[First clinical experience with nonreamed intramedullary nailing in Lithuania]. / Ikalama intrameduline vinis su skersiniu sutvirtinimu (pirmoji didesne klinikine patirtis Lietuvoje).

Long bone diaphyseal fractures are very common. Limited choice of implants for treatment of these fractures in Lithuania often leads to unsatisfactory treatment results and complications. Unreamed intramedullary nailing is relatively simple and effective method for treatment of severely injured patients. Using this method early stabilization and rehabilitation, decreased number of complications, and shortened stay in hospital can be ensured. Indications, technique and early results of first fifty intramedullary fixations with unreamed nails performed in the Clinic of Orthopedics and Traumatology, Kaunas University of Medicine are presented.

[Primary non-Hodgkin's lymphoma of bone]. / Pirmine kaulu ne Hodgkino limfoma.

Primary lymphoma of bone is a rare condition that has been described as a malignant neoplasm formed of lymphoid and myelopoetic tissues. Morphologic substrate is formed of lymphoid cells of different evolutional stages. Primary lymphoma of bone occurs predominantly in males; a male to female ratio is 1.8:1. It may occur at any age. The sites commonly affected are the long bones. In Lithuania 400 new cases of lymphoma are diagnosed every year. About 75% of them are non-Hodgkin's lymphoma. Many histological types and subtypes of lymphoma exist. This variation leads to difficulties when reviewing the literature and comparing prognoses, treatment and oncologic outcomes. Treatment options for primary bone lymphoma historically have included local therapy with radiation or surgery with or without systemic therapy. The aim of surgery is prophylactic fixation of impending fractures or treatment of pathological fractures. We present a clinical case report of 40-year-old male who developed primary lymphoma of bone with pathological fracture of femur. The systemic chemotherapy was applied during the time of treatment. The choice of surgical treatment was intramedullary nailing without using of methylmethacrylate, because regeneration of bone was visible on roentgenograms. After twelve-month follow-up the patient is full weight bearing without external support.

[Treatment of the upper cervical spine injuries with halo vest device]. / Virsutiniu kaklo slanksteliu suzalojimu gydymas "ziedo-liemenes" itvaru.

In the article are described cases, when patients sustained fractures of the first and the second cervical spine vertebrae and were treated with "Halo-vest" device. We performed this investigation in order to establish efficiency of "Halo-vest" immobilization and to establish regression of neurological evaluation, patients feelings and their come back to their usual environment, when 1-2 years passed after fracture and treatment. Investigation was performed in 1999-2001. We performed retrospective analysis of 58 cases. From this group we divided 25 cases. There were patients who sustained fractures of the first and the second cervical spine vertebrae and were treated with "Halo-vest" device. Twenty-two patients were treated with "Halo-vest" immobilization successfully. Three patients were operated, because close fractures repositions failed. We analyzed these patients 1-2 years after fracture and treatment, and after data analysis we made conclusion, that 69% patients after these injuries came back to their usual environment. CONCLUSIONS. Reposition of fractures in the upper cervical spine can be achieved with "Halo-vest" device. If close fractures repositions failed, then spondylodesis must be performed and alignment during operation can be maintained with "Halo-vest" device. After these injuries and treatment with "Halo-vest" device about 69% patients came back to their usual environment.

[Treatment outcome in femoral neck fractures]. / Slaunikaulio kaklo luziu gydymo rezultatai.

Retrospective study of 372 patients with Garden III-IV type intracapsular femoral neck fractures performed in Clinic of Orthopedics and Traumatology, Kaunas University of Medicine, Kaunas Red Cross hospital. Ninety eight percent of them were operated: osteosynthesis for 302 patients, and arthroplasty for 63 patients. Evaluating results of treatment we paid attention on walking ability, pain in hip joint. Mean follow-up time was 1.5 years. Satisfactory results we received for 41.8%. The best results we received after total hip replacement and after osteosynthesis with modern fixation devices. Delayed surgery worsens results. Type of anesthesia did not influence results of osteosynthesis.