Background/Aim: Segmental fractures represent complex tibial injuries, featuring a unique fracture type that is most commonly caused by a high-energy trauma. These fractures are considered to be a treatment challenge for orthopaedic surgeons due to their sporadic presentation, wide zone of soft tissue injury, and increased rate of complications. They are characterised by highly unstable intermediary segment and high rate of open fractures. The method of Ilizarov with its characteristics could offer many advantages over the existing operative techniques. This method, using a percutaneous approach, minimizes the intraoperative trauma and avoids the additional compromising of the biological environment at the fracture site. The aim of this study is to evaluate the results of Ilizarov fixator in treatment of segmental tibial fractures. Methods: We analysed 30 patients treated with an Ilizarov fixator between 2012 and 2017. Average age was 36 years (from 24 to 65). The most common mechanism of injury was a road traffic accident. Open fractures were noted in 22 cases. All fractures were reduced using indirect percutaneous techniques with a great focus on achieving the correct length, rotation and axial alignment of fragments. All patients were advised to bear weight as tolerated from the second postoperative day. Bone healing and functional results were evaluated according to criteria established by the Association for the Study and Application of the Method of Ilizarov. Results: Bone healing was achieved in all patients. The average time to union was 25 weeks (19 to 36 weeks). The bone results were excellent in 23 patients, good in five patients and fair in two patients. The functional results were excellent in 22 cases, good in 5 and fair in three cases. Eight patients had minor pin-tract infections, successfully treated with oral antibiotics. Patients were without any major complications. Conclusion: Ilizarov method is a safe and efficient treatment modality for segmental tibial fractures.

Considering the relevance of the pathogenesis research of different liver diseases, in our study we investigated the possible activity of IL-23/IL-17 axis on the im-munohepatotoxicity of two etiologically different CLD. A total of patients with CHC infection, 19 with NASH and 20 healthy controls (CG) were recruited. After histological verification from liver tissue obtain by liver biopsy, patients with CHC were divided into two groups: CHC-NSF (F0/F1/F2)-non-significant fibrosis, 20 patients, and CHC-SF (F3/F4)-significant fibrosis/cirrhosis, 16 patients. All anthropometric, biochemical, immunological cytokines (IL-6, IL-10, IL-17 and IL-23) tests were performed accordance to standard procedure. The plasma levels of IL-6, Il-17A and IL-23 were significantly higher in CHC-SF and NASH in compared with CG. Also, plasma levels of IL-23/IL-17A were significantly higher in NASH in compared to CHC-SF. In CHC-SF we had significantly lowest IL-10 level in compared with all three groups. Liver tissue levels of IL-17A and IL-23 in CHC-NSF were significantly lower in compared with NASH. IN CHC-SF and NASH, IL17-A and IL-23 in liver tissue were significantly higher in compare to plasma levels. In conclusan, proinflammatory response of IL-23/17A axis is dominant in plasma and liver tissue in CHC with higher levels of liver fibrosis and in NASH patients.

Portions of gastrointestinal tract may be used as microvascular transfers for reconstruction of hypopharynx and esophagus. Intestinal transfer by revascularization was reported by Seidenberg in 1959. It is important to monitor jejunum following its transfer.

Introduction/Aim: Total hip arthroplasty is the replacement of the hip joint with an artificial joint. Standard surgical procedures involve a long skin incision and extensive dissection of healthy tissue. Mini-incision surgery is a modification of standard operative approaches. The main difference, in addition to a significantly smaller skin incision, is based on much less damage to soft tissues, especially the muscles that move the hip. The aim of this paper is to compare the early results of the mini-incision and standard approach in total hip arthroplasty and to determine the advantages and disadvantages of the miniincision surgical technique. Method: A retrospective study analyzed data based on 63 patients who underwent total hip arthroplasty with a mini-incision and standard approach at the Institute of orthopaedics Banjica during the period from 2004 to 2010. All the patients suffered from primary coxarthrosis. All the operations were carried out by the same surgical team. All the patients were clinically evaluated before and after the surgery using the Harris Hip Score. Results: In the group of the patients operated with the mini-incision approach, there were 32 of them, while in the group consisting of the patients operated with the standard approach, there were 31 patients. Comparing these groups did not reveal a statistically significant difference in age, body mass index, surgery duration and Harris Hip Score before the surgery. A statistically significant difference was determined when comparing intraoperative blood loss, the amount of drainage fluid after the surgery, and the Harris Hip Score after the surgery. Conclusion: The Mini-Incision Posterolateral Approach compared to the standard approach, apart from an aesthetically more acceptable scar, achieves significantly less intraoperative blood loss and better hip function with almost the same risk of complications.

Introduction/Objective. The knee joint is prone to injuries caused by direct or indirect trauma. The meniscus and ligament injuries, cannot be completely diagnosed with clinical examination, therefore we use additional non-invasive and invasive diagnostic methods such as magnetic resonance imaging (MRI) and arthroscopy. The aim was to compare the accuracy of MRI and objective knee findings based on arthroscopic examination in case of meniscus and anterior cruciate ligament injuries. Methods. The study involved 50 patients treated with elective surgery which mandatory involved arthroscopic visualization of the knee structures. We compared the MRI findings, obtained from different institutions, and arthroscopic knee findings for all the patients involved in the study. Results. There were 50 patients included in the study with mean age of 31 years. MRI showed that Anterior cruciate ligament was damaged in 41 patients, while arthroscopy confirmed damage in 43 patients. Medial meniscus was damaged in 31 patients on MRI and in 27 on arthroscopic examination. Lateral meniscus was injured in 35 patients on MRI and arthroscopy showed damage in 32 patients. Using ?2 test we found no significant difference between MRI and arthroscopy as diagnostic methods. Wilcoxon Signed Rank Test shows similar results between MRI and arthroscopy findings. Conclusion. A comparative analysis of MRI and arthroscopy diagnostic value in case of anterior cruciate ligament, medial meniscus and lateral meniscus injuries have shown that there is no significant difference between these two methods.