Introduction: Fractures of the distal end of the clavicle account for 10% - 30% of all fractures of this bone, however, they account for as many as 50% of nonunions and malunions in clavicle fractures. Of all distal clavicle fractures, the highest percentage of complications appertain to Neer type IIB fractures. The aim of this paper is to describe the case of a female patient with a Neer type IIB clavicle fracture treated by fracture reduction and flexible stabilization of the coracoclavicular joint using the TightRope system. Case report: A 48-year-old female patient, injured in a traffic accident while driving a car, suffered a Neer type IIB fracture of the distal edge of the left clavicle. Three days after the injury, the patient underwent indirect stabilization surgery of the coracoclavicular joint by fixation, with the application of the TightRope system. Rehabilitation began on the first postoperative day and was completed three months after surgery, with the achievement of full range of motion in the left shoulder, return of muscle tone and strength of the shoulder muscles, followed by a return to everyday life and work activities, as before the injury. Conclusion: Although no gold standard exists in the operative treatment of the above-described injuries, the indirect method of stabilization and flexible fixation of the coracoclavicular joint, using different types of sutures, achieves good to excellent results. Comparing this method with other described techniques indicates that it has a better functional result, which is achieved faster with a lower complication rate. Our patient's functional results contribute to literature data and yet again demonstrate the effectiveness of this type of treatment for these complex injuries.

Osteons are the basic units of bone tissue. Four types of bone cells are responsible for building the bone matrix, maintaining it and remodeling the bone. Those are osteoprogenitor cells, osteoblasts, osteocytes, and osteoclasts. The main role of the bone is in the construction of the skeleton that provides support and enables the maintenance of a constant body shape and movement, which is achieved by a complex system of levers influenced by muscle forces at the attachment points. A fracture leads to the process of inflammation, healing and, remodeling that can restore the injured bone to its original state. Nowadays, we are more and more often faced with defects of different size and etiology, which increase the need for bone transplantation. This procedure involves a surgical technique that places a new bone or a suitable substitute between or around the fractured fragments or in the area of the defect to promote bone healing. Bone transplantation is possible because bone tissue, unlike most other tissues, has the ability to fully regenerate if it is provided with adequate conditions and the space in which it will grow. The basic biological mechanisms that justify and explain the principle and utilization of bone grafting are osteoconduction, osteoinduction, and osteogenesis, but the idea of osteopromotion is also worth mentioning. Autografts represent the "gold standard", but due to an increased need allografts from bone banks are primarily used nowadays, while the development of synthetic replacements is the primary research interest, especially the development of the form which could be applied with the use of minimally invasive techniques.

Assessments and testing of young athletes often exclude the fundamental and functional movement capacity, which are critical for healthy motor development of adolescents. The aim of this study was to evaluate functional capacity of young female volleyball players and determine if participation in volleyball leads to development of movement dysfunctions. Two-hundred fifty-eight (258) adolescent female volleyball players (14.3 ± 1.7 yrs) underwent the functional movement screen. Person correlation showed no significant relationship between functional tests and playing experience, while age showed significant, but weak relationship with total functional score (r = 0.189; p < 0.005). Overall, 44% of participants scored less than 14. Paired sample t-tests show significant bilateral asymmetries in hurdle step, in-line lunge, and shoulder mobility tests. Functional movement screen was useful in identifying functional limitations and asymmetries in young female athletes. However, as neither age nor playing experience were strongly associated with functional score, more attention should be given to the qualitative movement assessment of individual tests, rather than the composite score.

Purpose. Bones affected with metastatic breast carcinoma are prone to pathological fracture, impairing quality of life and survival rate. This study examined estrogen, progesterone, and HER2 receptors status, and Ki-67 index in skeletal metastases of breast carcinoma and their potential influence on pathological fracture occurrence.Methods. The study included 152 samples of skeletal metastasis of breast carcinoma, each obtained from an individual patient. Allred’s score was used for immunohistochemical interpretation. Clinical and radiological data were gathered from each patient`s history of the disease.Results. Femur stood out as an independent risk factor – it had a nine times higher chance for pathological fracture than other bones. Estrogen receptors, HER2, and Ki-67 status had no statistical significance for pathological fracture occurrence. Progesterone receptors showed significance for fracture development. The probability of fracture in progesterone receptor positive metastases was 68,1%, risk increasing with the rise of positive cells percentage, regardless of the expression intensity.Conclusion. Receptor status is important for skeletal metastases of breast carcinoma and can be used in clinical decision-making for systemic therapy and surgical treatment in fracture prevention.

Introduction. Tibial plateau fractures are complex injuries that, in most cases, require surgical treatment in order to prevent far-reaching consequences for the functionality and quality of life of the patient. While numerous surgical techniques have been described, it is evident that the technique of arthroscopically assisted repositioning (reduction) and internal fixation has the potential to take the lead in the management of these types of injuries. Case report. We present the case of a 36-year-old patient injured in a traffic accident with a fracture of the left tibial plateau, type III by Schatzker classification. After the diagnostic procedures and preparation, the patient was operated on using arthroscopically assisted repositioning (reduction) and internal fixation, with the filling of the bone defect with a combination of allogenic and synthetic bone graft. No other intra-articular injuries were diagnosed intraoperatively. The postoperative recovery went without complications, and after a period of 10 weeks of non-weight bearing and functional rehabilitation, the fracture healed completely, while the patient regained full range of motion in the knee. Conclusion. Although this type of injury has traditionally been treated with open surgery, we believe that minimally invasive surgery is the future, when it comes to tibial plateau fractures Schatzker types I-III. There is still not enough data in the literature regarding the long-term outcomes of this type of treatment, but the early postoperative results are extremely encouraging since this surgical technique enables faster recovery and fewer postoperative complications.