[POSSIBILITIES AND LIMITATIONS OF SEXUAL ACTIVITY FOLLOWING TOTAL HIP REPLACEMENT].

Total hip replacement in patients with osteoarthritis significantly reduces pain and enhances the quality of life (QoL). Sexual activity is an important component of QoL about which doctors rarely discuss with patients even though it is a matter of concern to many patients. In fact, patients who have previously had impaired sexual function due to preoperative hip pain and/or stiffness find that after surgery their hips are pain free and have better motion. After total hip arthroplasty range of hip motions is usually limited by surgeon's reccomendation in order to prevent dislocation of prosthesis. This creates limitations in activities of daily living, sport activities and also sexual activities. The aim of this paper is to give guidelines for safe sexual intercourse to patients following total hip replacement. During rehabilitation, patients should be educated on what positions are and are not recommended in the context of sexual activity.

Trends in the use of physical medicine and rehabilitation in Croatia between 1995 and 2012.

Until now, there have been no published researches evaluating referrals from family doctors (FDs) or utilizations of physical medicine and rehabilitation (PMR) in Croatia. The main study aim was of determining the referral trend and the trends in the number of PMR consultations. The data were collected from the Croatian Health Statistics Yearbook, 1995-2012. The results of this study pointed out to the large number of FDs referrals as well as the large number of consultations performed in PMR: about 11% of all specialists' consultations, or the first rank in 2012. While the number of referrals decreased until 2008, the number PNR consultations continuously increased. In the same time the number of the musculoskeletal diagnosed registered by FDs also increased. The geographical variations were observed too. The new researches are needed to get deeper inside in the problem of PMR utilization.

[The role of ultrasonography in evaluation of pathomorphological changes in humeroscapular periarthritis]. / Uloga dijagnostickog ultrazvuka u razlikovanju patomorfoloskih promjena kod humeroskapularnog periartritisa.

The aim of this study was to present the distribution and representation of shoulder ultrasonographic (US) examination findings in patients with diagnosis of humeroscapular periarthritis. US examination findings in 141 patients, that is 147 symptomatic shoulders with diagnosis of humeroscapular periarthritis, were evaluated retrospectively. Outcomes of ultrasonography were distributed in groups by anatomical location, US examination finding and age. Descriptive statistics were used to analyze the data. Out of 147 analyzed shoulders, 87 (59.2%) were positive and 60 (40.8%) were negative upon US examination. The most frequent US abnormalities were detected in a supraspinatus tendon (55.3%), followed by long head of the biceps tendon (15.2%), bursitis (12.6%), subscapularis tendinitis (10.6%) and infraspinatus tendinitis (0.7%). The highest number of US abnormalities, as well as negative ultrasonographies, were detected at the age 40 to 65. The least negative US examination findings were at age over 65, where also the highest number of supraspinatus tears were detected. Due to high specificity and sensitivity in the evaluation of the rotator cuff, subacromial bursa and long head of the biceps tendon changes, ultrasound is a reliable method for evaluation of patients with painful shoulder. Its availability, noninvasivity and relatively low cost make it a method of choice for inital evaluation of such patients. Detailed history and clinical examination are going to lessen inadequate medical requests for ultrasonography.

Bifocal stress fracture of pubic Rami after contralateral total hip arthroplasty and longstanding ipsilateral hip fusion.

In this case report we present a patient with bifocal pubic rami stress fractures after contralateral total hip arthroplasty for congenital hip dysplasia and longstanding ipsilateral hip fusion. Treatment protocol for patients with various degrees of hip arthritis on one side and contralateral longstanding hip fusion are proposed based on the literature and our and previously published cases.

Bifid median nerve in a patient with carpal tunnel syndrome--correlation of clinical, diagnostic and intraoperative findings: case report and review of the literature.

A young patient with symptoms of median nerve compression in carpal tunnel without known risk factors is presented. Ultrasonography and magnetic resonance imaging confirmed an anatomical variation of the median nerve in carpal tunnel, described in the literature as bifid median nerve. The knowledge of the existence ofbifid median nerve is important in planning surgical decompression of median nerve to avoid nerve injury or potential relapse if decompression of both branches has not been done. Carpal tunnel ultrasonography is a noninvasive, reliable and available diagnostic tool to diagnose bifid median nerve.