Purpose The goal of total hip endoprosthesis is to achieve painless and functional hip for long term. Accurate reconstruction of hip anatomy largely depends on the implant design. In order to select an implant in correspondence with the native hip, the proximal femoral morphology has been in focus of many studies in the past years. The purpose of this study is to analyze proximal femoral geometry in the Croatian population by radiographic evaluation. Methods We conducted a retrospective study analyzing conventional radiographies of the hip, obtained within the last four years from the database of Clinic for Orthopaedic Surgery Lovran. The number of studied patients was 300,168 women and 132 men. The proximal femoral geometric parameters assessed were as follows: femoral head diameter, femoral neck length, neck-shaft angle, angle of femoral neck anteversion, and lateral femoral offset. The results obtained were compared between genders and with results of other studies. Results Proximal femoral anatomy differed in femoral head diameter and lateral femoral offset between males and females in our group of patients, while femoral neck length, femoral neck shaft angle, and femoral neck anteversion have shown similar values in both genders. Our study also showed specificity of the Croatian population in almost all parameters of proximal femoral anatomy, in comparison with other ethnic groups. Conclusion Our results support the observation on high diversity in the morphology of the proximal femur and the specificity of the proximal femoral anatomy of the Croatian population.
Sažetak. Uvod: Liječenje zapuštenih slučajeva posttraumatskog pes equinovarusa u odrasloj dobi veoma je zahtjevno. Radi se o rigidnim deformacijama stražnjeg dijela stopala koje su popraćene uznapredovalim osteoartrotskim promjenama. U korekciji deformiteta potrebna je primjena kombinacije koštanih i mekotkivnih zahvata. Prikaz slučaja: U ovom radu prikazano je liječenje posttraumatskog deformiteta stopala s varusom gležnja od 40o i equinus deformacijom od 120o, te uz nazočnost uznapredovalih artrotskih promjena. Pacijent je liječen primjenom retrogradnog tibiotalokalkanealnog čavla. Zaključak: Primjenom retrogradnog tibiotalokalkanealnog čavla mogu se uspješno korigirati velike, rigidne i kompleksne deformacija stražnjeg dijela stopala, postići brzo koštano preraštanje te umanjiti rizik od nastanka komplikacija u visokorizičnih pacijenata.Ključne riječi: artrodeza; equinovarus; stopalo Abstract. Introduction: Neglected pes equinovarus deformity at the adulthood is difficult to correct. It is usually a rigid deformity associated with arthritic changes of the hindfoot joint. Combined bone and soft tissue procedure is necessary to correct the deformity. Case report: We present a case of acquired severe rigid pes equinovarus in adulthood with varus ankle of 40o and equines deformity of 120o with concomitant degenerative osteoarthritic changes of the ankle joint. The deformity was successfully corrected with use of tiob-talo-calcaneal retrograde nail. Conclusion: The acquired severe complex and rigid deformity of the hind foot in adult could be successfully treated with use of retrograde tibio-talo-calcaneal nailing techniques. With this technique good bone remodeling can be achieved as well as reduction of the risk of complications.
Povećana napetost lateralnog retinakula patele može se javiti kao samostalni entitet ili u sklopu drugih poremećaja patelofemoralnog zgloba kao što su patelofemoralna displazija, lateralna nestabilnost patele, ozljede medijalnog patelofemoralnog ligamenta i hondromalacija. Presijecanje lateralnog retinakula, kako bi se postigao bolji balans aktivnih i pasivnih stabilizatora patele i na taj način korigirao njen položaj, bila je jedna od najizvođenijih operacija u ortopediji bez obzira na etiologiju poremećaja. Biomehaničke i kliničke analize pokazale su mogućnost nastanka brojnih komplikacija koje mogu nastati neselektivnom primjenom ove operacijske tehnike od kojih je najteža medijalna nestabilnost patele. Danas se kao metoda za korigiranje napetosti lateralnih stabilizatora patele češće upotrebljava tehnika produljivanja lateralnog retinakula kojom se puno bolje može regulirati napetost lateralnih struktura uz značajno manje komplikacija.
Cilj: Cilj rada bio je prikazati da i manje traume u adolescentno doba mogu uzrokovati avulziju tuberositasa tibije te ukazati na mogućnost nastanka kompartment sindroma. Prikaz slučaja: Kod dječaka u dobi od 15 godina pri promjeni smjera kretanja došlo je do avulzije tuberositasa tibije. Ozljeda je popraćena velikim edemom. Nakon operacije razvila se pareza peronealnog živca koja je uz medikamentoznu i fizikalnu terapiju regredirala u cijelosti. Zaključak: Pri sumjnji na avulziju tuberositasa tibije potrebna je žurna dijagnostika i liječenje. Zbog mogućeg nastanka sindroma kompartmenta potreban je pojačan nadzor u perioperacijskom periodu.
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