Biomedical subjects
Publications and source records attributed to J Stehlík.
The article presents a most detailed description of the individual radiologic methods used for the examination of the fractures of the thoracolumbar spine, i.e. CAT examination including 3-D reconstruction and magnetic resonance. Apart from technical procedures and the assessment of individual methods the article also shows their comparison.
The authors demonstrate in their preliminary report the possibility of careful percutaneous application of spongy bone in the form of a bone paste. For collection of specimens and application of spongy bone the authors use instruments originally designed for transpedicular spongioplasty of fractured vertebrae of the thoracolumbar spine. The described procedure was used in four patients where the risk of complications, local or general, associated with classical spongioplasty was considerable. Healing occurred in all patients within a relatively short time.
The authors describe a group of patients where the surgical operation involved among others filling of bone defects with glass-ceramic material--dense (as granules) or porous (as a block). Glass-ceramics BAS O were developed in the laboratories of LASAK Co. in Prague. Two defects were of traumatic origin and osteosynthesis was part of three operations. The remaining defects were juvenile bone cysts, fibrous dysplasia and benign bone tumours. The follow-up period after operation varied in the first 11 patients between 6 months and 2 years. In patients of the mentioned group no problems of healing of the surgical wound were recorded nor allergic and side-reactions. The incorporation of glass-ceramic material was followed up by X-ray after three-months intervals. In no instance lighter areas were found on the X-ray pictures suggesting a fibrous outer layer. On the contrary, the trabeculae reached gradually its close vicinity. Based on experience from experimental work and investigation of X-ray signs of healing, the patients were allowed to burden the operated extremity after three months. The basic laboratory examinations made in these patients were within the normal range. In particular calcium throughout the investigation period in the normal range, the phosphorus levels varied near the upper borderline, alkaline phosphatase levels were in many young patients elevated and acid phosphatases varied. In eight patients during the postoperative period eosinophilia was revealed in the haemogram.
Using a clinical case, the authors demonstrate the technique of covering an extensive tibial defect unmanageable, due to blood supply to the limb and extent of the defect, by conventional methods. The required amount of tissue was provided by a flap obtained from m. latissimus dorst transferred to the site of defect as a free cross flap.
The authors present four-year surgical experience using Helal's oblique metatarsal subcapital osteotomy to manage metatarsalgy of various etiology. A total of 109 patients (131 feet) were operated on during the observance period. The amount of 79 patients (108 feet) were revised on the average 21 months after the surgery. According to Gainor's score excellent results were achieved in 76.9 per cent of cases, 3 patients were re-operated on for a relapsing preoperational condition. The indication for Helal's metatarsal osteotomy is the finding of metatarsalgy with reducible metatarsal capitula.
In the years 1986-1987 the authors operated on 14 patients with 15 fractures in the area of the distal part of the forearm. They performed external fixation in open fractures and in unstable, intra-articular and extra-articular closed fractures. They use Poldi 7 external fixation device, the clamp type of fixation with the insertion of 2 screws into the radius and 2 screws into the second metacarpal. Reduction is carried out by distraction using the principle of ligamentotaxy. The evaluation of the results in the period between' 8-22 months after the operation showed excellent clinical results in 6 patients, good results in 7 patients and a fair result in one elderly female patient where a sizable radionulnar synostosis occurred during healing. Subjective feelings evaluated ten times as excellent and four times as good. In one patient the choice of the method of treatment was incorrect; an extensive lesion of ligamentary apparatus did not allow the correct reduction of fragments by distraction it was necessary to perform open reduction and transfixation of the fragments by means of K-wires, This patient was not included into the clinical results. Other more serious complications were not found out. Proceeding from their own experience the authors present some of the advantages of the method used: 1. Easy reduction and reliable retention of fragments 2. Possibility of the control and treatment of the damaged soft tissues 3. Possibility to perform additional operations without the danger of losing the reduction achieved a) fasciotomy b) spongioplasty c) skin grafts
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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