[Stabilisation of the dislocated acromioclavicular joint and lateral fractures of the clavicle using a hook plate]. / Stabilizace luxace AC skloubení a zlomenin akromiálního konce klícku pomocí háckové dlahy.

INTRODUCTION: The aim of this study was to verify the hypothesis that the technique of stabilizing the acromioclavicular joint and lateral fractures of the clavicle using a clavicular hook plate can be considered a method of choice in the given types of injury. MATERIAL AND METHODS: The clinical part of the study included a total of 40 patients. The indication group was formed by patients with type III acromioclavicular joint dislocation, according to Tossy. As for lateral fractures of the clavicle, the patients of group II and types IIa, IIb according to revised Allman and Neers classification, underwent surgery. 40 patients with type III acromioclavicular luxation, operated on at the same clinic, were chosen as the control group; however, the technique of traction cerclage was used here. RESULTS: When evaluating our results, we recorded a lower occurrence of infectious complications in patients with a hook plate. No method failure or joint redislocation was observed in the hook plate group. There was no change in position even after the implant was removed. On the other hand, where traction cerclage was used, redislocation in the acromioclavicular joint occurred due to mechanical failure in 5 cases, in 15 cases mechanical implant failure was seen. As for patients with a hook plate, 11 cases showed irritation of the lower surface of the acromion. Statistical evaluation of parameters of the main set of patients was carried out in cooperation with the Institute of Biostatistics and Analyses of Masaryk University in Brno. CONCLUSION: Based on our results, the stabilisation of complete acromioclavicular separation and lateral end clavicle fractures using clavicle hook plate can be regarded as a suitable method for treating these lesions. Timely removal of the implant within 12 weeks of the intervention is needed to prevent irritation of the lower surface of the acromion.

[Mirizzi syndrome with cholecystoduodenal fistula--a rare complication of cholecyctolithiasis]. / Mirizziho syndrom s cholecystoduodenální pístelí--vzácná komplikace cholecystolitiázy.

Mirizzi syndrome is a rare complication of the long-term gallbladder stone disease. It's caused by a gallbladder stone impression to the common bile duct wall. The clinical appearance is an obstructive jaundice, pain in right subchondrium and dyspepsia. Higher pressure in the extrahepatal bile ducts leads to biliobiliary or enterobiliary fistula formation. In the described case a cholecystoduodenal fistula was found. Preoperative diagnosis of MS is a medical challenge, and majority of the diagnosis is set introperatively. Surgery is the treatment of first choice. Ignoring the possibility of MS can seriously damage patient's health by injuring bile ducts during the surgery.

Current multidisciplinary treatment of gastric cancer.

The aim of our study was to optimise current therapy of gastric tumours. The studied population consisted of 92 patients treated at the 1st Department of Surgery, St. Anne's Teaching Hospital, Brno, Czech Republic, and at the Department of Radiation Oncology of the same hospital during 1994-2000. We have proven that, nowadays, a radical surgical procedure still remains the best method used for the treatment of malignant illnesses of the stomach. Results from clinical studies show that preoperative chemotherapy is effective and that postponed surgical therapy has no impact on survival (Fig. 4, Ref. 21). Full Text (Free, PDF) www.bmj.sk.