[Topographic localisation of insertion of the anterior cruciate ligament].

INTRODUCTION: Determining the center of tibial insertion of the anterior cruciate ligament is important during reconstruction ligament. AIM: Determining the center of insertion of the anterior cruciate ligament on the anterior intercondylar area relate to anterior and medial edge of the upper end of tibia. MATERIAL AND METHODS: The messurement has been done on 102 tibia. We measured distance from the center of ACL to anterior and medial edge of the uper part of tibia, and the lenght and the width of the tibial insetion. Also, we showed the procentual ratio these distances with medio-lateral and anteroposterior diametar of upper tibial part. RESULTS: The distance between the centre of attachment and medial edge is at 39% from entire latero-medial diametar, while the distance from anterior edge is at 31% from entire anterio-posterior diametar. The possitive correlation between the distance of centar of the anterior cruciate ligament from anterior and inner edge (r = 0.366, p) was found. CONCLUSION: The center of the attachment of the ACL at anterior intercondylarl area is at 1/3 of antero-posterial diametar behind the anterior edge of the upper part of tibia and 2/5 of latero-medial diametar inside from the medial edge.

Our first experience with extended proximal femoral osteotomy for revision hip surgery.

INTRODUCTION: The extended proximal femoral osteotomy (EPFO) is a demanding but useful technique for revision of both cemented or noncemented femoral components. MATERIALS AND METHODS: Between 2000 and 2004 we performed extended proximal femoral osteotomy (EPFO) in 25 cases during revision hip surgery. The main indication for doing revision surgery was aseptic loosening of both total hip arthroplasty (THA) components (18 patients), whilst in the remaining 7 patients the indications were: aseptic loosening of acetabular component in three patients, septic loosening of THA in two patients, recurrent dislocation of the THA because of incorrectly positioned femoral component in one patient and aseptic loosening of cemented hip hemiarthroplasty in one patient. RESULTS: There were 14 women and 11 men. The mean follow-up was 22 months. The average time to revision was 8.3 years. The mean age at the time of revision was 70.3 years (range 55 to 81). At the time of the last control examination all osteotomy sites had healed with signs of remodelling. The mean time to union ranged from 11 weeks to 6 months, shown by the bridging callous formation in both radiographic projections. Bone remodelling occurred in all patients by 12 months and no complications such as nonunion, excessive fragment migration or wire breakage were found. CONCLUSION: In our experience, the extended proximal femoral osteotomy when properly indicated represents an efficient and reliable technique in revision hip surgery.

[Digital video technology in orthopedics].

Digital video technologies are new and powerful tools with wide applications in orthopaedics. Already integral to several common medical devices, digital images can be used for case documentation and presentation as well for diagnostic and surgical patient care information. Digital technologies allow easy manipulation of photographic, video and graphic materials in ways that were impossible with conventional techniques. Educational presentation has been transformed by use of computers and digital projectors. Understanding the basic foundations of digital imaging technology is important for effectively creating digital images, videos and presentations. In this review, we are going to discuss some of the issues that are raised by digital imaging in orthopaedics, digital image processing, as well as, we are giving some recommendations for good quality of pre-, post- and intra-operative photographs in clinical use.

[Functional and radiographic results in partial unipolar hip joint arthroplasty after 6-15 years].

Due to extreme conditions during civil war in early 1990's we were forced to deviate from accepted guidelines in treatment of intracapsular fractures of the femoral neck. Therefore, majority of patients were treated non-operatively. In those that were subjected to surgery, unipolar hemiarthroplasty was treatment of choice, since conditions permitted us to attempt osteofixation in very few, youngest of our patients. As a result of this practice born of necessity, we can now look back and learn from this unique experience.

[Antibiotics in the prevention of the surgical site infection in orthopedic surgery]. / Antibiotici u prevenciji infekcije hirurske rane u ortopedskoj hirurgiji.

Surgical site infection is an actual problem of orthopaedic surgery. Despite considerable efforts that have been done during last several decades (e.g. improvements in surgical techniques, preoperative preparation of the surgical site, infection-control practice, use of preventive antibiotics) surgical site infection still affects about 0.5-2% of patients after closed fracture surgery or insertion of prosthetic devices. They are associated with substantial morbidity and mortality. The adherence to the principles of rationale preventive antibiotic therapy has an important role in the prevention of the surgical infection. In addition, it is well known that inappropriate use of antibiotic promote development of resistance, superinfections and increase the cost of the treatment. This paper focuses on the basic principles of rational use of antibiotics, i.e. appropriate selection of drug, dose, and duration of treatment in the prevention of surgical site infections in orthopaedic surgery.

[Principles and new methods of flexible fixation of fractures of long bones]. / Aktuelni principi i neke od novih metoda fleksibilne fiksacije preloma dugih kostiju.

The modern developments in orthopedic traumatology brought various modifications of modes and principles in operative fixation of fractures. Contrastingly to previous concept of rigid fixation as a priori necessary element for complete fracture union, a principle of flexible or elastic fixation took an equal place in contemporary professional doctrine. The results of these changes were technological innovations of fixation implants, with their mechanical characteristics as a base for their biological application that promoted essential advancements in fracture treatment and full functional recovery of injured patients. We review in this paper the modern principles and some new implant generations in flexible fracture fixation.

Ecological features of the tularemia natural focus in central Posavina (Croatia).

A five-year ecological study of the largest tularemia natural focus in Croatia (Yugoslavia) has revealed that the focus is of a meadow-field type and that the common vole is the crucial member of the local tularemia pathobiocenosis. The occurrence of epizootics and of concomitant epidemics is associated with the bionomy of the latter which, in its turn, is strongly influenced by environmental factors. It was possible therefore to link tularemia outbreaks with special meteorological and hydrological conditions, i.e. with warm and dry spring-summer seasons and the Sava river floods. The proper understanding of the underlying ecological laws furnishes a sound basis for the forecasts of future epidemiological events.