3+4+Supplementum/2012 - Společnost pro pojivové tkáně

aBSTRakT
COMPReSSiOn and
deCOMPReSSiOn BiOMeCHaniCS
Of GRaViTaTiOn law in THe
TReaTMenT Of lOCOMOTiOn
SYSTeM
Alexej Pedan MD
TRENČÍN, Soblahovská 17/4 Slovakia.
The author during his fourty year experience
in myoskeletal medicine arrived to
the method „Decompressive automobilization
in autotraction“. The method is based
on the principle to create a therapeutic
alleviation up to underpressure in order to
ameliorate the alimentation of cartilages
and discs by suction of the synovial liquid.
The activation of paravertebral and
autochtonic muscles shall stimulate the
proprio-ception from intervertebral segments.
Pulling the muscles through the
periost of vertebral bodies and pressure
changes stimulate the physiological osteogenesis.
This biomechanics is recommended
more frequently in the rehabilitation therapy
particularly in chronic algic vertebral
syndrome with current osteoporosis in
senior population.
Improving the function of spine as
a balance guarantee improves the senior
space mobility and reduces the risk of falls
and the fractures rate.
aBSTRakT
nOn-uniOn in CHildRen
Professor Galal Zaki Said,
Assiut University Hospital, Assiut, Egypt
344 14 th Prague-Sydney-Lublin
Traumatic non-union in children is
rare. It may follow severe open fractures
with bone loss, or surgical treatment of
fractures due to inadequate fixation or
infection. Established or potential nonunion
in a healthy child with no general
or local pathology is usually treated
by open reduction and internal fixation.
Autogenous bone grafting might be needed
if there is bony defect or if the nonunion
is atrophic. Ilizarov techniques are
helpful in older children, especially if
non-union is associated with shortening.
Non-union may follow chronic osteomyelitis
with extensive sequestration of
the diaphysis. Large bony defects, scarring
and atrophic tapering bone ends are common
findings in this type of non-union.
Surgery includes freshening of bone ends,
excision of the avascular scar tissue, strut
bone grafting and K-wire and cast fixation,
or plate fixation.
Congenital pseudarthrosis of the tibia
is the hard core of non-union in children.
In about 50% of cases there is associated
neurofibromatosis. The currently adopted
techniques in our department are: excision
of the hamartomatous part of the
tibia, correction of alignment, intramedullary
roding and autogenous bone grafting.
Surgery on the fibula is essential, excision
of pseudarthrodis if present, or osteotomy
if the fibula is intact, followed by K-wire
fixation. Vascularised fibular graft is needed
if there is a large defect of the tibia
following excision. If there is shortening
in addition, telescopic vascularized fibular
graft is a successful solution.
Non-union of the tibia in osteogenesis
imperfecta is always associated with
severe curvature. Treatment consists of
multiple osteotomies, through small incisions,
with excision of bone segments to