of ulnar base fractures led to non-union in 60% of cases and to malunion in 25% of cases, altogether in 15 patients (75%) the clinical examination revealed a conclusive posttraumatic DRUJ instability of various severity and these patients showed healing in malunion ad latus greater than 2 mm and non-union of the fracture. By performing anatomical reduction and osteosynthesis of ulnar "base fractures", the stability and DRUJ function were restored in all the patients, thus also a better functional outcome was attained. Conservative treatment of ulnar head fractures brought worse outcomes due to malunion of fractures resulting in a noncongruent articular surface of DRUJ or a change in axial position of the distal end of the bone. The change in DRUJ biomechanics resulted in a limited rotation of radius and a limited range of forearm mobility. The operative treatment of subcapital ulna fracture had a very good early outcome as compared to conservative treatment of the fracture which healed in malunion, the change of axial position of the distal end of the bone resulted in a limited range of forearm mobility. CONCLUSIONS Based on the early functional and radiographic outcomes of RCT study it can be stated, in agreement with the other authors, that the operative treatment of distal ulna fractures associated with the distal radius fracture treated by ORIF should be indicated for base fractures of ulnar styloid process associated with DRUJ instability following the osteosynthesis of distal radius fracture and peripheral fragment dislocation ad axim or ad latus in radial direction by 2 mm and more, and also in case of displaced ulnar head fractures and instable and displaced subcapital fractures of the ulna. Key words: distal ulna fracture, plate osteosynthesis, LCP distal ulna plate.

• MeSH
• časové faktory MeSH
• fraktury ulny komplikace   terapie   MeSH
• fraktury vřetenní kosti komplikace   terapie   MeSH
• hojení fraktur MeSH
• konzervativní terapie * MeSH
• kostní destičky * MeSH
• lidé MeSH
• následné studie MeSH
• prospektivní studie MeSH
• rozsah kloubních pohybů MeSH
• vnitřní fixace fraktury * MeSH
• výběr pacientů MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

INTRODUCTION: Fractures affecting the entire glenoid fossa are termed comminuted or total glenoid fractures. However, there are no detailed studies of total glenoid fractures, and only brief mentions can be found in the literature. METHODS: The group comprised 12 patients (mean age, 39 years), who sustained 13 fractures of the glenoid fossa. In all the fractures, all parts of the glenoid fossa were separated from the scapular neck or body. In total 5 patients (6 fractures) were treated non-operatively and 7 patients were operated on. The method of treatment was based on displacement of the fragments, the patient´s general and local conditions. Indication for operative treatment was displacement of articular fragments of more than 3mm. This criterion was met by 10 patients (11 fractures). Owing to the general or local condition, operation was contraindicated in 2 patients with 3 fractures; one patient refused the operation. One patient with a bilateral fracture was lost to follow-up. RESULTS: According to the site of separation of articular fragments, the fractures were divided into three groups - the separation line passed through the anatomical neck; through the coracoid process or surgical neck of the scapula; or through the scapular body. In 6 of the 7 operated patients, a good or very good result was achieved. In 2 patients with minimal fragment dislocation treated non-operatively, the fractures healed in an anatomical position and full range of motion was achieved. In 2 patients with severe fragment displacement treated non-operatively, the healing resulted in glenoid fossa incongruence and painful and limited range of motion. CONCLUSION: Fractures of the entire glenoid fossa are the most severe injuries to scapula. Their diagnosis requires CT examination, including 3D CT reconstruction with subtraction of the surrounding bones. Displaced fractures are indicated for operative treatment from the Judet approach.Key words: scapular fractures glenoid fractures classification, operative treatment Judet approach.

