Results of Treatment of Displaced Supracondylar Humeral Fractures in Children by K-wiring

The supracondylar fracture of the humerus in children remains the most challenging injury for the orthopedic surgeon. It is important to consider the options of treatment very carefully and tailor the treatment according to the characteristics of each fracture. In this study we observed outcomes of surgical procedures using the Kirschner-wire for the dislocated (displaced) supracondylar fractures in 135 children (mean age 6.7 years). In 96 patients closed reposition (reduction) and fixation with crossed K-wire was done. A total of 41 children were operated by the means of open reposition and crossed K-wire fixation. Another 41 underwent similar (1-mm) K-wire application. In classifying the fractures Gartland classification of the supracondilar fractures of the humerus was used. Postoperatively, cubitus varus was found in seven, and cubitus valgus in three children (5% and 2% respectively). Stiffness of the elbow was recorded in 18 patients, while the paresis of the ulnar nerve was recorded in three cases (13 and 2% respectively). In conclusion, we can suggest crossed fixation while applying the K-wire throughout two cortexes, since such technique ensures the most superior fixation and stable osteosynthesis

Razvoj banke koštanog tkiva u Sveučilišnoj kliničkoj bolnici Mostar

Bone tissue banks are necessary for collection, production, testing, packaging, storage and delivery of bone transplants. Bone tissue bank is a link between the donor and the recipient by which the donation becomes a medium of health improvement for both the donor and the recipient. At the Department of Orthopedics, Mostar University Clinical Hospital, about 200 total hip replacements are performed per year. Most patients undergoing total hip replacement surgery (90%) have been diagnosed with osteoarthritis, and they are suitable donors, having in mind their age and comorbidities. In the same Department, around 50 procedures that require bone transplants are performed per year. A team of highly competent surgeons are working on an intensive process of adaptation oriented to quality improvement and intensification of the activity, both with the goal of meeting the standards of excellence in orthopedic surgery. The presence of a bone tissue bank has a favorable impact on the quality of health care owing to bone transplant availability, as well as on the scientific role of a highly specialized institution that examines the properties of bone tissue.Banke koštanog tkiva su odgovorne za skupljanje, proizvodnju, ispitivanje, pakiranje, skladištenje i isporuku koštanih transplantata. Banka koštanog tkiva premosnica je od donora k primatelju prilikom koje se donacija pretače u sredstvo za poboljšanje zdravstvenog stanja kako primatelja tako i davatelja. Na Klinici za ortopediju Sveučilišne kliničke bolnice Mostar na godinu se ugradi oko 200 totalnih proteza kuka. Većini bolesnika kojima se ugrađuje totalna proteza kuka (90%) identificirana je dijagnoza osteoartritisa te su pogodni davatelji, s tim da se u obzir uzimaju komorbiditeti i životna dob. Na godinu se na Klinici izvodi oko 50 različitih operacija za koje trebaju koštani presatci. Tim visoko kompetentnih kirurga bavi se intenzivnim procesom adaptacije koji je orijentiran poboljšanju kvalitete i jačanju aktivnosti s ciljem zadovoljenja standarda izvrsnosti u ortopedskoj kirurgiji. Prisutnost ovakve koštane banke učinkovito utječe na kvalitetu skrbi kako zbog brže dostupnosti implantata tako i zbog znanstvene uloge visoko specificirane ustanove koja bazično istražuje svojstva koštanog tkiva