Acta chirurgica Iugoslavica最新文献

{"title":"Intramedullary nail in the treatment of pertrochanteric fractures in elderly patients","authors":"G. Falzarano, A. Medici, P. Grubor, M. Grubor, E. Barron, Arianna Falzarano, S. Viglione, F. Ascione, Raffaele Franzese, G. Errico, L. Meccariello","doi":"10.2298/ACI1501039F","DOIUrl":"https://doi.org/10.2298/ACI1501039F","url":null,"abstract":"Introduction. Intramedullary nail is an important component of modern treatment of pertrochanteric femur fractures. Objective. In elderly population, pertrochanteric fractures treated with unreamed intramedullary nails cause less deep infections when compared to reamed intramedullary nails. Patients and Methods. From April, 2010 to May, 2012 at the Department of Orthopedics and Traumatology, Gaetano Rummo Hospital (Benevento, Italy), 156 patients with pertrochanteric fracture, average age 82.7 years (75-102 years), were treated. In the analyzed case, there were 90 females and 66 males with pertrochanteric fractures. The respondents were divided into two groups. The first group consisted of 78 respondents who were treated with reamed intramedullary nails and the second group of 78 respondents treated with unreamed intramedullary nails. Discussion. Infections are not the most common postoperative complications. The risk of infection is increased in patients with comorbidity and in cases when there is an empty space between the intramedullary nail fixation and bone. Proximal femoral fractures carry a high mortality, but its causes are unclear. Conclusion. Our research has shown that the application of unreamed intramedullary nails in the treatment of pertrochanteric femoral fractures reduces a mortality risk and risk of infection.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injuries of the Lisfranc joint","authors":"R. Lecic, Z. Krivokapic, D. Atkinson, B. Karovic, Z. Bumbasirević","doi":"10.2298/ACI1501075L","DOIUrl":"https://doi.org/10.2298/ACI1501075L","url":null,"abstract":"Injuries of the Lisfranc’s joint are not so common, but in most of cases they are misdiagnosed. This have been changed by better diagnostic procedures, CT scan and MRI in some of the cases. The number of patients increases and this is of importance, due to the mentioned overlooked cases. The surgical treatment is preferable, either within few days or postponed for a7-10 days in aim to oedema subside. Intraoperative fluoroscopy is mandatory and stable fixation is better for the first three metatarsal bones, while the lateral two MT bones could be stabilized by Kirschner wires. Prolonged nonweight beairing is prescribed as well as physical therapy if one should obtain favorable outcome. [Projekat Ministarstva nauke Republike Srbije, br. 175095]","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"75-79"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilemmas in the choice of treatment of tibiofibular syndesmosis in malleolar fractures","authors":"P. Grubor, Fuad Džanković, M. Mitković, L. Meccariello","doi":"10.2298/ACI1501033G","DOIUrl":"https://doi.org/10.2298/ACI1501033G","url":null,"abstract":"Introduction. Ankle joint fractures are one of the most common injuries dealt with by orthopedic surgeons. Objective. To determine to what extent do diagnostics, estimation and choice of treatment of tibiofibular syndesmosis injuries affect the final clinical result. Patients and Methods. The study represents retrospective-prospective analysis of the data obtained from 102 patients treated for ankle injury due to malleolar ankle joint fractures and tibiofibular syndesmosis at the Clinic of Traumatology. The average value of monitoring was 61.62 months. According to the Danis-Weber classification, C1 fracture was present in 77 respondents (75.49%); C2 in 23 (22.5%); and C3 fracture in 2 respondents (1.96%). The Danis-Weber classification was used in this paper and hence we divided 102 patients with type C fractures according to the above mentioned classification. The first group (G1) was consisted of 48 (47%) patients who had undergone the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The second group (G2) was consisted of 54 (53%) patients who did not require the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The syndesmotic screw was placed in cases of: supra-syndesmotic fractures of the fibula associated with rupture of the deltoid ligament and fracture types according to the Topliss A and B. Three, six and twelve months after the surgery, the clinical results were examined using the American Orthopaedic Foot and Ankle Society scoring scale. Discussion. All acute unstable injuries should be treated surgically, which includes the deltoid ligament repair, open reduction and internal fixation of the injured syndesmosis. This is considered to be the best way to avoid unwanted complications. Conclusion. There was no significant difference in the final results of treatment between patients from the group G1, where the syndesmotic screw fixation was performed, and patients from the group G2, where the syndesmotic screw fixation was not performed.