Introduction/Objective. Subtrochanteric fractures are unstable, tending to a varus, antecurvatum, and shortening deformity. The aim of this paper was to compare operation time and fluoroscopy time between different internal fixation methods in the treatment of subtrochanteric fractures. Method. The prospective study of the group of 27 patients with a subtrochanteric fracture treated by the SIF (selfdynamisable internal fixator with a trochanteric unit) method had been done. Operation time and fluoroscopy time values from this group were compared to the same parameters data from the literature for intramedullary (IM) nails, proximal femur locking plates (PF-LCP), dynamic condylar screws (DCS), and the 95?-angled blade plate. Results. In the SIF group, operation time was 62.2 (25?140) minutes and fluoroscopy time was 43 (20?95) s. Average operation time from the literature data was: 102.1 (43?181) minutes for IM nail, 94.2 (75?129) minutes for PF-LCP, 105.3 (70?166) minutes for DCS and 221.5 (171?272) minutes for blade plate. Average fluoroscopy time from the literature data was: 109.6 (34?250) seconds for IM nail, 102.3 (47?180) seconds for PF-LCP, 238 seconds for DCS. Operation time and intraoperative fluoroscopy time were higher in IM nail, PF-LCP, DCS and blade plate comparing to SIF method (p < 0.05). Conclusion. The above mentioned difference could be explained by a degree of required accuracy in the initial operative technique maneuvers, by used number of screws and by the type of the fracture reduction performance in different fixation methods. Operation time during IM nailing of subtrochanteric fractures sometimes can be shorter than average operation time in SIF method, what could be explained by the skill of the surgeon to perform as fast closed reduction for insertion of guide wire. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice]
Tension-free repair of large incisional hernia with autodermal grafts was unjustly neglected despite the fact that it is safe and effective. It can be applied in all cases where synthetic mesh are not indicated (presence of infection, immunodeficient patients, after radiotherapy). They are especially important in war surgery and in lack of funds when commercial grafts cannot be purchased.
Supracondylar periprosthetic femoral fractures after total knee arthroplasty are very rare, but very difficult to treat. They occur most often as a result of low energy trauma (slips and fall) in older patients with present osteoporosis and periprosthetic osteolysis. The treatment of these fractures is very difficult due to reduced biological capacity for healing in most cases. Surgical treatment of these fractures is accompanied by severe complications (prolonged healing, nonunion and disintegration osteosintets material) in 25 to 70% of the cases. The aim of this paper is to present the treatment of supracondylar femur fractures after total knee arthroplasty in men aged 72 with selfdynamisable internal fixator Mitkovic. Surgical treatment of fracture performed on the six day after the injury with minimally invasive surgical technique through two incisions. Verticalization and walking with crutches with non-weight-bearing started the first postoperative day. Patient discharged from hospital fifth postoperative day. Full weight-bearing on the operated leg is allowed after 6 weeks. The patient started a stationary physical therapy 6 weeks after surgery. Postoperative follow-up was 10 months. The fractures healed with an excellent functional result. Application of selfdynamisable internal fixator Mitkovic with minimally invasive technique in the treatment of these complex fractures provides excellent biomechanical conditions for healing.
Introduction/Objective. There are extramedullary and intramedullary methods of trochanteric fractures? internal fixation with implants having a lag screw. The objective of this study was to examine the difference in impact of these fixation types on final hip function and health-related quality of life. Method. There were 75 patients treated for a trochanteric fracture, using self-dynamisable internal fixator (SIF group), as an extramedullary method, or gamma nail (GN group), as an intramedullary method. These patients were called for the evaluation of Harris Hip Score (HHS) and SF-12 questionnaire at least two years after surgery. The SF-12 questionnaire has dual expression ? physical component score (PCS) and mental component score (MCS). Results. There were no significant differences between the SIF group and the GN group regarding HHS, PCS, and MCS. Positive correlation was confirmed between HHS, PCS, and MCS, with the strongest relation between HHS and PCS. Negative correlation was confirmed between age and HHS. Conclusion. There was no difference in final hip function and health-related quality of life between SIF and GN methods in trochanteric fractures treatment (p > 0.05). These parameters of outcome were confirmed to have positive interrelation (p < 0.05). Both submuscular presence of extramedullary implant with dimensions of SIF and the need for bone reaming in cephalomedullary fixation were considered not to have significant impact in HHS and SF-12 scores after trochanteric fractures treatment by internal fixation. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice]
Background / Aim: Measles is a contagious disease with good prognosis; however, severe complications may sometimes develop. C-reactive protein (CRP) and blood cells countderived inflammatory indices, granulocyte-lymphocyte ratio (GLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), mean platelet volume-platelet count ratio (MPR), red blood cell distribution width (RDW) and mean platelet volume (MPV) are the indicators related to the clinical outcome in various inflammatory diseases. Aim: The aims of this study were to analyze the values of CRP, blood cell count and GLR, PLR, MLR, MRP, RDW, MPV in measles-affected children compared to healthy controls and between measles-affected children with severe and without a severely complicated form. A particular aim of the paper was to assess the suitability of inflammatory-derived markers for predicting the severity of the disease. Methods: The examination group included 55 measles-affected children who developed complications. The control group included 30 healthy children. The first peripheral blood count, obtained on the first hospitalization day (before treatment), was used for further analyses. Results: The white blood cells, lymphocytes, monocytes and platelets count were significantly lower, while the values of GLR, PLR, MPR and CRP were significantly higher in measles-affected children (p?0.05). In severely complicated measles, significantly higher values of granulocytes, CRP, GLR, PLR and lower lymphocytes (p<0.05) were documented. A linear regression analysis showed that CRP was the only indicator with predictive significance for the severity of the course of measles. Conclusion: The blood cell count and derived inflammatory indices should not be crucial in assessing the severity of measles in children. CRP was the most valuable predictive factor for the development of the severe course of measles in measles-affected children.
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