PURPOSE OF THE STUDY: Hip osteoarthritis (OA) has a prevalence of around 6.4% and is the second most commonly affected joint. This review aims to assess the clinical outcomes of intra-articular high molecular weight hyaluronic acid (HMWHA) in the management of hip osteoarthritis. MATERIAL AND METHODS: We conducted a comprehensive search across PubMed, Google Scholar, and the Cochrane Library for randomised trials investigating the effectiveness of high molecular weight hyaluronic acid (HMWHA) in the treatment of hip osteoarthritis. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. To synthesise the data, we utilised the Standardised Mean Difference (SMD) for assessing pain relief through the Visual Analogue Scale (VAS) and the Lequesne index (LI) for evaluating functional outcomes. Risk Ratio (RR) was calculated to assess the occurrence of complications. RESULTS: A total of four studies involving HMWHA and control groups were included. The standardised mean difference (SMD) for the Visual Analogue Scale (VAS) (SMD -0.056; 95% CI; -0.351, 0.239; p = 0.709) and the Lequesne index (SMD -0.114; 95% CI; -0.524, 0.296; p = 0.585) were not statistically significant. Analysis for complications demonstrated an overall relative risk ratio (RR) of 0.879 (95% CI; 0.527, 1.466; p = 0.622), and was not statistically significant. DISCUSSION AND CONCLUSIONS: Intra-articular HMWHA in hip OA can significantly reduce pain and improve functional recovery when compared with the condition before treatment. However, there is no significant difference between HMWHA, or saline, or other therapeutic treatments. Currently, available evidence indicates that intra-articular HMWHA in hip OA would not increase the risk of adverse events. KEY WORDS: hip osteoarthritis, hyaluronic acid, intra-articular, molecular weight, viscosupplementation.

• MeSH
• artróza kyčelních kloubů * farmakoterapie   komplikace   MeSH
• injekce intraartikulární MeSH
• kyselina hyaluronová * terapeutické užití   škodlivé účinky   MeSH
• lidé MeSH
• měření bolesti MeSH
• molekulová hmotnost MeSH
• randomizované kontrolované studie jako téma * MeSH
• viskoelastické doplňky kloubní tekutiny * aplikace a dávkování   terapeutické užití   MeSH
• viskosuplementace * metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH
• Názvy látek
• kyselina hyaluronová * MeSH
• viskoelastické doplňky kloubní tekutiny * MeSH

A narrative review of the literature was conducted to examine the data on femoral head fractures, with a particular focus on their management, complications and clinical outcomes. A PRISMA strategy was used. Medline and Scopus library databases were queried using pre-defined MeSH terms and Boolean operators. Quality of evidence was evaluated based on OCEBM and GRADE systems. The 50 eligible articles that met the predefined inclusion criteria reported on 1403 femoral head fractures. A detailed analysis of the surgical approaches used was performed in 38 articles with 856 fractures. Most fractures were treated surgically (90,8 %) with preferred anatomical reconstruction in 76,7 % of all operatively treated cases. Posterior approaches were the most common (52.5 %). This was evenly split between surgical hip dislocation and the classic Kocher-Langenbeck approach. 70.5 % of surgically treated cases achieved excellent or good result according to Thompson-Epstein criteria. Highest rate of excellent results showed minimal invasive osteosynthesis and surgical hip dislocation. Major late complications were avascular necrosis (10.8 %), post-traumatic arthritis (16.2 %) and heterotopic ossification (20.8 %). Secondary THA was necessary in 6.9 %. Highest rate of major complications was joined with anterior approach (77 %), lowest rate from frequently used approaches surgical hip dislocation (37.8 %). Conservative treatment recedes into the background. The Ganz flip osteotomy with surgical hip dislocation allows safe treatment of all types of fractures and should be considered the first choice, offering the lowest rate of complications and one of the best functional outcomes. Reconstruction of Pipkin Type III fractures should be reserved for very young patients due to high rate of major complications.

