Fractures of the bones that make the wrist joint together with injury to the ligaments and joint capsules are frequent traumas. It can cause besides limited movement also the pathological mobility. These mild injuries often do not provide the degree of recognizable symptoms and signs. They are diagnosed by X-ray imaging, stress images. Before arthrography was an important method, but nowadays arthroscopy has the advantage. Fresh bone and ligament injuries can be and should be repaired in the early posttraumatic period. Unrecognized and undiagnosed injuries are leading to instability of the wrist, to motion abnormalities or impingement overload syndrome. In the treatment of instability important place have reconstruction of the ligaments and arthrodesis of the wrist.

<p><strong>Aim<br /></strong> To evaluate immobilization with dorsal forearm plaster splint with the wrist in dorsal flexion vs palmar flexion in patients with distal radius fracture. <br /><strong>Methods<br /></strong> In the prospective study (2012-2014) 122 patients (of which 22 patients lost) with fractures of the distal radius type A2, A3 and C according to the AO classification were investigated. At the end there were 50 patients in each of the two groups: the dorsiflexion (DF) group had a total of 37 women and 13 men, mean age was 63.48 ± 14.70, and in the palmar flexion (PF) group there were respectively 38/12, and the mean age was 64.20 ± 12.99. In both groups measurements of radiological, clinical and functional parameters were conducted. Patient related wrist evaluation survey (PRWE) and SF12 questionnaire were used for evaluation of pain and function of the wrist and physical and mental condition, respectively. <br /><strong>Results<br /></strong> The study showed excellent results in both groups but there was significant improvement in the range of motion (ROM) on every measurement in the DF group: dorsal flexion 47.70±15.29; ulnar deviation 24.10±7.80; radial deviation 11.50±5.65 vs PF 22.80±19.04; 16.00± 9.31; 4.80± 494 (p<0.001). Also, radiological parameters showed significant improvement until the end of the follow-up. Functional parameters showed significant improvement of physical component of SF-12 in the DF group (p˂0.014). <br /><strong>Conclusion<br /></strong> Immobilization with forearm plaster splint on the dorsal side and with the wrist in dorsiflexion gives better early clinical, radiological and functional results in patients with fractures of type A2, A3, C1-3 in patients of all age groups, compared to immobilization with the wrist in palmar flexion.</p>

<p><strong>Aim <br /></strong>To determine differences between reviparin and dalteparin treatment in patients with extracapsular hip fractures treated with intramedullary nailing and their effects on perioperative blood loss and early postoperative recovery.<br /><strong>Methods</strong> <br />Retrospective comparative study included 68 patients with extracapsular hip fracture who were divided into dalteparin<br />and reviparin group. Medical records were used to obtain demographic data, laboratory parameters, haemoglobin and haematocrit levels, platelet count, mortality rate and medical complications.<br /><strong>Results</strong> <br />Out of total 68 patients, 31 were in reviparin and 37 in dalteparin group. Mean age of patients was 70.5 (±14.4) and<br />76.8 (±8.4) years in reviparin and dalteparin group, respectively (p=0.071). Median values of haemoglobin levels on the first postoperative day were lower in dalteparin group compared to reviparin group (p=0.012). On the first postoperative day haematocrit values were also lower in dalteparin than in reviparin group (p=0.015).<br />Both groups showed an increase in platelet count on the first postoperative day, but without significant difference (p=0.084). There was no statistically significant difference in intrahospital mortality between the groups (6.4% vs. 2.7%; p=0.588). One case of pulmonary embolism was detected in the dalteparin group.<br /><strong>Conclusion</strong> <br />Low-molecular-weight heparin is the drug of choice in patients with hip fractures for thromboprophylaxis. Due to<br />non-antithrombin-mediated actions, reviparin and dalteparin could have different effects on perioperative blood loss. Both dalteparin and reviparin are safe and effective agents for thromboprophylaxis in patients with proximal femur fractures.</p>