Results of application of external fixation with different types of fixators

Introduction. Extra-focal or external fixation is the method of fracture fixation through the healthy part of the bone using pins or wires. Objective. The aim was to determine which external splints (Ortofix, Mitković, Charnley and Ilizarov) had the best biomechanical properties in primary stabilization of spiral, transverse and commutative bone fractures. Methods. To determine the investigation methodology of biomechanical characteristics of the external fixator we used mathematical and computer simulator (software), juvidur physical model and clinical examination. Results. Values of advancing fragments in millimetres obtained by the study of mathematical and computer simulator (software): Charnley - 0.080 mm, Mitković M 20 - 0.785 mm, Ilizarov - 2.245 mm and Ortofix - 1.400 mm. In testing the juvidur model the following values were obtained: the external fixator Mitković M20 - 1.380 mm, Ortofix - 1.470 mm, Ilizarov - 2.410 mm, and Charnley - 2.510 mm. Clinical research of biomechanical characteristics of the effect of vertical force yielded the following results: Mitković M20 - 0.89 mm, Ortofix - 0.14 mm, Charnley - 0.80 mm and Ilizarov - 1.23 mm. Conclusion. When determining the total number of the stability test splints under the effect of vertical force (compression) and force effect in antero-posterior, later-lateral plane of cross, spiral and comminuted long bone fractures, the best unified biomechanical stability was shown by the following external fixators: firstly, Mitković M20 (0.93mm), secondly, Charnley fixator (1.14 mm), thirdly, Ortofix (1.22 mm), and fourthly, Ilizarov (1.60 mm)

RELIABILITY AND VALIDITY OF CLINICAL AND ULTRASOUND EXAMINATIONS OF DEVELOPMENTAL HIP DYSPLASIA

Developmental dysplasia of the hip (DDH) is the most common congenital deformation of the musculoskeletal system and its successful treatment is closely related to early diagnosis. The study is aimed at examining the incidence of developmental dysplasia of the hip (DDH) and at analysing the validity of clinical examination, which is used for the early detection of DDH in the neonatal period, compared to ultrasound examination.The study involved 400 neonates born in the Banja Luka Region. A new questionnaire was open during the first regular ultrasound and clinical examination of the neonates’ hips and anamnestic and clinical data were recorded in it: the asymmetry of the gluteal, inguinal and femoral folds (Bade sign), the result of abduction testseparately for each hip, the Ortolani sign of luxation and the Palmen sign of reposition, then hip sonography. A Toshiba ultrasound machine with a 7.5 MHz linear probe was used. The method employed was Professor Reinhard Graf’s. Out of the total number of the children with a positive sonographic finding for DDH, 63.16% of them have one of the clinical signs of DDH. The ability of a clinical finding to identify those patients who do not have DDH and have a negative sonographic finding is 79.8%. Out of the total number of the examined children with a positive clinical finding, only 15.58% of them also have a positive sonographic finding for DDH. This research has showed that clinical examination of the hips is of low sensitivity, specificity and reliability, and that not all types of DDH can be detected. Clinical examination must remain an integral part of every infant’s examination, but it constitutes a complementary diagnostic procedure to ultrasound examination. The ultrasound examination of DDH has created new possibilities and has filled the void that existed due to the deficiency of clinical tests, and at the same time it has reduced the number of X-ray examinations of the hips. This research has confirmed that clinical examination of the hips does not meet the screening criteria. It must remain an integral part of an infant’s examination because it, among other things, provides the information which enables the orthopaedic surgeon to choose the most beneficial therapeutic procedures in DDH treatment

EXPERIENCES IN TREATING LAUGIER'S FRACTURES

Laugier's fractures are rare because they are located deep in the elbow joint and are thus protected from any direct trauma. This study shows two patients whose Laugier's fractures were surgically treated. Surgical interventions were performed using the Campbell surgical approach. The ulnar nerve was mobilised for a distance of 12 cm, and then a tenotomy of the triceps brachii muscle and a posterior capsulectomy of the elbow joint were performed. A temporary repositioning followed by a permanent fixation were undertaken using two 3.2mm screws. The screws were inserted from the back, through the posterolateral and posteromedial pillars of the humeral condyle, to the front and medially. The tip of the screw was kept subchondrally in the bone of the humeral capitellum or trochlea and did not go through the cartilage. The stitches of the wound were done by layers, and prior to that a transposition of the ulnar nerve was performed medially. A plaster cast was worn on the upper arm for three weeks, with mandatory prophylaxis of periarticular ossification by taking indomethacin, 25mg three times a day. Upon removing the plaster cast, the patients underwent outpatient physical therapy for two weeks followed by inpatient physical therapy with full weight-bearing. Laugier's fractures have been insufficiently described in the literature. Surgical treatment does not have an alternative, and timely diagnosis and surgical and physical therapy yield, according to the Mayo elbow performance index, good results

emergent hybrid external fixation for tibial pilon fractures in adults

Abstract Objective To investigate that if the hybrid external fixation is the definitive treatment and management of tibial extra articular and intra-articular pilon fractures of the adult in emergency. Methods We treated 237 cases of pilon fractures using hybrid external fixation with or without minimal osteosynthesis from February 1999 to December 2014. All fractures were classified according to the Association for the Study of Internal Fixation. The three groups were represented by 108 patients (45.5%) for the Type A; 75 patients (31.8%) for Type B and 54 patients (22.7%) for Type C. Road accidents [118 patients (50.0%)] were the most common cause of tibial pilon fractures. Results According to a mean follow-up of 7.3 years we had bone healing after 4.8 months from surgery in the 61.18% of the patients. The results were subjectively excellent, while the 54.00% were objectively excellent according to Ovadia and Beals score, and the results showed 29 complications. Conlusions From our data hybrid external fixation with or without minimal fixation is a good surgical method to treat pilon fractures

High-resolution flurescence spectroscopy in immunoanalysis

The work presented in this dissertation combines highly sensitive and selective fluorescence line-narrowing spectroscopy (FLNS) detection with various modes of immunoanalytical techniques. It has been shown that FLNS is capable of directly probing molecules immunocomplexed with antibodies, eliminating analytical ambiguities that may arise from interferences that accompany traditional immunochemical techniques. Moreover, the utilization of highly cross-reactive antibodies for highly specific analyte determination has been demonstrated. Finally, they demonstrate the first example of the spectral resolution of diastereomeric analytes based on their interaction with a cross-reactive antibody

Treating and management in acute Laugier's fracture: a case report

Abstract Laugier's fractures are rare because they are located deep in the elbow joint and are thus protected from any direct trauma. Laugier's fractures have been insufficiently described in the literature. Surgical treatment does not have an alternative, and timely diagnosis and surgical and physical therapy. We presented a case report of a 23 years' old man, sustained a Laugier's fracture in June 2012 after falling from motocycle (low energy trauma) and hit with his flexed elbow against the street

The Many Faces of Internet Marketing

In the last decade marketing discipline has been revolutionized. Internet marketing in now considered to be one of the fastest growing branches of marketing theory and practice, which has emerged as a direct response to fast-growing and changing market landscape. The power of the web has transformed both consumer behaviour and lifestyle and traditional marketing strategy path towards completely new patterns that has become an imperative in modern business surroundings. Thus, the intention of this paper is to examine all faces of Internet-based marketing and to highlight all challenges and opportunities that should be addressed today, and in the near future, in the context of Internet as a centre of business operations. Relying on the results of research and analysis in the given field, it is clear that Internet improvements are going to create even more dynamic and challenging environment in just next few years, and that embracing digital marketplace rules and engaging in full range of internet marketing activities is vital for companies across all industries. This work is licensed under a&nbsp;Creative Commons Attribution-NonCommercial 4.0 International License.</p

Brand Strategies in the Era of Sustainability

Today, brands are powerful instruments of change. They are tightly connected with consumers all over the world and profoundly incorporated into their everyday life and choices they made. Consumers indicate with brands they love and strongly advocate the ideas that are embedded in their philosophy and image. Consequently, companies that own successful brands, which are followed by large group of loyal consumers, have the power to generate modification and even complete shift in consumers’ lifestyle, value system, attitudes and behavior. Accordingly, environmentally friendly brands are inevitable element of sustainable marketing strategy and sustainability concept, given that its implementation requires changes that will trigger mass rather than individuals. However, regardless of positive opinion about socially responsible practice on the market, attitude – behavior gap is widely present among consumers, making segment of green consumers just a market niche. Thus, the most challenging task for marketing and brand managers is to find interest for consumers in a sustainable way of life and to make it easy accessible and attractive for them. This article aims to highlight the leading role of sustainability in branding theory and practice and to point out strategies for successful implementation of green values into the brand management, with an accent on brand equity construct, relying on the results of research and analysis in the given field

Social Media Marketing: Engaging with Consumers in Digital Era

In technology driven world, social media has become one of the cornerstones for growing a successful business. As a costly-effective tool, it overcomes traditional media channels, improves word-of-mouth communication and transforms business models adjusting them to the next generation of interaction with whole market in digital environment. Various social media platforms provide wide spectrum of options for creative approach in engaging consumers, taking them and their whole network of connections on an exciting decision journey, through each step of marketing funnel. Embracing inputs from all users, social media marketing is evolving each day and generates numerous opportunities for digital marketing managers. Consequently, it has become top communication priority, which is both challenging and risky, but inevitable part of integrated marketing communication strategy. Thus, the aim of this paper is to point out all dimensions of social media marketing in digital era, by analysing theoretical and practical standpoints from the available literature, scientific papers and studies in the given field. This work is licensed under a&nbsp;Creative Commons Attribution-NonCommercial 4.0 International License.</p