Uses of the postural stability test for differential diagnosis of hereditary ataxias.

Friedreich's ataxia (FRDA) and spinocerebellar ataxia type 2 (SCA 2) are among the most commonly diagnosed hereditary ataxias in Czech Republic. Although criteria differentiate the ataxias, disorder onset symptoms may be similar. Our goal was to determine whether and to what degree of validity posturographic examination may be utilized, with the aim of differential diagnosis; which specific posturographic parametres are suitable for differential diagnosis; and which differences in FRDA and SCA 2 patient posturographic findings may be established. 17 SCA 2 and 12 FRDA patients were examined with ten healthy controls. A multi-sensor tenzometric platform was used for posturographic examination. Toe standing position was added to basic tests, including standing position with and without visual control. There was no difference between patients in standing position with visual control but there were distinct differences between FRDA and SCA 2 patients, based on upright stance without visual control and medio-lateral deviation. There were no differences between patients in toe standing position, suggesting not only the cerebellum, but also deep sensation, helps to create the so-called adaptive controller. Posturography is attested to as a useful method for differential diagnosis of hereditary ataxias and provides neurophysiological findings in cerebellar and sensoric ataxias.

[Fractures of the upper part of the femur treated by means of the Ender osteosynthesis method]. / Zlomeniny horního konce stehenní kosti, resené osteosyntézou podle Endera.

Intramedullary osteosynthesis by Ender's method proved very successful and easily managed from the technical aspect, while it causes relatively little discomfort to the patient and resolves the problem of fractures of the femur in the trochanteric area. The greatest advantages, as compared with other types of osteosynthesis, are that it is not as time consuming as other procedures, that it is a minor operation which reduces the incidence of infection and causes minimal stress to the patient. When careful anaesthesia is used, it is frequently the only operation which can be used in biologically old and high risk patients.