• Klíčová slova
• Avn, Femoral head, Fracture, Pipkin, Surgical approach,
• MeSH
• fraktury kyčle chirurgie   MeSH
• hlavice femuru zranění   chirurgie   MeSH
• lidé MeSH
• luxace kyčle chirurgie   MeSH
• náhrada kyčelního kloubu metody   MeSH
• pooperační komplikace epidemiologie   MeSH
• vnitřní fixace fraktury * metody   MeSH
• výsledek terapie MeSH
• zákroky plastické chirurgie metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

BACKGROUND: Alternative autologous veins can be used as a conduit when adequate great saphenous vein is unavailable. We analyzed the results of our infrainguinal bypasses after adopting upper extremity veins in our practice. METHODS: This is a single-center observational study involving all patients whose infrainguinal bypass involved the use of upper extremity veins between April 2019, when we began using arm veins, and February 2023. RESULTS: During the study period, 49 bypasses were done in 48 patients; mean age 68.1 ± 9.8; men 32 (66.7%); body mass index 28.0 ± 4.8; indications for surgery: chronic limb threatening ischemia 41 (83.7%); acute limb ischemia 3 (6.1%); complications of previous prosthetic 3 (6.1%), or autologous 2 (4.1%) bypass grafts. Vein splicing was used in 43 (87.8%) bypasses with 3-segment grafts being the most common (26; 53.1%). There were 24 (49.0%) femorotibial, 11 (22.4%) femoropopliteal, 9 (18.4%) femoropedal, and 5 (10.2%) extension jump bypass procedures. Eighteen (36.7%) operations were redo surgeries. Twenty-one (42.9%) bypasses were formed using only arm veins. The median follow-up was 12.9 months (4.5-24.2). Two bypasses occluded during the first 30 postoperative days (2/49; 4.1%). Overall 30-day, 1-year, and 2-year primary patency rates were 93.7% ± 3.5%, 84.8% ± 5.9%, and 80.6% ± 6.9%, and secondary patency (SP) rates were 95.8% ± 2.9%, 89.2% ± 5.3%, and 89.2% ± 5.3%. One-segment grafts had better patencies than 2-, 3-, and 4-segment grafts (1-year SP 100% ± 0% vs 87.6% ± 6.0%). Two-year amputation-free survival was 86.8% ± 6.5%; 2-year overall survival was 88.2% ± 6.6%. CONCLUSIONS: Integration of arm vein grafts in infrainguinal bypass practice can be done safely with low incidences of perioperative graft failure. One-segment grafts had better patencies than spliced vein grafts. The achieved early patency and amputation-free survival rates strongly encourage their use. In the absence of a single-segment great saphenous vein, upper extremity vein grafts should be the preferred conduit choice.

• MeSH
• amputace MeSH
• autologní transplantace * MeSH
• časové faktory MeSH
• horní končetina krevní zásobení   MeSH
• lidé středního věku MeSH
• lidé MeSH
• okluze cévního štěpu etiologie   patofyziologie   chirurgie   MeSH
• onemocnění periferních arterií * chirurgie   patofyziologie   diagnostické zobrazování   MeSH
• průchodnost cév * MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace cév škodlivé účinky   metody   MeSH
• vena saphena transplantace   MeSH
• vény transplantace   chirurgie   patofyziologie   MeSH
• výsledek terapie MeSH
• záchrana končetiny MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Fractures of the proximal humerus constitute approximately 5% of all fractures. Shoulder joint injuries without any external mechanical impact during seizures with the occurrence of spasms occur only sporadically. The occurrence rate is reported in approximately 0.4% of patients. Very rarely they occur in the form of epileptic seizure-induced dorsal fracturedislocation impacting both sides. The case report describes a case of a 48-year-old woman with no treatment for epileptic seizures in her medical history. During the first seizure she sustained a bilateral dorsal fracture-dislocation caused by a muscle spasm, without any other mechanical impact. The fractures were classified as a 3-fragment fracture on the right side and a 4-fragment fracture on the left side. After the patient's admission to the inpatient emergency department, reduction under anaesthesia was attempted. Subsequently, after preparation, open reduction and osteosynthesis using an angularly stable plate were performed as a two-stage surgery. No complications were observed postoperatively Currently, at 3 years after surgeries, the female patient has full mobility of her shoulder joints with no subjective difficulties. Key words: epilepsy, seizure, dorsal fracture-dislocation of the proximal humerus.

