Introduction:The use of radical surgical treatments in treating congenital clubfoot is decreasing. Minimally invasive surgical treatment (MIST) is a way of treating congenital clubfoot, which is a kind of compromise between a radical surgical treatment and non-operational one. A few protocols of different authors McKay, Macnicol, Stevens, Meyer, G.W.Simons and Laaveg-Ponseti were used in the evaluation of the results. SCIENTIFIC OBJECTIVE: To determine the importance and role of groups of parameters (clinical, radiographic and functional) in the evaluation of the results in patients treated with the two methods (radical operation and MIST).Subjects and methods:This paper covers children who were treated for structural (idiopathic) form of PEVC. The testing is a prospective study and was conducted in two groups of patients. Group A (radical surgical treatment) – control group, where the total number of subjects was 50, out of which 35 male (70%) and 15 female (30%). The number of feet tested was 88. Group B (minimally invasive surgical treatment–MIST)–experimental group. The total number of subjects was 48, out of which 35 male (73%) and 13 female (27%). The number of feet tested was 84. For the analysis of the results, we used a questionnaire. The total number of parameters was fifteen, clinical, radiographic and functional, five parameters of each. Normal findings or measured value was determined by 0 points. The range of the total score (TS-a- total score range) 0-27 points, and the results were sorted out into the folowing categories: good result (0-5) satisfactory (6-11), poor (12-19) and deformity recrudescence (20-27) points.Results:The proportion of good results at 88 feet in group A was 0,477 as at 84 feet in group B it was significantly higher and came to 0,893. The difference between these proportions is statistically highly significant (t = 5.84, p <0.001). Chi-square test (χ2 = 30.083 df = 1 N = 172, p <0.001) indicated that there is a highly significant correlation between the method of treatment used and results of treatment. Good results of treatment in group A were observed in 48% and in group B in 88% of cases. The Charles Spearman nonparametric method showed that the rank correlation coefficients for the group A are positive, quite high (between 0.70 and 0.85), similar and statistically highly significant (p <0.001). The influence of radiographic scores on the total score is the lowest, and clinical score on the overall score is the highest. Rank correlation coefficients for group B were also positive but somewhat smaller than in group A (between 0.55 and 0.75) and statistically highly significant (p <0.001). It is possible to notice the difference here and say that the impact of functional scores on the total score is the highest and of radiographic score the lowest.Conclusion:Minimally invasive surgical treatment (MIST) gives better functional results in the treatment of congenital clubfoot than radical surgical treatment. The role of radigraphic parameters in the evaluation of the results of ...

The initial width of the fracture crack is important for the evaluation of the fracture stability, the evaluation of the risk for the creation of secondary dislocations and for the choice of treatment. The upper limit of the fracture crack width which influenced the selection of the method of treatment was 2.5 mm.

Due to the pain in the lumbosacral area spreading down the right leg and positive Lazarevic's sign, a 13-year-old boy was referred to a neuropaediatrician. He was suffering from lumbosciatica. In the first three sick days, laboratory tests were done as well as X-ray examination. High febrility and laboratory results indicated the existence of infection of unknown localisation. Diagnostic examination: radiography of the lungs and heart, computerized tomography (CT), nuclear magnetic resonance (NMR), ultrasound (US) of hips and painful sacroiliac area and US of abdomen could not localise the infection. Radiography of SIJ (Barschoni) focused the attention on SIJ). Scintigraphy of the skeleton with 99mTc-DPD pointed to the intensified collection of radiopharmaceuticals in the area around SIJ. Localised changes, erythema and signs of abscess in the projection of SIJ appeared the fifth day since the appearance of the disease. Incision was performed as well as evacuation of purulent content, and bacterial analysis isolated Staphylococcus aureus. Therapy with antibiotics was applied according to the antibiogram three weeks parenterally (intravenously) and two weeks per os. After five weeks, clinical and laboratory results were normal. The patient has been monitored for eight months since the appearance of the disease. Conclusion In children with symptoms and signs of lumbosciatica, among other things, attention should be paid, differentially and diagnostically speaking, to pyogenic infection of SIJ. The skeletal scintigraphy helps early diagnosis of pyogenic infection of SIJ, when localised clinical signs have not been formed yet. In our patient, the infection was caused by localised spreading from a skin abrasion.

Kratak sadržajUvod. U radu se istražuje mogućnost neoperativnog liječenja suprakondilarnih fraktura humerusa ekstenzionog tipa kod djece uzrasta od 5-10 godina.Metode. Obrađeno je 51 dijete sa suprakondilarnim prelomom humerusa liječeno tokom perioda od dvije godine (1998)(1999)(2000) na Dječjoj hirurškoj klinici u Banjaluci. Od ukupnog broja preloma, 21 prelom je tip III. Lateralno pomjeranje distalnog fragmenta bilo je prisutno kod 16 djece, dok je kod preostalih 5 djece pomjeranje bilo medijalno. Sve repozicije rađene su u opštoj anesteziji, pod kontrolom portabilnog rentgen aparata. Dužina imoblizacije iznosila je 3-4 nedjelje.Rezultati. Kod 70% djece repozicije je bila uspješna bez značajnije naknadne redislokacije. Kod petoro djece je zbog naknadne dislokacije rađena ponovo zatvorena repozicija. Kod jednog pacijenta urađena je otvorena repozija i fiksacija fragmenata Kurschner-ovim iglama.Zaključak. U oko 80% slučajeva moguć je efikasan konzervativni tretman suprakondilarnog preloma tip-III. Operativno liječenje treba ostaviti za strogo indikovane slučajeve.Ključne riječi: suprakondilarni prelomi tip-III, neoperativni tretman, djeca

1 Klinika za dječiju hirurgiju, UKC Banja Luka ²Klinika za torakalnu hirurgiju, UKC Banja Luka, Republika Srpska, Bosna i Hercegovina Kratak sadržajUvod. Ciste jajnika nastaju kada se jedan dio jajnika napuni tekućinom. Najčešće su to funkcionalne ciste i njihova veličina je najčešće od 2 do 6 cm, mada su opisani i slučajevi cista velikih dimenzija.Prikaz bolesnice. Prikazan je slučaj šesnaestogodišnje djevojčice koja je primljena zbog velike tumorske mase u abdomenu, nejasne etiologije. Deset mjeseci prije prijema primijetila je da "joj raste stomak". Nije imala nikakvih subjektivnih tegoba. Pred hospitalizaciju žalila se na otežano kretanje i zamaranje pri većoj aktivnosti. Na osnovu laboratorijskih nalaza i radioloških pretraga (ultrazvuk i CT abdomena) nije se moglo utvrditi porijeklo tumorske mase, odnosno pripadnost nekom od abdominalnih organa. Pretpostavljeno je da se radi ili o mezenterijalnoj ili cisti jajnika. Urađena je laparotomija i utvrđeno, na osnovu operativnog i patohistološkog nalaza, da se radi o velikoj seroznoj cisti lijevog jajnika čije su dimenzije bile 35,65x14,90 cm i koja je sadržala 10,5 l tekućine. Operativni i postoperativni tok protekli su uredno.Zaključak. U diferencijalnoj dijagnozi cističnih lezija jajnika od pomoći mogu biti vizualizacione dijagnostičke metode, mada se često definitivna dijagnoza postavi tek nakon operativnog zahvata i patohistološke analize.