Comparative Analysis of Complication Rates in Tibial Shaft Fractures: Intramedullary Nail vs. Ilizarov External Fixation Method.

: The external fixation (EF) Ilizarov method, shown to offer efficacy and relative safety, has unique biomechanical properties. Intramedullary nail fixation (IMN) is an advantageous alternative, offering biomechanical stability and a minimally invasive procedure. The aim of this study was to assess outcomes in patients undergoing tibia fracture fixation, comparing the Ilizarov EF and IMN methods in an early phase of IMN implementation in Serbia.

The Importance of Patellar Resurfacing in Total Knee Arthroplasty for Symptomatic Valgus Degenerative Deformity.

PURPOSE OF THE STUDY Patellar surface replacement during total knee arthroplasty is still a matter of discussion among orthopedic surgeons. The purpose of this study was to examine possible benefits of patellar surface replacement in selected patients with symptomatic degenerative valgus deformity. We have not found any studies in the literature that compare the results of patella management solely for valgus or varus knee deformity nor those that compare both.

[Chiari pelvic osteotomy in treatment of hip dysplasia].

Chiari pelvic osteotomy is a surgical procedure having been performed for almost sixty years in patients with the insufficient coverage of the femoral head. It is most frequently used in young patients with dysplastic acetabular sockets as a part of developmental hip dysplasia. Even though performance of the Chiari osteotomy is associated with positive therapeutical results, above all, its main goal is to delay inevitable degenerative changes.

Acetabular component position of the noncemented total hip endoprosthesis after previous Chiari pelvic osteotomy.

Introduction: The aim of the study was to determine the validity of acetabular component position of the noncemented total hip endoprosthesis after Chiari pelvic osteotomy.

Material And Methods: The study involved 75 patients operated on at the Institute of Orthopedic Surgery "Banjica" in the period from 1990-2009. The first group consisted of 39 patients (46 hips) who underwent Chiari pelvic osteotomy and also later the implantation of a noncemented total hip endoprosthesis.

[Total hip arthroplasty].

Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability.

Physical treatment of foot deformities in childhood.

During the period of development foot deformities can occur, not only during the growth and development, but also in the later age. The most frequent foot deformity is flatfoot, congenital club foot and hallux valgus. Prior to the decision on surgical treatment of the deformity, whenever possible the patient should be referred for physical therapy that may yield acceptable results in specific treatment phases.

Kinesiological characteristics of ankle joint and rearfoot motion.

Kinesiological analysis of tarsal bones provides better understanding of foot disorders, especially in early childhood, when radiography is hindered by delayed ossification of foot bones. Children begin to walk in the age of 9-15 months, with rearfoot inversion only in initial contact phase, while inversion during terminal stance phase is delayed. Adult walking pattern is usually established at six years of age.

Acute patellar dislocation in adolescents: operative versus nonoperative treatment.

Purpose: The purpose of this prospective non-randomised study was to compare the efficacy of two opposed methods, operative and conservative. Our hypothesis was that if the method was selected correctly, on an individual basis, the results should be approximately equal.

Methods: The study included 37 adolescents aged between 12 and 16 years, with a mean follow up of 6.

[Treatment of missed Monteggia lesion in children--case report].

Introduction: A Monteggia lesion is a dislocation of the radial head associated with a fracture with the proximal third of the ulna. It is rare in children and the dislocation of the radial head is often missed at the time of injury. There are a lot of described treatment methods: open reduction of the radial head and reconstruction of the annular ligament combined with ulnar osteotomy, the same method without reconstruction of the annular ligament, gradual lengthening and angulation of the ulna by Ilizarov method without the opening of radiocapitelar joint.

Chiari pelvic osteotomy in the treatment of adolescent hip disorders: possibilities, limitations and complications.

Ninety-nine hips treated by the Chiari pelvic osteotomy were included in this study designed as a retrospective review. The group consisted of 36 male and 50 female patients, with mean age of 15.6 years.

[Congenital club foot].

Congenital club foot is the most frequent foot deformity. It occurs in 1% of newborns, two times more frequently in boys, with family inheritance. Patoanatomicaly, entity consists of bone deformities, articular malpositions and soft tissues retraction.

[Diagnosis and treatment of Paget disease of the spinal vertebrae].

Paget disease, localized only on thoracic spine is extremly rare. It is a huge diagnostic problem and an equally big therapy challenge. Course of this disease is slow, it chronically worsens, thus demanding differentiation of various conditions, along with orthopaedic, neurological, radiographic and endocrine evaluation.

[Unstable fractures of the pelvis treated by Ilizarov external fixation device].

