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Most of the surveyed hospitals are capable of providing essential diagnostic tests, but very few are able to do so at the point or time of presentation. While emergency medical services (EMS) have improved system-wide, emergent care interventions by EMS and within all hospitals remain limited. Further system-wide acute and emergency care improvements are forthcoming.

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Introduction: Low back pain is common medical disorder that can be caused by different etiologies, some of them being very rare. During the past decades, much of the etiology and pato-mechanics of low back pain has been clarified. However, defining precise cause of low back pain in a small subset of patients is still challenging.Case presentation: We are presenting a case of long lasting low back pain caused by impingement of the enlarged spinous process of the fifth lumbar spine into the spina bifida of the first sacral segment, so called De Anquin syndrome. We delineated the precise morphology of the anomaly using CT scans, and since the patient was symptomatic, the resection of the enlarged spinous process was undertaken. During the follow up period, the patient remained completely symptom free.Discussion and Literature review: We undertook literature review and small number of studies describing De Anquin syndrome were found. The most remarkable finding of the case presented is the immediate and complete release of pain. Conclusion:We do recommend seeking for the exact etiology in the patients with long lasting low back pain.

Aim: The aim of this study is to show our experience in cases of dislocated extension typesupracondylar humeral fractures and evaluate the results of their treatment in the period from 2000 to 2010 with a follow up of a maximum six months. Material and Methods:A retrospective analysis of the clinical cases for the period 2000 -2010 was done. Children from 4 to 14 years of age with supracondylar fractures of the humerusextension type are included. The total number of patients treated at the Clinic for Pediatric Surgery was 230. Results:The results of the treatment were evaluated after the last control examination six months later. We noticed postoperative neurological damage in 10 cases (4.85%). In 14 patients (6.8%) we noticed long term deformities such as cubitus varus or cubitus valgus. Infection at the entering place of the needles occurred in 4 patients (1.94%), which did not indicate premature extraction of the needles and conversion of the treatment. Conclusion:As a conclusion, we can stress that our outcomes in treatment of dislocated suparacondylar fractures of the humerus in children meet the world standards.