• MeSH
• dospělí MeSH
• fixace fraktur MeSH
• fraktury proximálního humeru diagnostické zobrazování   terapie   MeSH
• hojení fraktur MeSH
• imobilizace MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• pasivní pohybová terapie CPM MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY: The aim of the study was to describe the indication criteria and operative technique and to present the first conclusions of a prospective study dealing with an assessment of functional and radiographic findings in patients with concurrent fractures of the distal ulna and distal radius; the former was treated by osteosynthesis using an LCP Distal Ulna Plate (De Puy Synthes, USA) and the latter by plate osteosynthesis. MATERIAL AND METHODS: Between August 2013 and September 2014, 18 patients (3 men and 15 women; average age, 58 years; range, 25-74 years) with a fracture of the distal ulna and a concurrent distal radius fracture were treated by plate osteosynthesis. The indications for surgery included displaced ulnar styloid base fractures in 10 patients, displaced comminuted fractures of the ulnar head in seven patients and a subcapital fracture of the ulna in one patient. The average follow-up was 9 months, with 13 (72%) patients being followed up for 6 months at least. The outcome of surgery was evaluated on the basis of X-ray views and multiplanar reconstruction of CT scans. Functional results were based on measuring the range of motion at wrist and forearm and hand grip strength and on the scores obtained from the Mayo Wrist Score System and Quick DASH Questionnaire. RESULTS: The average values for wrist and forearm range of motion were as follows: 68° in flexion (60-80°), 71° in extension (40- 90°), 87° in pronation (70-90°), 81° in supination (50-90°). This corresponded to a 92% (74-100%) range of motion at the contralateral wrist and forearm. The average hand grip strength measured with a dynamometer was 80.6% (53-100%) of the gripping force exerted by the unaffected extremity. Post-operative X-ray and CT findings showed good reduction of both distal radius and distal ulna fractures as well as good fragment retention by means of LCP implants. During follow-up complete bone union and full stability of the radioulnar joint were achieved in all patients. The functional outcome of treatment was shown by the average Mayo wrist score and Quick DASH score of 84 (55-100) and 7.4 (0-47.7) points, respectively. DISCUSSION: The functional outcome of treatment in our patients corresponded to the severity of their distal forearm fractures. The patients with more serious distal radius fractures, frequently associated with ulnar head fractures, had poorer functional results than the patients with less serious fractures. According to the AO classification, in the distal radius fractures, prevailing fracture types were 23-C3 (78%) and 23-C2 (16%). In relation to the distal ulna fracture type, the patients with ulnar styloid base fractures had better functional results than the patients with ulnar head fractures, because a fracture of the styloid process does not affect the congruency of the distal radioulnar joint (DRUJ). Fractures of the ulnar styloid process base, following distal radius fracture osteosynthesis, were invariably associated with DRUJ instability. This fracture type is always accompanied by injury to the distal radioulnar ligament of the triangular fibrocartilage complex (TFCC) and, in case of a displaced fracture, surgical management is indicated. In agreement with the results of other authors it was found in our study that, when the anatomical position of the distal radioulnar joint had been achieved, both the functional and the radiographic findings were post-operatively very good. The final average values for the range of wrist and forearm motion, hand grip strength and hand and arm function were assessed as very good. CONCLUSIONS The assessment of our results and their comparison with the literature data showed that osteosynthesis of distal ulna fractures with concurrent distal radius fractures managed by open reduction and internal fixation are indicated in displaced fractures of the ulnar styloid process base, displaced comminuted fractures of the ulnar head where fragments interfere with DRUJ congruency, and unstable displaced subcapital fractures of the ulna. The early results of this study provide evidence for the efficiency of plate osteosynthesis in the treatment of distal ulna fractures.

• MeSH
• dospělí MeSH
• fraktury ulny diagnostické zobrazování   chirurgie   MeSH
• fraktury vřetenní kosti diagnostické zobrazování   chirurgie   MeSH
• kostní destičky * MeSH
• lidé středního věku MeSH
• lidé MeSH
• obnova funkce MeSH
• polytrauma diagnostické zobrazování   chirurgie   MeSH
• poranění zápěstí diagnostické zobrazování   patofyziologie   chirurgie   MeSH
• prospektivní studie MeSH
• rentgendiagnostika MeSH
• senioři MeSH
• tříštivé fraktury diagnostické zobrazování   chirurgie   MeSH
• vnitřní fixace fraktury škodlivé účinky   přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• zápěstní kloub fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

INTRODUCTION: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy. METHODS: The majority of purely ligamentous injuries ("high ankle sprains") is not sassociated with a latent or frank tibiofibular diastasis and may be treated with an extended protocol of physical therapy. Relevant instability of the syndesmosis with diastasis results from rupture of two or more ligaments that require surgical stabilization. Syndesmosis disruptions are commonly associated with bony avulsions or malleolar fractures. Treatment consists in anatomic reduction of the distal fibula into the corresponding incisura of the distal tibia and stable fixation. Proposed means of fixation are refixation of bony syndesmotic avulsions, one or two tibiofibular screws and suture button. There is no consensus on how long to maintain fixation. Both syndesmotic screws and suture buttons need to be removed if symptomatic. RESULTS/COMPLICATIONS: The most frequent complication is syndesmotic malreduction and may be minimized with open reduction and intraoperative 3D scanning. Other complications include hardware failure, heterotopic ossification, tibiofibular synostosis, chronic instability and posttraumatic arthritis. CONCLUSION: The single most important prognostic factor is anatomic reduction of the distal fibula into the tibial incisura.

• Klíčová slova
• Ankle, Fixation, Instability, Syndesmosis, Treatment,
• MeSH
• biomechanika fyziologie   MeSH
• dislokace kloubu diagnóza   patofyziologie   chirurgie   MeSH
• fibula chirurgie   MeSH
• fraktury kotníku diagnóza   patofyziologie   chirurgie   MeSH
• fyzikální vyšetření metody   MeSH
• hlezenní kloub chirurgie   MeSH
• kloubní ligamenta zranění   chirurgie   MeSH
• kostní šrouby MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• nestabilita kloubu patofyziologie   prevence a kontrola   MeSH
• odstranění implantátu MeSH
• počítačová rentgenová tomografie MeSH
• pooperační komplikace etiologie   MeSH
• poranění kotníku diagnóza   patofyziologie   chirurgie   MeSH
• ruptura chirurgie   MeSH
• šicí techniky MeSH
• tibie chirurgie   MeSH
• torzní deformity etiologie   MeSH
• vnitřní fixace fraktury přístrojové vybavení   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

