Search

In 1979 - 1989 at the Orthopaedic Clinic of the Institute for Postgraduate Medical Training a total of 62 alloplasties of the hip joint were removed. On account of infection 44 endoprostheses were removed, the remainder for other reasons. The authors examined a total of 19 patients who attended check-up examinations. Evaluation of the function of the hip joint after removal of the endoprosthesis was made by Harris' method. Evaluation of the painfulness of the hip joint revealed that 6 patients were free from pain, 4 patients reported only slight pain after burdening. The remaining patients suffered from pain which had to be mitigated by analgetics, two patients suffered from constant pain even at rest. Evaluation of the function of the hip joint revealed a marked disorder in all investigated subjects, none of the investigated patients was able to walk without support, walking was impaired by marked limp on the affected extremity. In a general evaluation of the condition of the hip joint according to Harris none of the hip joints after removal of the endoprosthesis were evaluated as excellent, in three patients the result was good, in 4 patients it was satisfactory, in 12 patients the results were unsatisfactory. Key words: removal of an infected total endoprosthesis of the hip joint.

At the Orthopaedic Clinic of the Institute for In-Service Training of Physicians and Pharmaceuts of the Teaching Hospital at Bulovka in Prague Helal's metatarsal osteotomy was performed between 1979-1987 in 54 patients for obstinate pain in the forefoot. Evaluated were 41 patients which underwent the operation minimum two years ago. The control group comprised 38 female and 3 male patients, the average age was 54 years. In 17 patients the operation was performed bilaterally. Thus in total we evaluated 58 osteotomies according to Helal. Excellent result was found out in 19 patients (46 per cent), good result in 20 patients (48 per cent). Only in 4 cases there occurred complications (2 cases of superficial infection, 1 case of thrombophlebitis, 1 case of painful pseudoarthrosis), out of which only the last one required another intervention. Helal's osteotomy seems to be a simple effective operation with a shortterm hospitalization and good postoperative results.

In their communication the authors describe two cases of a very rare injury presented in the world specialized literature under the title "luxation pedis cum talo". They treated two professional sportsmen with this diagnosis at the clinic. The authors describe the pathological anatomy of this injury where there occurs almost complete rupture of both deltoid and fibular ligaments of the ankle. In both mentioned cases, despite the severe instability of the nakledorsally placed parts of both ligaments have been preserved, and namely pars tibiotalaris post. lig. deltoidei and lig. fibulotalare post. The authors deal with the question if the cases of "luxatio pedis cum talo" consist in the actual momentary dislocation or rather an extreme subluxation in this joint. Surgical treatment of this injury--the suture of the ruptured ligaments--is an absolute indication and necessity. Adequate reconstruction of the ligamentary apparatus of the ankle gives a guarantee of complete recovery and full functional return of the injured ankle.