• MeSH
• dislokovaná fraktura chirurgie   MeSH
• epilepsie etiologie   MeSH
• fraktury proximálního humeru * chirurgie   komplikace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• luxace ramenního kloubu chirurgie   etiologie   MeSH
• vnitřní fixace fraktury metody   MeSH
• záchvaty etiologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

PURPOSE OF THE STUDY: Our study aims to compare the results of preoperative radiography and intraoperative visual assessment of the cartilage with histological assessment of joint surfaces of the medial and lateral compartments resected in patients during the total knee replacement. MATERIAL AND METHODS: The cohort included 20 patients (9 men and 11 women) with the mean age of 66.6 (±7.0) years who met the inclusion criteria of the study. Degenerative changes of the knee joint seen on a preoperative weight-bearing anteroposterior X-ray were evaluated according to the Kellgren-Lawrence grading system separately for the medial and lateral compartment. Based on the visual appearance, the condition of articular surfaces was assessed using the International Cartilage Repair Society Score (ICRS Grade). The histological assessment of degenerative changes was conducted by a pathologist with the use of the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment System based on six grades of articular cartilage degeneration. RESULTS: The mean degree of degenerative changes based on the radiological classification was assessed as 3.5 (±0.6) for the medial compartment and 2.1 (±0.4) for the lateral compartment. The visually assessed chondropathy according to the ICRS Grade was 3.7 (±0.6) for the medial femoral condyle and 1.8 (±1.0) for the lateral femoral condyle. The histological score obtained using the Osteoarthritis Research Society International Osteoarthritis Cartilage Histopathology Assessment was 4.9 (±1.1) for the medial femoral condyle and 2.4 (±0.7) for the lateral femoral condyle. In respect of the medial compartment, there was no statistically significant parametric correlation between the intraoperative visual assessment of the cartilage degeneration and the preoperative radiological grade r = 0.45. The histological assessment showed a statistically significant concordance both with the degree of chondropathy r = 0.76 and the radiological grade r = 0.64. In the lateral compartment, the parametric test showed a statistically significant concordance only between the radiological grade and the histological score r = 0.72. The correlation between the visual assessment of chondropathy and the radiological grade r = 0.27 as well as the histological score r = 0.24 was very low. DISCUSSION: In our cohort assessing the early degenerative changes of the lateral compartment as well as the more advanced degenerative changes of the medial compartment, the correlation between the intraoperative assessment of cartilage degeneration as a diagnostic method to examine the lateral compartment and the preoperative radiological grade was not confirmed. Our results failed to confirm a better reporting value of the visual cartilage degeneration assessment of the lateral compartment as against the preoperative X-ray. The space width without narrowing on an X-ray has no reporting value for this compartment in case of varus deformity. CONCLUSIONS: The results clearly indicate that the assessment of macroscopic appearance of the cartilage degeneration during arthroscopy does not necessarily guarantee good long-term clinical outcomes after high tibial osteotomy. The respective degrees of cartilage degeneration identified during the intraoperative visual assessment and the radiological grading of osteoarthritic changes did not correlate in either compartment. In the lateral compartment, the initial radiological and histological findings preceded the visually detectable cartilage changes. KEY WORDS: knee, cartilage, osteoarthritis, radiology, histology, arthroscopy, osteotomy.

