In this prospective study, 35,550 neonates were examined shortly after birth by a team of orthopaedic surgeons. They diagnosed 775 unstable or dislocated hips in 656 babies; there were two teratological dislocations. Treatment was first with a Frejka pillow and, if this failed to give a normal hip, a Pavlik harness at three months. Early clinical examination did not identify 21 infants who were found to have subluxation or dislocation of the hip at the three-month review. The number of missed cases declined during the study, however, reflecting the increasing experience of the examiners. One case of avascular necrosis occurred in the group treated from birth and one in the late-diagnosed group. Open reduction was necessary only in the two teratological dislocations. Experienced examiners are needed for accurate clinical diagnosis; and treatment should be started before the baby is discharged from the maternity ward.
The aim of the study was to present the results of video-assisted fractional lengthening of the triceps surae muscle and the hamstrings in children with spastic cerebral palsy. In the period from September 2003 to December 2004, triceps surae muscle contractures were treated in 35 lower extremities (22 patients) and hamstring lengthening was performed in 12 knees (eight patients). The patients were between 4 and 10 years of age. Lengthening of the gastrocnemius-soleus was sufficient for achieving 10 degrees dorsiflexion of the foot in 31 of the 35 extremities. The short-term follow-up, at least 1 year after operation, did not reveal any complications. The hamstring lengthening resulted in full correction in nine knees; one endoscopic procedure required conversion to open surgery owing to bleeding. In one case, incomplete sciatic nerve palsy developed. Video-assisted gastrocnemius-soleus recession as well as video-assisted lengthening of the hamstrings proved to be fully efficient in the group reported here.
PŮVODNÍ PRÁCE ORIGINAL PAPER
ÚVODCílem studie je porovnat v souboru 297 dětí postižených spastickou formou dětské mozkové obrny (66 hemiparéz a 231 diparéz) klinické indikace k operačnímu výkonu s indikacemi určenými na základě vyšetření v laboratoři chůze s instrumentální pohybovou analýzou a navíc se zvláštním zřetelem na diskrepance mezi oběma indikačními metodami. Zatímco dříve laborato-ře chůze produkovaly více méně akademické výstupy bez větší snahy o praktickou aplikaci (2, 10, 17) nebo se bádání opírálo jen o vizuální hodnocení různými skorovacími systémy (3), v poslední době se objevila řada prací s výraznou snahou o klinické uplatnění (1,13,14,16,24,25,27,29). Vybudování laboratoře chůze v naší nemocnici nám umožnilo pracovat s touto sofistikovanou diagnostickou metodou od června 2009.
PURPOSE OF THE STUDYTo test the hypothesis that the application of tricalcium phosphate (TCP) mixed with autologous bone marrow can achieve better and faster healing of benign bone lesions than the application of tricalcium phosphate granules alone.
MATERIAL AND METHODSThe prospective study included two groups, each consisting of 10 patients, treated for benign cystic bone lesions at the
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