We reviewed seven patients with an unstable fracture of the pelvic ring who had been treated with a Ilizarov external fixation device after a mean follow-up of 5.5 years. There were four "open-book" injuries (type B according to Tile) and three rotationally and vertically unstable injuries (type C according to Tile).

[Slipped capital femoral epiphysis: a modern treatment protocol].

The treatment of a patient with slipped capital femoral epiphysis begins with an early diagnosis and accurate classification. On the basis of symptom duration, clinical findings and radiographs, slipped capital femoral epiphysis is classified as pre-slip, acute, acute-on-chronic and chronic. The long-term outcome of slipped capital femoral epiphysis is directly related to severity and the presence or absence of avascular necrosis and/or chondrolysis.

Alumina-on-alumina ceramic versus metal-on-highly cross-linked polyethylene bearings in total hip arthroplasty: a comparative study.

The aim of the study was to evaluate the reliability and durability of alumina-on-alumina ceramic in comparison to metal-on-highly cross-linked polyethylene (CoCr/HXLPE) bearing couples. This prospective randomised study involved 150 patients (157 hips). All patients (mean age: 54.

Triple pelvic osteotomy in the treatment of hip dysplasia.

Introduction: Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment.

Objective: This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation.

Methods: The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery "Banjica" in Belgrade.

[Spinal localization of Paget disease--case report].

Introduction: Paget disease, localized on thoracal vertebrae, presents a significant challenge in diagnostics and treatment. Presenting with progressive neurological symptoms, it has a broad differential diagnostic spectrum and requires additio-nal radiological, neurological and endocrinological evaluation. Besides drug therapy, an operative decompression of nerve elements is performed when indicated.

[Effect of resection of the lateral retinaculum of the knee in surgical treatment of symptomatic patello-femoral incongruency].

Biomechanical malfunction of the knee extensor mechanism in the patello femoral joint is regarded as patella malalignment but major patients complaints are anterior knee pain and patellar slipping. Lateral retinacular release is one of the basic surgical procedures in the treatment of patellar malalignment. The aim of the study was to estimate the achievements of the lateral retinacular release in solving particular biomechanical disorders of the patello femoral joint, as well as individual patients complaints.

[Developmental dislocation of the hip is still important problem--therapeutic guidelines].

The authors are describing currently important problem--developmental dislocation of the hip. Guidelines for the treatment have been given according to literature date and upon their own experience. Therapeutic suggestions for the first twelve months of life are based on the ultrasound typing--it is advised to perform nonoperative treatment (abduction devices, "over head" traction, Pavlik harnesses).

[Chondrofibrosis of adolescent hip].

Authors present 420 hips with slipped capital epiphysis treated in the IOHB "Banjica", during the period between 1970 and 2005. Research includes the analysis of incidence, diagnostics and causes which contribute to the genesis of hip chondrofibrosis. Risk factors are shown, as well as the approach to eliminate them.

[Complications of slipped capital femoral epiphysis].

Slipped capital femoral epiphysis is well known disorder of the hip in adolescents, which is characterized by displacement of the capital femoral epiphysis from the metaphysis through the physeal plate. The incidence of slipped capital femoral epiphysis is about 5-8 cases per 100,000 adolescents. Etiology of slipped capital femoral epiphysis is still unknown, but this disorder is probably combination of genetic, hormonal and mechanical factors.

[Factors influencing the development of avascular necrosis in non-operative treatment of the acute slipped capital femoral epiphysis].

Introduction: The acute slipped capital femoral epiphysis can result in development of avascular necrosis of the femoral head which is very difficult condition to treat. Orthopedic surgeon can influence the development of avascular necrosis.

Objective: The main objective in our study was to identify factors influencing the development of avascular necrosis in nonoperative treated patients for the acute slipped capital femoral epiphysis.

[Chondroblastoma--current opinion].

Chondroblastoma of bone is rare bone tumor, representing around 1% of benign bone lesions. It is considered a benign lesion, although primary malignant form as well as malignant alteration in the form of chondrosarcoma has been documented. It occurs predominantly in the second decade, more commonly in males.

[Diagnosis and treatment of chondroblastoma--our experience].

The paper presented the results of diagnostics and treatment of patients with diagnosis of chondroblastoma, treated at the Institute of Orthopedic Surgery "Banjica", Belgrade. A total of 30 patients were analyzed, involving the period from 1975-2004. All important data were obtained using the complete medical documentation, physical examination, radiographic findings and available additional diagnostic procedures.

[Postoperative cognitive deficits].

Cognitive dysfunctions are relatively common in postoperative and critically ill patients. This complication not only compromises recovery after surgery, but, if persistent, it minimizes and compromises surgery itself. Risk factors of postoperative cognitive disorders can be divided into age and comorbidity dependent, and those related to anesthesia and surgery.