The aim of this study was to analyze the association of potential risk factors such as positive family cleft history, smoking, use of drugs during pregnancy, and parental age with oral clefts in offspring within the Kosovo population. We conducted a population-based casecontrol study of live births in Kosovo from 1996 to 2005. Using a logistic regression model, 244 oral cleft cases were compared with 488 controls. We have excluded all syndromic clefts. Heredity increases the risk of clefts in newborns [odds ratio (OR) ¼ 8.25, 95% confidence interval (CI) 3.12-23.52]. Clefts were also associated with smoking (OR ¼ 1.87, 95% CI 0.75-4.08), use of drugs during pregnancy (OR ¼ 2.25, 95% CI 0.82-5.12), increasing maternal age (OR ¼ 1.83, 95% CI 1.42-2.49), and increasing paternal age (OR ¼ 1.3, 95% CI 1.2-1.4). We found heredity to be the most important factor for cleft occurrence in Kosovar newborns. Another significant potential risk factor for occurrence of clefts is the parental age. We found the use of drugs and smoking during pregnancy to be less significant.

Renal osteodystrophy (ROD) is a complex and rare entity that refers to a large spectrum of abnormalities of skeletal homeostasis in patients suffering from chronic kidney disease. The goal of this study was to present the outcome of the very rare case of an adult with severe deformity of painful bilateral valgus knees due to ROD, requiring multilevel osteotomies above and below the knee. A 42-year-old male patient was admitted to our department with painful severe bilateral valgus knees deformity due to ROD. The patient underwent bilateral lateral opening-wedge osteotomy of distal femur and medial tibial closing-wedge osteotomy. The osteotomies site healed in 8 weeks without complications. The surgical treatment of lower limb valgus knee deformities secondary to ROD is a challenging and demanding procedure. In our patient, the femoral opening-wedge osteotomy with blade-plate fixation, and tibial closing-wedge osteotomy with plate fixation, restored almost normal knee congruency to prevent lateral unicompartmental degenerative deterioration of the knee.T he kidney has a notable role in bone metabolism, maintaining equilibrium of calcium and phosphate in blood and activation of vitamin D3. Renal osteodystrophy (ROD) is generally considered as a consequence of hyperparathyroidism, which occurs because of hyperphosphatemia and hypocalcaemia, due to impaired phosphate renal elimination. 1,2 ROD is a complex entity that refers to a large spectrum of abnormalities of skeletal homeostasis in patients suffering from chronic kidney disease or end-stage renal disease. 3,4 The treatment of valgus malalignment of the knees in patients with ROD remains a challenge, especially in adult nontreated patients. The goal of this study was to present the outcome of a rare case of an adult with severe and painful valgus knee deformity due to ROD, treated with multilevel osteotomies above and below the knee.The ethical committee approved the study, and the patient signed an informed consent.

Introduction:A misdiagnose and inadequate treatment of neonatal septic arthritis of the hip has multiple sequelae and causes a severe disability. The aim of this study is evaluation of treatment of residual deformity after type IVA neonatal septic arthritis of the hip by Pelvic support osteotomy.Case presentation:A 11-year-old, white girl, was treated surgically by pelvic support osteotomy. The patient underwent two surgical interventions. The first operation consists in lengthening of the left femur for 6 cm with monolateral lengthening external fixation device. The second operation consists in pelvic support osteotomy of the left femur and lengthening for 4 cm. The limb was well aligned after healing, with the axis aligned under the medial wall of the acetabulum.Conclusion:Pelvic support osteotomy can successfully correct a Trendelenburg-Duchenne gait and simultaneously restore knee alignment and correct lower-extremity length discrepancy.