Biomedical subjects

J Matejka

Publications and source records attributed to J Matejka.

18 recordsLinked to original sources

PubMed2006

[Hyperextension injuries of the thoracolumbar spine].

A group of 965 patients treated for thoracolumbal spine injury in the period 1998 till 2003 were analysed. 307 fractures were operated on. Out of this number, 4 fractures were type B3 according to Magerl's classification, i. e. 0.21 % of the admitted and 1.31 % of the operated patients. All 4 patients were operated by stabilization with internal fixator and posterior or combined fusion. Fractures were diagnosed in older patients, age average being 63.75 years, with the range of 57-72 years. All patients were obese, average body mass index being 32.75, with the range of 30.9 to 36.4. Fractures ensued two times in patients with heavy spondylarthrosis and spondylosis, once in ankylosing spondylitis and once in intact spine. Only one patient was injured by heavy trauma, the others sustained the injury during ordinary falls. One of the predisposing factors for occurrence of this injury is probably the increased body mass index resulting in increased moment of deceleration hyperextension force.

Accidental Falls↗

PubMed2006

[Peripheral primitive neuroectodermal tumor -- PNET].

The authors describe three cases of peripheral primitive neuroectodermal tumor. The tumor was found in soft tissues of the crus, shoulder girdle and perineum, and was also located paravertebrally and epidurally at the level of L1-L2 vertebrae. Radiological findings were not specific for this disease. The results of imaging methods (sonography, CT, MRI, DSA) were important for the assessment of tumor size, its boundary and invasion of the surrounding tissues, and for the evaluation of tumor response to therapy and detection of recurrent disease. The PNET diagnosis was based on immunohistochemical, biochemical and cytogenetic examinations. One patient died 5 months after the first clinical signs were manifested; the two patients surviving for 2 and 1 3/4 years after first sign manifestation, respectively, remained in the care of cancer specialists. Key words: skeletal Ewing's sarcoma, extra-skeletal Ewing's sarcoma, Ewing's sarcoma family of tumors, peripheral primitive neuroectodermal tumor.

Adolescent↗

PubMed2005

[Osteosynthesis of ipsilateral hip and femoral shaft fractures with the PFN-long].

AIM: The paper retrospectively evaluates a set of patients with ipsilateral fractures of the proximal femur and shaft treated with PFN-long. MATERIAL: 19 patients (14 males and 5 females), aged 48 in average, were treated from 1998-2003. The fractures included 2 types: combined intraarticular femoral neck and shaft fractures: 8 cases, and 11 cases of complex extraarticular proximal femoral fractures and its shaft. RESULTS: A total of 17 patients followed up for at least 12 months was evaluated according to the Sanders and Regazzoni scoring scale. Bone union resulted in all patients. This was accomplished within 6 months in 10 patients (59 %), 9 months in 16 patients (94 %), and one patient healed within 12 months. Excellent results were achieved in 59 %, good results in 35 % and a satisfactory result in 6 %. We have recorded 3 cases of postoperative complications (16 %). These complications were all due to imperfect reduction. Early complications included a wound haematoma with necessary operative revision. Late complications, such as delayed healing, were resolved by reoperation in 1 case. CONCLUSION: Long PFN is a quality implant which extends our options in the treatment of ipsilateral hip and femoral shaft fractures. It is one of the most beneficial implants in the category of reconstruction nails. The availability of only 3 nail lengths and 1 diameter presents a certain drawback.

Adult↗

PubMed2005

[Long-term results following fracture of the femoral neck in children].

