Distal radius fractures--systematic review.

Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. They represent approximately 3% of all upper extremity injures. Severity of these fractures is directly related to bone mineral density of the patient, and clinical results are dependent on this parameter as well. There is a bimodal distribution of these injuries, with a peak between 18 to 25 years of age, predominantly male population and a second peak in the elderly, older than 65 years, predominantly female population. Early reports of fractures of the distal radius considered these fractures to be group of injuries with a relatively good prognosis irrespective of the treatment given. When it comes to complex fractures, regardless of the method applied, major or minor functional invalidity persists. With that in mind fractures of the distal radius are medical, social and economic problems of modern society.

Operative treatment of metacarpal and phalangeal fractures with Kirschner wire fixation--a review.

Although hand fractures are most common fractures treated in orthopedic practice, many practicians treat them as trivial injuries. Improperly managed they can cause consequences and impair hand function. Metacarpal and phalangeal fractures are classified based on geometry, anatomic localization and wound presence and treatment depend on mechanism of injury. Many of them can be treated nonoperatively with reposition and immobilization, but in some cases osteosynthesis is a method of choice. Surgeon can choose various range of fixation material, and choice depends on fracture type and surgeons affinity. Kirschner wire fixation is one of the most frequently used operative procedure for hand fracture treatment. It provides good stability, early mobilization and excellent functional result.

Fractures of the scaphoid, diagnosis and management--a review.

The scaphoid is vitally important for the proper mechanics of wrist function. Fracture of the scaphoid bone is the most common carpal fracture. Among all wrist injuries the incidence of scaphoid fracture is second only to fractures of the distal radius. Scaphoid fractures are significant because a delay in diagnosis can lead to a variety of adverse outcomes that include nonunion, delayed union, decreased grips strength, range of motion and osteoarthritis of the radiocarpal joint. To avoid missing this diagnosis, a high index of suspicion and a through history and physical examination are necessary, because initial radiographs are often negative. Regardless of the technique of bone grafting, there will almost always be some loss of motion even if the fracture unites.

Current treatment options of acquired flatfoot.

Symptomatic acquired flatfoot is an important orthopaedic problem, due to progressive loss of whole foot function and the increasing problem of patient disability. It is a complex entity, involving the tibialis posterior tendon, ankle joint, hindfoot and midfoot. In most cases the posterior tibial tendon (PTT) is the root cause of acquired flat foot, but there are other contributors and many different factors have an influence. The clinical picture varies depending on the stage of the deformity, as well as the treatment approach. Initially soft tissue procedures, synoviectomy and augmentation of the PTT are advised. In stage 2, lateral column lengthening and calcaneal osteotomy, with soft tissue - tendon transfers (TA, FHL, FDL) are recommended. In stage 3 subtalar, double or triplearthodesis is preferable, while in stage 4 pantalar fusion is indicated. This article elaborates on the etiology, the clinical picture, diagnosis and treatment modalities.

Emil Theodor Kocher (1841-1917)--orthopaedic surgeon and the first surgeon Nobel Prize winner.

Theodor Emil Kocher (1841-1917), born in Bern, educated in many universities in Europe. Kocher as many surgeons of that time performed orthopedic surgery, general surgery, neurosurgery and endocrine surgery, but he become famous in orthopaedic surgery and endocrine surgery. He is remember as a surgeon who described the approach to the hip joint, elbow joint, maneuver for the reduction of dislocated shoulder joint. He introduced many instruments and many of them, such as Kocher clamp is still in use. Most important Kocher work was the thyroid gland surgery, and he received the Nobel Prize for Medicine in 1909, for-in this matter. His nature of meticulous surgeon, scientific and hard working person, dedicated to his patients and students made- found him the place in a history of medicine.

[Friedrich von Esmarch--surgeon, one career].

Friedrich von Esmarch was born in 1823 in Germany and he is one of the greatest surgeons of the Germany of that time. Fridrich von Esmarch introduced the Esmarch tourniquet, which enables operative field bloodless. This revolutionary innovation is still present in the orthopaedic surgery all around world, as well as for the first line hemostasis. Beside this, Esmarch also improves others fields of surgery: immobilizations, methods of antiseptic surgery, modified Esmarch mask for anesthesia. He joined few wars and had a rang surgeon-general. Although his experience was primary from the trauma, he also introduced the training courses of the First aid for the ordinary people, making medicine of that time more modern and efficient

Talar injuries--the orthopaedic challenge.

Injuries of the talus represents an important part of the foot and ankle trauma. Since talar bone connect the lower limb and foot, the sequelas of its trauma could have significant influence on the function of the whole lower limb and gait. The specific vascularization of the talus results in delayed union and even in the avascular necrosis. The diagnosis of the fractures of the talus can be made on the x-rays, but sometimes real picture of the fracture pattern can be seen only in the CT scans. Ocult fractures such as osteochondral fractures and avascular necrosis can be exactly detected on MRI in aim not to be overlookded as the ankle sprain diagnosis. The precise reduction and stable internal fixation is mandatory in the treatment to enable the anatomical position of the talonavicular, talocrural and subtalar joint and to make possible early motion and rehabilitation, without weight bearing. On the other hand, crushed fractures, open fractures and the Hawkins III-IV fractures with the dislocations of the talar body sometimes needs salvage procedures like Blair or tibio-talar or tibio-calcaneal fusion.

Impact of the injury pattern on the pedestrian fatalities in the city of Belgrade.

INTRODUCTION: In the city of Belgrade pedestrians are under the high risk to sustain injuries in the road traffic accidents, they are often with multiple injuries, with long-term treatment and significant consequences. Most of them are in the )senior or in the school age group. METHODS: We present the results of the epidemiological analysis of the mechanism of injury and treatment outcome of the pedestrians who sustained the lower limb injuries and additional, the injuries of the other organic systems. We also analysed the relevant data about the moment of the collision. RESULTS: Regarding the gender, male were significant more injured., in the senior age of life. Patients with multiple injuries, especially with the pelvic injuries or injuries of more than two systems were significant more likely to have a fatal outcome. CONCLUSION: The pedestrians are the most vulnerable group in road traffic accidents. Thus, we need to make actions on two levels: appropriate environment conditions and effective prehospital and hospital treatment.

[Psoas major abscess by heroin addictive patients--a case report].

Drug abuse is related to many medical complications, which depend on the drug type, dose injected, the method of delivery and site of injection. We report a case of psoas abscess in young heroin addict, HIV negative, who was admitted in Emergency Center of Clinical Center in Belgrade because of fever, anaemia, prostration and right groin pain. Clinical and radiological examination were performed. CT showed large abscess of the right psoas muscle, 12 x 4 cm large. Treatment included percutaneous drainage and administration of iv antibiotics. There is regression of inflamation. At discharge patient was in good condition without signs of infection.