PURPOSE OF THE STUDY: The 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 METHODS: Between 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 fie, 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. RESULTS: The 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 fial 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 fidings were stable in 11 (79%) patients; elbows in three patients (21%) showed progression of degenerative changes (osteophyte formation and periarticular ossifiation). The fial 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. DISCUSSION: The 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. CONCLUSIONS: From the results of early functional assessments and radiographic fidings 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 severe stiffness of the elbow or in stiffness due to extrinsic causes. Although the improvement in ROM achieved during the surgical procedure cannot be maintained in its full extent, this technique relieves persisting pain and signifiantly improves ROM of the elbow joint.

• MeSH
• artroskopie metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• loketní kloub patofyziologie   chirurgie   MeSH
• mladý dospělý MeSH
• nemoci kloubů etiologie   patofyziologie   chirurgie   MeSH
• prospektivní studie MeSH
• rozsah kloubních pohybů MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

PURPOSE OF THE STUDY: The aim of this prospective study was to present injury characteristics and to evaluate therapeutic procedures and midterm functional and radiographic results of the surgical management of talus fractures. MATERIAL AND METHODS: In the period from January 1, 2004, to December 31, 2009, a total of 53 patients with 56 talar bone fractures or peritalar dislocations were treated surgically. The prospective study included 39 patients with 42 fractures of the talar neck and body; of these, 31 men had 34 fractures (79.5%) and eight women had eight fractures (20.5%). There were recorded demographic data, medical history, associated injuries, polytrauma criteria, time to surgery and its type, failure of osteosynthesis, complications associated with soft tissue healing, length of hospital stay, duration of follow-up, radiographic evidence of bone healing and the presence of avascular necrosis or arthritis. Fractures were classified according to the systems of Hawkins (modified by Canale), Sneppen and Marti. Outcomes were assessed on the basis of functional and radiographic scores (West Point Ankle Score). The injuries included 21 (50%) talar neck fractures, 12 (28.5%) isolated fractures of the talar body and nine (21.5%) combined fractures of the talar neck and body. There were four (9.5%) open fractures. Twenty-five (64.1%) patients had associated skeletal injuries; eight (20.5%) patients suffered polytrauma. Staged treatment was used in five patients (12.8%). The average time to final surgery was 4.2 days. The technique of minimally invasive osteosynthesis under fluoroscopic or arthroscopic control was used in 18 (42.9%) fractures, and open reduction and internal fixation was carried out in 24 (57.1%) fractures. The average follow-up was 30.9 months. RESULTS: Signs of avascular necrosis partly or completely affecting the talar body were found in six fractures (14.3%), three of which required secondary arthrodesis. Arthritis developed in 10 cases (23.8%) Functional and radiographic results assessed with the West Point Ankle Score, regardless of fracture type, were excellent in 17 (43.5%), good in 11 (28.2%), satisfactory in five (12.8%) and poor in six (15.5%) patients. DISCUSSION: High incidence of polytrauma and complex injuries of the hindfoot makes the timing of surgical management difficult and also affects its outcome. Timing used in our study is in agreement with general trends of staged talus fracture treatment. In accordance with the international practice, the majority of non-displaced talar neck fractures (Hawkins 1) were treated by means of osteosynthesis. We preferred minimally invasive fracture reduction under arthroscopic control in less complicated fracture types of the talar neck and body. The incidence of avascular necrosis, as reported in the literature, has had a decreasing tendency. Incidence of avascular necrosis without talar dome collapse does not necessarily lead to functional impairment. The results of functional and radiographic scoring were in agreement with the literature data and confirmed that functional outcome is related to the severity of fracture. CONCLUSIONS: Our results confirmed that the management of talar fractures by means of osteosynthesis is indicated even in nondisplaced Hawkins type 1 fractures, staged treatment is effective in dislocated and open fractures, delayed surgery is a safe procedure for less dislocated fractures and injuries requiring complex care should be referred to foot surgery centres.

• MeSH
• dospělí MeSH
• fraktury kostí klasifikace   diagnostické zobrazování   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• rentgendiagnostika MeSH
• talus diagnostické zobrazování   zranění   chirurgie   MeSH
• vnitřní fixace fraktury metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• fraktury humeru dějiny   chirurgie   MeSH
• lidé MeSH
• ortopedie dějiny   MeSH
• vnitřní fixace fraktury dějiny   metody   MeSH
• Check Tag
• dějiny 20. století MeSH
• dějiny 21. století MeSH
• lidé MeSH
• Publikační typ
• biografie MeSH
• dopisy MeSH
• historické články MeSH
• portréty MeSH
• Geografické názvy
• Německo MeSH

• O autorovi
• Hackethal, Karl Heinz