• MeSH
• artróza kolenních kloubů * chirurgie   diagnostické zobrazování   patologie   MeSH
• kloubní chrupavka * patologie   diagnostické zobrazování   MeSH
• kolenní kloub diagnostické zobrazování   patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• rentgendiagnostika * metody   MeSH
• senioři MeSH
• totální endoprotéza kolene * metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY: Laminectomy with fusion (LF) is commonly performed with laminoplasty (LP) for cervical myelopathy. Foraminal stenosis is important in the surgical treatment of cervical myelopathy. LF and LP can affect foraminal size in different ways. This study aimed to compare foraminal dimensions after LF and LP using a medical computer-assisted design (CAD) program. MATERIAL AND METHODS: Computed tomography (CT) scans of the cervical vertebrae of 16 patients with cervical myelopathy were retrospectively viewed in the Digital Imaging and Communications in Medicine format on a CAD program. CT images were reformatted in an oblique plane perpendicular to the long axis of each foramen from C2-C3 to C6-C7. The narrowest foraminal crosssectional dimension (FCD) was measured and compared between the LF and LP groups at the operated, non-operated, and C4-C5 levels. The difference between the preoperative and postoperative FCDs was also calculated and compared between the operated and C4-C5 levels. Intra- and interobserver reliabilities for FCD measurements were evaluated using intraclass correlation coefficients. RESULTS AND DISCUSSION: At the operated spinal levels, the LF and LP groups showed decreased and increased mean FCDs, respectively. At the adjacent non-operated levels, the mean FCD slightly increased in both the groups. In the LF group, the difference between the preoperative and postoperative FCDs in the C4-C5 levels was larger than that in the other operated levels, but this difference was insignificant. CONCLUSIONS: LF and LP showed contrary results for FCD. Therefore, FCD and kyphosis should be considered for LF and LP. KEY WORDS: three-dimensional, foraminal cross-sectional dimension, laminoplasty, laminectomy fusion, computer-aided design, drafting system, preoperative-postoperative comparison.

• MeSH
• fúze páteře * metody   MeSH
• krční obratle * chirurgie   diagnostické zobrazování   MeSH
• laminektomie * metody   MeSH
• laminoplastika * metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci míchy chirurgie   diagnostické zobrazování   MeSH
• počítačová rentgenová tomografie * metody   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• zobrazování trojrozměrné * metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

This study was aimed to compare the variability of inter-joint coordination in the lower-extremities during gait between active individuals with transtibial amputation (TTAs) and healthy individuals (HIs). Fifteen active male TTAs (age: 40.6 ± 16.24 years, height: 1.74 ± 0.09 m, and mass: 71.2 ± 8.87 kg) and HIs (age: 37.25 ± 13.11 years, height: 1.75 ± 0.06 m, and mass: 74 ± 8.75 kg) without gait disabilities voluntarily participated in the study. Participants walked along a level walkway covered with Vicon motion capture system, and their lower-extremity kinematics data were recorded during gait. The spatiotemporal gait parameters, lower-extremity joint range of motion (ROM), and their coordination and variability were calculated and averaged to report a single value for each parameter based on biomechanical symmetry assumption in the lower limbs of HIs. Additionally, these parameters were separately calculated and reported for the intact limb (IL) and the prosthesis limb (PL) in TTAs individuals. Finally, a comparison was made between the averaged values in HIs and those in the IL and PL of TTAs subjects. The results showed that the IL had a significantly lower stride length than that of the PL and averaged value in HIs, and the IL had a significantly lower knee ROM and greater stance-phase duration than that of HIs. Moreover, TTAs showed different coordination patterns in pelvis-to-hip, hip-to-knee, and hip-to-ankle couplings in some parts of the gait cycle. It concludes that the active TTAs with PLs walked with more flexion of the knee and hip, which may indicate a progressive walking strategy and the differences in coordination patterns suggest active TTA individuals used different neuromuscular control strategies to adapt to their amputation. Researchers can extend this work by investigating variations in these parameters across diverse patient populations, including different amputation etiologies and prosthetic designs. Moreover, Clinicians can use the findings to tailor rehabilitation programs for TTAs, emphasizing joint flexibility and coordination.