PURPOSE OF THE STUDY: This retrospective study was designed to evaluate the severity and nature of long-term sequelae of femoral neck fractures in children in relation to the strategy and technique of therapy. MATERIAL: The study included 15 patients with a fracture of the femoral neck who, at the time of injury, had an opened proximal physis. The average age at the time of injury was 11.5 years (range, 4 to 16.3 years). There were eight boys and seven girls. Twelve children suffered injury due to a fall varying in gravity, two were knocked down by a vehicle, and one was injured as a co-driver in a car accident. The group involved no type I fracture, six type II, seven type III and two type IV fractures, as classified by the Delbet and Colonna system. METHODS: All children were operated on within an average of 4.1 days after injury. The delay was caused by a late referral from an outside hospital or was due to associated complications.However, the majority of fractures were treated within 24 hours of injury. Surgery was carried out from the anterolateral approach. Miniarthrotomy was performed in 11 patients to remove hematoma and decompress the intra-articular space. The methods of stabilization included Kirschner's wires in four children, compressive osteosynthesis using lag screws inserted extraphyseally in 10 children and the combination of both methods in one child. No plaster of Paris spica or traction was applied after surgery. RESULTS: The long-term results were evaluated at a minimum of 5 years after injury. The average follow-up was 9 years and 11 months, with the range from 5 years and 1 month to 15 years and 5 months, and 12 patients were involved. Six had a type II and six had a type III fracture. Ten patients were treated by arthrotomy. Stabilization of the fracture was performed with lag screws in nine children and Kirschner's wires in three patients. Both subjective and objective findings were evaluated by the modified Rattlif criteria. Concerning pain, eight (67 %) children had excellent outcomes, three (25 %) reported good outcomes and only one (8 %) had a poor outcome. The activity following injury was subjectively evaluated as excellent by 11 (92 %) patients and as good by one (8 %) patient. None of the patients was noticeably limited in their activity, as compared with the pre-injury state. Objective findings were based on X-ray images and the range of hip motion. No or minimal radiographic changes were found in five (42 %) patients and were assessed as excellent outcomes. A good outcome, i. e., a spherical head with a moderate neck deformity, was achieved in five (42 %) patients. A poor outcome, i. e., avascular necrosis free of revitalization, but with collapse, on X-ray images was recorded in two (16 %) patients. The values for the range of motion and limb-length discrepancy were excellent in eight (67 %), good in two (16.5 %) and poor in two (16.5 %) patients. Poor objective and subjective findings were recorded in the patients who had not undergone miniarthrotomy. DISCUSSION: A comparison with the literature data showed that the occurrence of each fracture type was in agreement with the reports of other authors. The finding of a higher frequency of type I fractures can be explained by a pathological slip due to hormonal changes. The opinions on treatment of these fractures have developed to the view that surgery is necessary in the early post-injury period, preferably with the use of compressive osteosynthesis or Kirschner's wires. However, subsequent immobilization in a plaster cast spica is not necessary. The subjective and objective findings were not exactly correlated due to differences in patients' age and different intervals between injury and treatment. CONCLUSIONS: The authors recommend early surgery and stabilization by compressive osteosynthesis or Kirschner's wires, together with miniarthrotomy in order to decompress the articular space.

Adolescent↗

PubMed2005

[Use of a hybrid external fixator for treatment of tibial fractures].