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"33-37"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal fixator \"Mitkovic\" in the treatment of fractures of femoral shaft: A possible solution for fractures in heavier children and adolescents","authors":"D. Živanović, Z. Radovanovic, A. Slavkovic, Z. Marjanovic","doi":"10.2298/ACI1501045Z","DOIUrl":"https://doi.org/10.2298/ACI1501045Z","url":null,"abstract":"Background: Management of femoral shaft fractures in older and heavier children and adolescents is still challenging and controversial and includes several modalities of fixation. Aim of this study was to analyze single center experience in application of selfdynamisable internal fixator Mitkovic (SIF) for the treatment of fractures of femoral shaft in children and adolescents. Methods: Retrospective analysis of data of pediatric and adolescent patients treated for diaphyseal fracture in single center has been conducted. Results: Eleven patients, with 12 femoral shaft fractures were treated in ten-year-period with internal fixator “Mitkovic“. Time to fracture healing ranged from 4-12 weeks (average 8.9 weeks). All fractures healed without complications. No rotational or angular mall-alignment was noticed. No external cast immobilization was applied in any patient. Conclusion: Selfdynamisable internal fixator Mitkovic may be considered as viable option for treatment of femoral fractures in older/heavier children and adolescents particularly with unstable fracture patterns.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"45-47"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait analysis of patients following totalcondylar knee arthroplasty","authors":"N. Prodanović, B. Ristic, A. Matic, Suzana Petrovic-Savic, G. Devedžić","doi":"10.2298/aci1501027p","DOIUrl":"https://doi.org/10.2298/aci1501027p","url":null,"abstract":"The aim of this study was to evaluate total knee arthroplasty success, throw gait analysis of patients who were underwent a surgery according to objective indicators. Material and methods: Fourteen patients were participated in our study who suffered from a certain type of gonarthrosis. Data were gathered(collected) using a commercial OptiTrack system for motion recording using six infrared cameras. Markers were placed on patients’ lower extremities, on previously determined anatomical regions. After recording the data were processed using computing environment MATLAB. Results: Observing our lab results we noticed a significant reduction in range of motion (ROM) of arthritic knees in relation to the healthy knees. ROM reduction is primarily related to flexion and extension, as well as to medial and lateral translation. Following the TKA, ROM increases, and these values get close to the values that were measured in a healthy knee. The results were presented using graphs for a healthy, damaged and operated knee, and values of corresponding parameters were given using tables. Conclusion: Using our results we showed that there is a big difference in the movement pattern of patients with gonarthrosis before and after the TKA and that that difference can be determined successfully quickly using Optitrack system. [Projekat Ministarstva nauke Republike Srbije, br. III-41007: Application of Biomedical Engineering in Preclinical and Clinical Practice]","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selfdynamisable internal fixator Mitkovic in treatment of periprosthetic supracondylar femoral fracture after total knee arthroplasty","authors":"M. Stojiljković, B. M. Mitkovic, V. Z. Golubovic, D. Micic, S. Milenkovic, M. Djordjevic, M. Mitkovic, Z. Golubović, D. Mladenović, S. Sasa, N. Kocic, M. Pešic, J. Tošić","doi":"10.2298/aci1501049s","DOIUrl":"https://doi.org/10.2298/aci1501049s","url":null,"abstract":"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.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of high-energy pilon fractures with external fixation as a method of minimal invasive approach - long term results","authors":"I. Kostić, M. Mitković, M. Mitrović","doi":"10.2298/aci1501057k","DOIUrl":"https://doi.org/10.2298/aci1501057k","url":null,"abstract":"High energy pilon fractures present a unique challenge to the patient and orthopaedic surgeon. Care for the soft tissue envelope is as important as management of this articular fracture. This article present long term results of patients suffered type C pilon fractures treated with the method of external fixation with minimal invasive approach,. We observe a total of fifty five patients, between August 2008 and January 2015, underwent external fixation of type C pilon fractures with minimal invasive approach at Clinic of Orthopaedic and Traumatology, Clinical center Nis, Serbia. Infectious complications secondary to wound healing problems are a major concern after open surgery for pilon fracture. Therefore, soft-tissue management is critical for successful operative treatment of these fractures. According to our long term results in the present study, it seems that external fixation represent a rational approach to obtain and maintain alignment of the distal tibia through ligamentotaxis, thereby avoiding formal open reduction for treatment of the patient with severe pilon fracture.