• Klíčová slova
• Coordination, Coordination variability, Gait, Transtibial amputation,
• MeSH
• amputace * MeSH
• amputovaní MeSH
• biomechanika MeSH
• chůze (způsob) * fyziologie   MeSH
• chůze fyziologie   MeSH
• dolní končetina MeSH
• dospělí MeSH
• hlezenní kloub patofyziologie   MeSH
• kolenní kloub patofyziologie   chirurgie   MeSH
• kyčelní kloub chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• rozsah kloubních pohybů * MeSH
• tibie chirurgie   patofyziologie   MeSH
• umělé končetiny * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: This systematic review aims to identify previously used techniques in biomechanics to assess pelvic instability following pelvic injury, focusing on external fixation constructs. METHODS: A systematic literature search was conducted to include biomechanical studies and to exclude clinical trials. RESULTS: Of an initial 4666 studies found, 38 met the inclusion criteria. 84% of the included studies were retrieved from PubMed, Scopus, and Web of Science. The studies analysed 106 postmortem specimens, 154 synthetic bones, and 103 computational models. Most specimens were male (97% synthetic, 70% postmortem specimens). Both the type of injury and the classification system employed varied across studies. About 82% of the injuries assessed were of type C. Two different fixators were tested for FFPII and type A injury, five for type B injury, and fifteen for type C injury. Large variability was observed for external fixation constructs concerning device type and configuration, pin size, and geometry. Biomechanical studies deployed various methods to assess injury displacement, deformation, stiffness, and motion. Thereby, loading protocols differed and inconsistent definitions of failure were determined. Measurement techniques applied in biomechanical test setups included strain gauges, force transducers, and motion tracking techniques. DISCUSSION AND CONCLUSION: An ideal fixation method should be safe, stable, non-obstructive, and have low complication rates. Although biomechanical testing should ensure that the load applied during testing is representative of a physiological load, a high degree of variability was found in the current literature in both the loading and measurement equipment. The lack of a standardised test design for fixation constructs in pelvic injuries across the studies challenges comparisons between them. When interpreting the results of biomechanical studies, it seems crucial to consider the limitations in cross-study comparability, with implications on their applicability to the clinical setting.

• Klíčová slova
• Biomechanics, Cadaver, Computational analysis, External fixator, Initial trauma treatment, Pelvic ring injury, Temporary external stabilisation,
• MeSH
• biomechanika MeSH
• externí fixátory MeSH
• fixace fraktur metody   MeSH
• fraktury kostí * MeSH
• lidé MeSH
• pánevní kosti * chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled 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.

• Klíčová slova
• German literature, History, Internal fixation, Proximal femur fractures,
• MeSH
• femur chirurgie   MeSH
• fraktury krčku femuru * chirurgie   MeSH
• fraktury kyčle * chirurgie   MeSH
• fraktury proximálního femuru * MeSH
• kostní hřeby MeSH
• lidé MeSH
• vnitřní fixace fraktury MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

PURPOSE OF THE STUDY: Surgical options for paediatric femoral fractures include fl exible intramedullary nailing (FIN), plating, and external fi xators. Length unstable fractures are usually spiral, long oblique, or comminuted and are often associated with > 2 cm of shortening. The purpose of this study was to see whether FIN is effective for managing unstable femur fractures in children. MATERIAL AND METHODS: An electronic literature search was performed up to 25 February 2022 in Cochrane Library, PubMed, and Embase databases using a combination of MeSH search terms and keywords related to the population (e.g., "child" AND "diaphyses" AND "femur"), and intervention (e.g., "nail" OR "ESIN"). The data extracted included the study details, Demographic data, surgical details, postoperative immobilization, complications, and outcome. RESULTS: Eight studies with a total sample size of 369 patients were reviewed. The mean operative time, blood loss, and length of stay in the hospital were 67.62±12.32 minutes, 33.82±16.82 ml, and 4.9±1.27 days, respectively. The results were excellent in 61.92% of the patients, satisfactory in 32.61%, and poor in 5.43%. 4.54% of patients had major complications requiring reoperation and 32.46% of patients had minor complications. the most common complication was nail prominence seen in 26.30% of patients. Locked Ender's nail was associated with the least reoperation, malunion, and LLD rate compared to other types of FIN. CONCLUSIONS: FIN along with a single walking spica cast is a good choice in all forms of paediatric femoral fracture patterns allowing proper alignment and rotation. Locked Ender's nail is safe and effective for managing unstable paediatric femur fracture. KEY WORDS: pediatric femur fracture, length unstable, fl exible intramedullary nailing, submuscular plating, Flynn criterion.

• MeSH
• dítě MeSH
• dolní končetina MeSH
• femur MeSH
• fraktury femuru * chirurgie   MeSH
• interní fixátory MeSH
• intramedulární fixace fraktury * škodlivé účinky   MeSH
• lidé MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH