War wounds to the foot.

Thirty-nine patients with foot injuries were admitted to the Clinic for Orthopedic Surgery in Lovran during the war against Croatia. All of them were soldiers wounded by antipersonnel mines. All of the patients were treated using the same protocol. Primary wound care included debridement, necrectomy, and three-dimensional external fixation with or without Kirschner wires. External fixation facilitated postoperative wound care, prevented vicious contracture position, and made fracture healing possible with early weight bearing.

Femoral neck anteversion: values, development, measurement, common problems.

The femoral neck anteversion angle is an important factor for hip stability and normal walking. It is multifactoral result of evolution, heredity, fetal development, intrauterine position, and mechanical forces. Abnormal FNA sometimes can be associated with many clinical problems ranging from harmless intoeing gait in the early childhood, to disabling osteoarthritis of the hip and the knee in the adults. In most cases is associated with minor functional problems in children during growth, but cause a concern in parents for children future. The child must be examined carefully and an accurate diagnosis must be established. The most important part of care is observation of the children. If abnormal femoral neck anteversion produces severe functional disability, derotational osteotomy should be done, but delayed until late childhood.

Comparison in regression of femoral neck anteversion in children with normal, intoeing and outtoeing gait--prospective study.

We studied the 950 children for spontaneous regression of femoral neck anteversion (FNA) angle. The children were divided in three groups. The first group comprised children with normal gait, second group comprised children with intoeing gait and the third group children with outtoeing gait. All children were seen first time at age seven. Second examination was performed at age 10 and the third at age 14. The FNA was measured using ultrasound techniques. The mean FNA angle in the first group was 24 degrees, and decreased during examined period for average 1 degree per year. The FNA angle in the second group was on average 42 degrees at age 7 and decreased average 1.6 degrees per year. FNA angle in group of children with outtoeing gait was average 13 degrees and did not significantly change during all three examinations. We found that medial and lateral rotation in the extended hip correlate with FNA angle as well as differences between medical and lateral rotation. On the third examination percentage of children with intoeing gait decreased from 12.8% to 1%, while number of children with outtoeing gait did not change significantly during examined period.

Kniest dysplasia: patient's growth progress and development--evolution of abnormalities, 30 year follow up.

A case of a male patient with Kniest dysplasia is reported. The patient's growth and the development and evolution of the patient's abnormalities were tracked for a 30 year period, starting at the patient's birth. The clinical and radiographic features during this period, along with the differential diagnosis of Kniest dysplasia, are discussed. Femoral capital epiphyses and the presence of a cataract in one eye were noted from the early stages of the patient's life. The patient's final height was 165 cm. We believe this to be the first long-term follow up of this condition.

Femoral anteversion related to side differences in hip rotation. Passive rotation in 1,140 children aged 8-9 years.

We assessed whether the range of passive hip motion is reliable for predicting abnormal femoral anteversion. We measured the passive medial and lateral rotation in extension in both hips of 1,140 children between 8 and 9 years of age. The children were divided into 3 groups: group 1: difference between lateral and medial rotation less than 10 degrees; group 2: medial rotation more than 10 degrees greater than the lateral; group 3: lateral rotation more than 10 degrees greater than the medial. Group 1 comprised 90% of the children, whereas 8% belonged to group 2 and 2% to group 3. The angle of femoral neck anteversion was measured in 57 children from the first group, in 67 from the second and in 24 children from the third group, using biplane radiography. The mean anteversion angles in the 3 groups were 24 degrees, 36 degrees and 14 degrees, respectively. To predict an abnormally high anteversion angle (above mean +2SD), the difference between medial and lateral rotation must be 45 degrees or more, whereas an abnormally low anteversion angle (lower than mean -2SD) could be predicted when the lateral rotation was at least 50 degrees higher than the medial rotation.

[Arthroscopic treatment of lateral meniscal cyst by intraarticular dekompression.]. / Artroskopické lécení cysty laterálního menisku pomocí intraartikulární dekomprese.

47 cases of lateral meniscal cyst treated by arthroscopy are presented. Average follow up was 44 months, with a range of 14 to 63 months. 43 out of 47 knees had lateral meniscus tear. Torn menisci were arthroscopically partially resected and the cyst was evacuated inside the joint. Although the tear did not extend up to the insertion of the meniscus, a curved central resection was performed. Thereafter the palpation hook was inserted into the cyst and was manipulated in order to evacuate its content. The same procedure was applied in all 43 cases. With one exception there was neither cyst recurrence nor evidence of meniscal instability. In the remaining 4 cases with no evident meniscal tear, only extraarticular cyst extirpation was done. Key words: lateral meniscus cysts, arthroscopy of the knee joint.

[Alcoholism, risk factors and prevalence of arterial hypertension in naval personnel]. / Alkoholizam, faktori rizika i prevalencija arterijske hipertenzije u pomoraca.

In this paper, the authors tried to establish the association of alcoholism with arterial hypertension as well as with risk factors for atherosclerosis, which are invariably accompanying arterial hypertension, in engine-room personnel (N = 80), in other seamen of the "Jugolinija" (N = 119), and in the control group which was made up of employees of the Technical Department, Shipyard, "3. maj", Rijeka (N = 108). The chi 2-test showed a statistically significant difference in the prevalence of alcoholism, and the t-test a statistically significant difference in the daily consumption of alcohol between the two groups of seamen and the control group. The prevalence of alcoholism and the daily consumption of alcohol were higher in seamen. There were no such differences between the two groups of seamen. Similarly, arterial hypertension was more prevalent and systolic (SBP) and diastolic blood pressure (DBP) were higher in the two groups of seamen compared with the control group. Since, there were no significant linear correlations between the alcohol consumption and SBP and DBP, it could not be said that higher values of SBP and DBP were positively related to the greater consumption of alcohol in seamen as compared to the control group. No significant linear correlation was found between alcohol consumption and studied risk factors too. However, higher prevalence of arterial hypertension in alcoholics among the engine-room personnel suggested some association of the alcohol consumption with arterial hypertension.

[New aspects in the use of artificial hip joints]. / Novosti u primjeni umjetnog zgloba kuka.

The implantation of hip joint endoprosthesis is one of the greatest achievements in orthopedic science. At present, research is aimed at permanent fixation of endoprosthesis into the bone bearing. Refinements of both endoprosthesis and cementation techniques are being made. Uncemented endoprostheses are usually applied in younger patients and in revision surgery. Personal experience in use of uncemented endoprosthesis of patients under 50 years of age is presented. Reconstruction of the hip joint by using endoprosthesis enables overcoming of numerous problems of young persons such as limping, difference in length of the lower extremities, painfulness, early development of degenerative changes and for some persons very important visible cosmetic problems and sexual difficulties. Use of the special tumor modular uncemented endoprosthesis which is a highly differentiated surgical procedure, necessitates special technical preparations and the experience of most distinguished centralized orthopedic institutions. Use of most up-to-date hip endoprosthesis now makes it possible to restore painlessness, movability and to improve the quality of life of treated patients.