PURPOSE OF THE STUDY: The study deals with treatment of the articular ends of the tibia, using a hybrid external fixator. A group of patients treated in the years 2001-2003 is retrospectively evaluated. MATERIAL: Between 2001 and 2003, 21 patients (16 men and 5 women) with a fracture of either the distal or the proximal end of the tibia were treated, using a Synthes external hybrid fixator, at the Department of Orthopedics and Traumatology, Faculty of Medicine, Charles University, Plzen. The average age of the patients was 49.2 years. The fractures, evaluated by the AO classification, included five type A3 fractures and 16 type C1 or C2 fractures. In 14 patients the fracture was associated with multiple trauma or polytrauma and in seven it was a single injury. Open fractures were treated in five patients (grade 2 in two and grade 3 in three patients), closed fractures in 16 patients (Type CII in 12 and type CIII in four patients, as assessed by Tscherne's classification). Fifteen patients had fracture of the proximal tibia and six had distal tibial fracture. A hybrid external fixator was used alone in six patients, and in combination with miniosteosynthesis in 15 patients. METHODS: The first aim was to perform closed reduction or reduction from a minimal approach with an intraoperative image intensifier. Subsequently, the fracture was temporarily stabilized with pelvic reduction forceps or Ki wires and, if indicated, the articular ends were stabilized by miniosteosynthesis. When the outer ankle was fractured, plate osteosynthesis was carried out. Finally, a hybrid external fixator was applied. In the case of an open fracture, this procedure was preceded by soft tissue debridement. RESULTS: The evaluation, based on clinical and radiographic findings and subjective complaints of the patients, was made with the use of the Rasmussen and Bray scoring system. Nineteen patients were followed up, two failed to turn up. The results were excellent in five, very good in six, satisfactory in five and poor in three patients. Two repeat operations were necessary. DISCUSSION: The treatment of injury to the articular ends of the tibia, with the use of a hybrid external fixator, is one of the options for stabilization of both open and closed fractures. This method enables us to stabilize fractures of the tibial metaphysis as well as intra-articular fractures. Application of a hybrid external fixator is indicated in type A and type C fractures (AO classification). The state of crural soft tissues must be taken into consideration. The advantage of this method is the use of Kirschner wires, as fixation components, stretched in a circular frame. The fixation components require only minimum space for insertion in the metaphysis or epiphysis, the implant is stable and permits easy treatment of soft tissues. Another advantage is the possibility of early rehabilitation of the adjacent joints and loading of the extremity. Relatively frequent "pin infection" and therefore more frequent visits to the outpatient department can be considered a disadvantage. CONCLUSIONS: The method described here is, in addition to other options of fracture osteosynthesis, suitable for treatment of fractured ends of the tibia. External fixator application can be used with advantage for treatment of supra or infra-articular fractures of the tibia and fractures associated with marked swelling of soft tissues, for which internal osteosynthesis is not indicated, and in open fractures as well.

Adolescent↗

PubMed2005

[Complications of internal fixation by a short proximal femoral nail].

PURPOSE OF THE STUDY: The article presents analysis of complications of the treatment of unstable fractures of the proximal femur by the proximal femoral nail (PFN Synthes). MATERIAL: Between October 1997 and October 2003, 239 patients were treated for unstable fractures of the proximal femur, 89 men and 150 women, average age 71 years. The minimum follow-up was 12 months. Unstable was considered a fracture in which it was impossible to restore by reduction the medial support -- the Adams' arch, i. e. the region below the lesser trochanter in subtrochanteric fractures. Prevailing in the group of patients were unstable pertrochanteric fractures (AO 31 A2.1, A2.2) that occurred in 55 % of patients, per-subtrochanteric fractures (AO 31 A2.3) accounted only for 26 % and subtrochanteric fractures (AO 31 A3.3) for 19 %. RESULTS: The fracture healed in 95 % of patients within 6 months and in 98 % of patients within 9 months. There were 29 intraoperative complications recorded in 19 patients (12 %). This category included also intraoperative technical difficulties. Only 9 patients (4 %) were reoperated on. Early postoperative complications occurred in 16 patients (8 %) requiring reoperation in 7 cases. Six late postoperative complications occurred in 3 patients. DISCUSSION: Intramedullary implants for internal fixation of the proximal femur tolerate higher static and several times higher cyclical loading as compared to DHS types of implant. As a result the fracture heals even without the primary restoration of the medial support. The implant temporarily compensates the function of the medial column. When this function is not restored in a limited period of time, the internal fixation, although correctly performed, fails. The main cause of complications are technical mistakes or failure to observe the proper surgical technique. CONCLUSION: The most frequent mistake is reduction with the persisting varus position or distraction in the fracture line, incorrect placement of the screw in the femoral neck or the nail in the femoral shaft, wrong choice of the length of the screws, unnecessary hesitation in solving the defect in the course of the treatment. Forced insertion of the implant may cause additional damages to the skeleton. PFN is a quality implant for the treatment of unstable pertrochanteric and subtrochanteric fractures of the femur. The number and severity of complications may be reduced by the observance of proper principles of reduction and exact surgical technique.

Adult↗

PubMed1991

Use of DI-S and CPITN as predictors in dental caries studies in the primary dentition.

The DI-S (simplified oral debris index), CPITN (Community Periodontal Index of Treatment Needs) and dmfs (dental caries experience in the primary dentition were recorded in 395 5-year-old black children living in rural and urban areas of Southern Africa. The DI-S and CPITN were grouped, independently and together, to examine their use as simple field methods of predicting dental caries. For each grouping the sensitivity, specificity and positive and negative predictor values were calculated. A CPITN grouping of 0 or of two or more sextants with bleeding, provided the most convenient specificity, sensitivity and predictor values. It is recommended that this simple method should now be used in prospective studies of caries activity.

Black or African American↗

PubMed1990

Community Periodontal Index of Treatment Needs (CPITN) in KwaZulu and Namibia in 11-year-old children in 1988.

A sample of 603 11-year-old children from four low fluoride (less than 0.15 ppm) and one higher fluoride (1.56 ppm) communities in Namibia and KwaZulu were examined in 1988 using the CPITN. In a rural low fluoride community in Namibia only 6 per cent of children had healthy mouths compared with 42-58 per cent in the other communities. The main periodontal lesion seen was gingival bleeding (19-47 per cent) followed by calculus (6-47 per cent). There is a need for both oral hygiene improvement and simple intervention.

Child↗

PubMed1990

Social class, parents' education and dental caries in 3- to 5-year-old children.

The caries prevalence of 1273-, 4- and 5-y-old white children was determined with mirror and probe under natural light at mother and child clinics. The social class of the family, the educational level of the mother and that of the father were determined from a questionnaire filled in by the accompanying adult at the time of examination. Both social class and parent's education had a statistically significant influence on the caries prevalence: those in the lower social classes and with parents without tertiary education had a much higher prevalence of caries.

Child, Preschool↗

PubMed1990

Permanent dentition caries in KwaZulu and Namibia 11-year-olds.

The permanent dentitions of 11-year-old children in Namibia (n = 295) and KwaZulu (n = 308) living in rural and urban areas were examined using WHO caries diagnostic criteria. In low fluoride areas (less than 0.15 ppmF) significantly more caries was present in rural compared to urban KwaZulu but the prevalences in rural and urban Namibia were similar although significantly higher than in an area with 1.56ppmF in the drinking water. There was significantly more caries in rural Namibia than KwaZulu but the urban prevalences in both regions were similar. It is suggested that the urban findings are useful predictors for the needs of 11-year-old black children but local baseline surveys should be undertaken before considering dental programmes, treatment or preventive, for different rural communities in South Africa.

Child↗

PubMed1989

Dental caries at five and twelve years in a South African Indian community: a longitudinal study.

In 1979, 515 of 767 available Indian children born in Lenasia in 1974 were examined and their dental caries status was described. In 1986, 515 of the original 715 were re-examined in order to determine the pattern of dental caries in the primary and permanent dentitions of the same individuals. In contrast to studies in the literature in which treatment records have been used, both investigations were formal epidemiological field studies using calibrated examiners and WHO (1971) caries diagnostic criteria. A firm association was found between caries in the primary and permanent dentitions (r = 0.34).

Child↗

PubMed1988

Caries prevalence and severity in the primary dentition and Streptococcus mutans levels in the saliva of preschoolchildren in South Africa.

The caries prevalence (dmft) and severity (css) in 3-, 4-, and 5-yr-old children in South Africa were examined. Four levels of S. mutans in the saliva of 228 of these children was estimated by the spatula method. In all three age groups a statistically higher dmft and css was found with a S. mutans level of greater than 10(6) CFU/ml in saliva than at lower concentrations. At age 5 ANOVA showed significant differences between dmft and css at all S. mutans levels. A high concentration of S. mutans in the saliva may be an indicator of the high risk child at an early age.

Child, Preschool↗

PubMed1987