[Infectious complications of surgically treated musculoskeletal injuries: review of risk factors and etiological agents in years 2000-2005]. / Infekcní komplikace operacní lécby poranení pohybového aparátu: prehled rizikových faktoru a eiologických agens za roky 2000-2005.

PURPOSE: Infection is considered one of the most serious complications of the surgical treatment of musculoskeletal injuries. The aim of the study was to evaluate known risk factors and etiological agents of infectious complications in patients surgically treated for musculoskeletal injuries within 6 years. METHODS: In a group of 5 234 patients followed in 2000-2005 the early or delayed infectious complication developed in 65 patients (26 women, 39 men, age 22-83 years). In every patient with infectious complication the important risk factors related to personal history, type of the injury, surgery and other treatment were recorded and microbiological culture results were collected. RESULTS: In 60 patients (92.3%) at least one of the following risk factors was registered: diabetes mellitus, age above 75 years, abuse of alcohol and drugs, distant infectious focus or severe skin disease at the time of surgery, polytrauma requiring long-termed stay in intensive care unit, extensive soft tissue injury associated with closed or opened fracture. In 27 patients (41.5%) grampositive cocci and in 17 patients (26.2%) gramnegative bacteria were isolated, in 12 patients (18.5%) mixed bacterial flora was identified and 9 patients (13.8%) had negative cultures. The most severe findings from microbiological view occurred in patients with extensive soft tissue injury associated with fracture, diabetes or long-termed stay in intensive care unit. CONCLUSION: The infectious complications after the surgical treatment of musculoskeletal injuries occurred predominantly in patients with risk factors. The extensive soft tissue injury associated with fracture, diabetes and long-termed stay of the polytrauma patient in intensive care unit were identified as the most frequent risk factors. The patients of these risk groups also presented with the most serious microbiological findings.

[Ligament injuries of the superior tibiofibular joint and their care in type I polyclinic hospitals]. / Poranení vazu horního hlezenného kloubu a jejich resení v NSP I. typu.

The author analyzes the possibilities of accurate diagnosis of acute injuries of soft tissues, in particular ligaments of the superior tibiofibular joint and compares different diagnostic methods. he draws attention to the sequelae of inadequate treatment when the symptoms of the injury, in particular in young people and sportsmen, are underrated. The author presents then experience from his department with the diagnosis of ruptured ligaments by means of socket symptoms. As regards treatment he prefers in total ruptures a surgical approach and submits the results from his catchment area of a hospital and policlinic type I during the past four years.

[Acute injuries of knee joint ligaments and their treatment in a type I hospital]. / Akutní poranení vazivového aparátu kolenního kloubu a jejich resení v nemocnici I. typu.

Based on an analysis of the biomechanics of the knee joint the author provides evidence of the importance of its ligaments not only as a passive stabilizer but mainly the irreplaceable function in the cinematic chain due to the ample propriception of ligaments. He emphasizes the necessity to preserve or restore the isometricity of ligaments as the basic prerequisite for smooth and fully coordinated movement. The author presents experience with the diagnosis and surgical treatment of these injuries in their department of a type 1 hospital with policlinic. He provides evidence of the necessity of an active approach and early solution of acutely developed instabilities in surgical and traumatological departments of type 1 and 2 of hospitals with policlinics with regard to previously proved poorer results of delayed operations of acute and unsatisfactory therapeutic results of chronic instabilities.