Interpretation of the Ostalgia phenomenon in academic discourse on the example of the movie Good Bye, Lenin!

Department of German and Austrian StudiesKatedra německých a rakouských studiíFakulta sociálních vědFaculty of Social Science

Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif

AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons..

Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif

AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons..

Variant Anatomy and Its Terminology

Variant anatomy, which is an integral part of anatomical science, is related to abnormalities in the human body structure. Our understanding of variant anatomy is based on thousand years of anatomical experience. These abnormalities generally do not interfere with the function of the human body and do not typically manifest as pathological nosological units. However, under certain conditions, these abnormalities can worsen existing pathological states or even evoke new ones. Understanding variant anatomy is a basic skill not only of mere anatomists, but also of clinicians who work in fields involving both diagnostic techniques and therapeutic interventions. To gain and retain a good knowledge of the most frequent and clinically relevant anatomical variations, a simple, clear, and exactly defined nomenclature of variant structures is needed. A list of items comprising variant anatomy, which have been incorporated into the internationally accepted nomenclatures Terminologia Anatomica (1998) and Terminologia Neuroanatomica (2017), is described and analyzed. Examples of the most common anatomical variations related to terminology are mentioned, and variant anatomy as a whole and its role in understanding current anatomy are discussed

Perilunate Injuries to the Wrist

Úvod Perilunátní dislokace a perilunátní zlomeniny jsou vážné poranění zápěstí, které jsou často přehlíženy při primární léčbě. Jejich nepřiměřená léčba vede k vážnému poškození zápěstí a postižení pacienta. Včasná diagnóza a správná léčba mohou předcházet takovým stavům. MATERIÁLY A METODY Je prezentována skupina 25 pacientů se 26 poraněními zápěstí. Soubor zahrnoval devět pacientů s izolovanými perilunátovými dislokacemi (34%), 11 pacientů s transkaphoidními perilunátovými dislokacemi (44%), dvěma s trans-radiálním trans-scaphoidním perilunátemdislokace (7%) a další dva pacienti s trans-radiálními perilunátovými dislokacemi (7%). Jeden pacient měl vedle perilunátová dislokace i poškození kutohamátového kloubu s poškozením obou částí interaktivního vazu (4%). Jeden pacient (4%) trpí transkaphoidní perilunátovou dislokací se zraněním na scapholunátovém vazu, ve kterém proximálnípól scaphoidu byl oddělen a narušován redukcí dislokace. VÝSLEDEK Správná diagnóza byla provedena na časném vyšetření u 16 pacientů (62%), během týdne po úrazech u 4 pacientů (15%), během měsíců po poranění u dvou pacientů (8%) a dokonce později u čtyř pacientů (15%). Výsledky vyhodnocení léčby založenéna Wrightington Hospital Wrist Scoring System byly vynikající v 19%, dobré ve 54%, uspokojivé u 19% a špatné u 8% pacientů. Špatný výsledek u jednoho pacienta byl kvůli nekróze lunární kosti, diagnóza perilunární dislokace byla provedena do měsíce úrazu. Špatné výsledky u druhého pacienta byly spojeny s komplexním syndromem regionální bolesti. DISKUSE Perilunate zranění zápěstí jsou poměrně časté a ačkoli léčebný postup je běžně známý, jeho principy nejsou vždy dodržováni. Dobrý výsledek souvisí s včasnou diagnózou a správnou rekonstrukcí poškozených struktur. V naší skupině byla diagnóza provedena při prvním vyšetření pouze u 62% pacientů a později než týden po úrazu 23%. Pacient, u něhož se objevila nekróza lunární kosti, měla diagnózu provedenou v 1 měsíci po poranění. Brzy snížení kostních struktur a rekonstrukce vazů také přispívají k dobrým výsledkům. ZÁVĚRY Dobré výsledky při ohrožení zranění závisí na časné a správné diagnóze, vhodném léčebném postupu a ortopedický chirurg, který má zkušenosti s léčbou takových zranění. Hluboká znalost kinetiky zápěstí je nutná pro tuto terapii, protože ne všechny zranění se dějí podle popisu učebnice.PURPOSE OF THE STUDY Perilunate dislocations and perilunate fractures are serious wrist injuries which are often overlooked at primary treatment. Their inadequate therapy results in severe wrist damage and patient disability. An early diagnosis and correct therapy can prevent such conditions. MATERIAL AND METHODS A group of 25 patients with 26 wrist injuries is presented. It included nine patients with isolated perilunate dislocations (34%), 11 patients with trans-scaphoid perilunate dislocations (44%),two with trans-radial trans-scaphoid perilunate dislocations (7%) and next two patients with trans-radial perilunate dislocations (7%). One patients had, in addition to perilunate dislocation, injury to the capitohamat joint with damage to both portions of the interosseous ligament (4%). One patient (4%) sustained a trans-scaphoid perilunate dislocation with injury to the scapholunate ligament, in which the proximal pole of the scaphoid was separated and interfered with dislocation reduction. RESULTS The correct diagnosis was made on early examination in 16 patients (62%), within a week of injury in four patients (15%), within a months of injury in two patients (8%) and even later in four patients (15%). The results of treatment evaluation based on the Wrightington Hospital Wrist Scoring System were excellent in 19%, good in 54%, satisfactory in 19% and poor in 8% of the patients. The poor result in one patient was due to necrosis of the lunate bone;the diagnosis of a perilunate dislocation was made within a month of injury. The poor results in the other patient were associated with complex regional pain syndrome. DISCUSSION Perilunate injuries of the wrist are quite frequent and although the treatment procedure is commonly known, its principles are not always obeyed. A good outcome is related to an early diagnosis and correct reconstruction of the injured structures. In our group, the diagnosis was made at the first examination in only 62% of patients and later than a week after injury in 23%. The patient in whom necrosis of the lunate bone developed had the diagnosis made at 1 post-injury month. Early reduction of bone structures and reconstruction of ligaments also contribute to good results. CONCLUSIONS Good outcomes in perilunate injuries depend on an early and correct diagnosis, an appropriate therapeutic procedure and an orthopaedic surgeon who has experience with management of such injuries. A deep knowledge of wrist kinetics is necessary for this therapy as not all injuries happen according to textbook descriptions