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"62 1","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68393292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation surgery in patients with localized renal cell cancer--nephron sparing surgery.","authors":"Jasenko Djozić,&nbsp;Senjin Djozić,&nbsp;Jovo Bogdanović,&nbsp;Vuk Sekulić,&nbsp;Maša Djozić,&nbsp;Saša Vojinov,&nbsp;Ivan Levakov,&nbsp;Srdjan Zivojinov,&nbsp;Dimitrije Jeremić,&nbsp;Goran Marušić,&nbsp;Damir Djozić","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Renal Cell Cancer ( RCC) is third most frequent urological cancer behind Prostate cancer and Bladder cancer. It represents 2-3 % of all cancers with annual increase in incidence of 2% in Europe (except Denmark and Sweden) and worldwide. Surgery is the only curative procedure, performed as radical nephrectomy (RN) or partial nephrectomy (nephron sparing surgery-NSS). Radical nephrectomy consists of nephrectomy with ipsilateral adrenalectomy and lymphadenetomy, but partial nephrectomy means resection of the tumor only with 1-3 mm of healthy surrounding tissue and preservation of the rest of the kidney as well as ipsilateral adrenal gland and lymph nodes. NSS is a method of conservation of attacked kidney and preservation of kidney's function with previous radical resection of localized RCC, respecting of all oncological principles. The aim of this study is to describe NSS procedure in details and present results of its 13 year use at Clinic of Urology in Novi Sad.</p><p><strong>Material and methods: </strong>In the last 13 years there were 868 patients (pts) with RCC. NSS has been performed in 242 pts (27.88%). Bilateral tumors: synchronous 8 pts, asynchronous 3 pts. Better kidney has been operated, first. Indications for NSS were: absolute--34 pts (15.0%), relative--58 pts (23.1%) and elective--150 pts (61.9%).Surgery was performed according to esta- blished protocol for this procedure based on recommendation of Prof. A. Novick, Cleveland, USA.</p><p><strong>Results: </strong>All patients underwent surgery under general anesthesia through lumbothomy, mostly.Tumor size was between 2.5-4.5 cm: over 4.5 cm (4-7 cm): 4 pts. Average age of pts--63.5 years (37-84), male: 148 (61.1%), female: 94 (38.9%). From 2001-2005, 2006-2010 i 2011-2013, 39,111 i 92 NSS has been done, respectively. It represented 13.5%, 36.6% , 50.54% of all pts with RCC underwent surgery in that period, respectively. There was an increase of NSS in that period compared to RN for localized RCC. There were no death outcomes inpts underwent NSS, local recurrence was seen in 1 patient (0.6%), urine leakage > 2 weeks 5 pts (5/242 = 2.06%),severe hemorrhage: 3 pts (1.23%), nephrectomy has been done. We do not have patients with von Hippel Landau (VHL) disease.</p><p><strong>Conclusion: </strong>Nephron sparing surgery Is the first choice of surgery for patients with low grade kidney tumors (up to 4.5 cm, even 7 cm), has excellent onco- logical results-comparable with radical nephrectomy, but with preservation of renal function and should be done by an experienced urological team in specialized urological centers with good anesteziological support.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"45-9"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33014416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications associated with percutaneous nephrolitholapaxy (PCNL)--our experience and literature review.","authors":"Predrag Nikić,&nbsp;Otas Durutović,&nbsp;Boris Kajmaković,&nbsp;Djordje Nale,&nbsp;Uroš Bumbaširević,&nbsp;Milan Radovanović,&nbsp;Dragica Milenković-Petronić,&nbsp;Zoran Džamić","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>PCNL is safe procedure which is well tolerated, but as with any other surgical procedure, it is associated with a specific set of complications. There is a marked heterogeneity in reporting complication rates in literature, and this problem was highlighted in Ad Hoc EAU guidelines panel who recommended urgent creation of uniform and reproducible quality system. Modified Dindo-Clavien grading system today is the most utilized classification for complications in urology, and standard in reporting complications for PCNL.</p><p><strong>Aim(s): </strong>To analyze the complication rate for PCNL using the modified Dindo-Clavien grading system in our patients and literature review.</p><p><strong>Methods: </strong>In our institution, with few breaks, PCNL was performed since mid 2010. Complication rate in 63 patients was analyzed retrospectively. Modified Dindo-Clavien grading system that is validated for PCNL has been accepted for classification of complication for PCNL, and literature review was performed. We have summarized the most significant factors which may affect the complication rate during and after PCNL.</p><p><strong>Results: </strong>Overall complication rate was 30% in our study population. The most common complications observed were: postoperative fever Grade 1-2 (9.52%) and bleeding Grade l (7.9%), Grade 2 (3.17%), Grade 3a (4.76%) and Grade 3b (1.58%). Nephrostomy tube leakage was not found in our sample, mostly due to specific postoperative utilizing of auxiliary procedures.</p><p><strong>Conclusion: </strong>Reporting of complication for PCNL should be uniform, and modified Dindo-Clavien grading system that is validated for PCNL should be accepted to be a standard in urology. Surgeons training and experience are the most important to ensure the efficacy of procedure, therefore we suggest that learning of percutaneous renal access should be mandatory in residents trainee program.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"51-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33014417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence.","authors":"Hadži-Djokić Jovan,&nbsp;Babić Uroš,&nbsp;Argirović Aleksandar,&nbsp;Aćimović Miodrag,&nbsp;Radovanović Milan,&nbsp;Milojević Bogomir,&nbsp;Pejčić Tomisla,&nbsp;Džamić Zoran","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also performed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33020022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}