Mehanical complications in total hip joint endoprosthesis implantation

Ugradnja totalnih endoproteza zgloba kuka praćena je određenim brojem mehaničkih komplikacija. Analizom radioloških snimaka 250 totalnih endoproteza zgloba kuka (SAS, AHS, Muller) prikazanje položaj acetabulame i femoralne komponente ugrađenih endoproteza. Mjerenjima je ustanovljeno daje nagib ugrađenih acetabula u 44,4% bolesnika iznosio 41 do 50 stupnjeva, odnosno, u 75,6% bolesnika acetabul je imao kut nagiba od 36 do 55 stupnjeva. Trup je endoproteze bio u neutralnom položaju u 84,4% bolesnika. Varusni je položaj stema nađen u 7,2% bolesnika, a valgusni položaj u 8,4% bolesnika. Usavršavanje operacijske tehnike nepobitno je glavni čimbenik pri smanjenju broja mehaničkih komplikacija prilikom ugradnji totalnih endoproteza zgloba kuka.Implantation of total hip endoprosthesis may be accompanied by a number of mechanical complications. Radiographics images of 250 total hip endoprostheses (SAS, AHS, Muller) show the positions of acetabular and femoral components of implanted endoprostheses. Measurements have shown that the decline of implanted acetabulum ranged from 41 to 50 degrees in 44.4% of patients, i. e. in 75.6% of patients the angle of acetabular decline ranged from 36 to 55 degrees. The position of endoprosthesic shaft was neutral in 84.4% of patients; 7.2% of patients had varus position of the stem of shaft, whereas 8.4% of them had valgus shaft position. Improvement in operative technique is undoubtedly the major factor contributing to a decreased number of mechanical complications in total hip joint endoprosthetic implantation

Volume dynamics of the front shin compartment in muscle contraction

Ultrazvučna dijagnostika predstavlja značajnu pomoć u promatranju promjena unutar prostora prednjeg odjeljka potkoljenice. Vršena su istraživanja na 100 ispitanika. Linearnom je ultrazvučnom sondom 7.5 MHz učinjen poprečni prikaz prednjeg odjeljka potkoljenice na tri razine: u neutralnom položaju stopala, položaju dorzalne te plantame fleksije stopala. Pri dorzalnoj se fleksiji stopala površina proksimalnog presjeka prosječno poveća za 26.86%, dok se površina srednjeg i distalnog presjeka smanjuje. Volumen ovoga prostora poveća se prilikom dorzalne fleksije stopala za prosječno 4,13% , ali i prilikom kontrakcije stražnje muskulature poveća se za prosječno 1,13%.The ultrasound diagnostic procedure is of great help in observing the changes within front shin compartment. 100 patients had the diametrical scan of the front shin compartment at three levels of the same distance, made with ultrasound with the linear probe of 7.5 MHz. We repeated the measuring at the same levels with the feet in the neutral position as well as in dorsal and plantar flexion. In case of feet dorsal flexion, the proximal diameter of the surface is increasing by 26.86%, whereas in case of middle and distal diameter decreases. The volume of this space it increases by 4.13% in feet dorsal flexion, and by 1.13% in feet plantar flexion

Volume dynamics of the front shin compartment in muscle contraction

Ultrazvučna dijagnostika predstavlja značajnu pomoć u promatranju promjena unutar prostora prednjeg odjeljka potkoljenice. Vršena su istraživanja na 100 ispitanika. Linearnom je ultrazvučnom sondom 7.5 MHz učinjen poprečni prikaz prednjeg odjeljka potkoljenice na tri razine: u neutralnom položaju stopala, položaju dorzalne te plantame fleksije stopala. Pri dorzalnoj se fleksiji stopala površina proksimalnog presjeka prosječno poveća za 26.86%, dok se površina srednjeg i distalnog presjeka smanjuje. Volumen ovoga prostora poveća se prilikom dorzalne fleksije stopala za prosječno 4,13% , ali i prilikom kontrakcije stražnje muskulature poveća se za prosječno 1,13%.The ultrasound diagnostic procedure is of great help in observing the changes within front shin compartment. 100 patients had the diametrical scan of the front shin compartment at three levels of the same distance, made with ultrasound with the linear probe of 7.5 MHz. We repeated the measuring at the same levels with the feet in the neutral position as well as in dorsal and plantar flexion. In case of feet dorsal flexion, the proximal diameter of the surface is increasing by 26.86%, whereas in case of middle and distal diameter decreases. The volume of this space it increases by 4.13% in feet dorsal flexion, and by 1.13% in feet plantar flexion

Pain therapy after lumbar discectomy

Cilj: Svrha istraživanja utvrditi je moguću prednost primjene Tramadoluma, Diclofenacuma i Dexamethasonuma u liječenju postoperacijskog bola nakon lumbalne discektomije u odnosu na uobičajenu postoperacijsku primjenu Tramadoluma i Metamizolum Natricuma. Metode: Istraživanjem je obuhvaćeno 46 ispitanika prosječne životne dobi od 45.29 ± 14.06 godina. U svih ispitanika učinjena je otvorena lumbalna discektomija. U prvoj skupini od 23 bolesnika postoperacijski su primjenjivani Tramadolum i Metamizolum Natricum, a kod druge skupine od 23 bolesnika Tramadolum, Dexamethasonum i Diclofenacum. Obrazac za praćenje postoperacijskog bola sastojao se iz dva dijela: prvog, koji je ispunjavao liječnik i koji je sadržavao podatke o kliničkom nalazu, dok je drugi dio obrasca ispunjavao bolesnik i bilježio podatke o preoperacijskom bolu te bolne smetnje dva dana i osam dana nakon operacije, stupnjujući ih prema skali od 0 do 10. U statističkoj obradi rabljen je program Statistica 5.0. Značajnost razlika određivana je Studentovim t-testom za nezavisne uzorke, dok se značajnost razlika između pojedinih uzoraka s obzirom na bolnost i vrijeme anketiranja utvrđivala Studentovim t-testom za zavisne uzorke. Rezultati: Rezultati istraživanja neovisno o mjerenju preoperacijskog bola govore da skupina ispitanika tretirana Tramadolumom, Dexamethasonumom i Diclofenacumom ima značajno manju bolnost u području noge (p < 0.01), dok je bolnost u križima nešto manja, još uvijek u području statističke značajnosti (p = 0.03; p = 0.01) u odnosu na skupinu ispitanika tretiranih Tramadolumom i Metamizolum Natricumom. Rasprava: Rezultati istraživanja potvrđuju učinkovitost i prednost kombinirane primjene Tramadoluma, Diclofenacuma i Dexamethasonuma u kupiranju postopercijskog bola nakon lumbalne discektomije u odnosu na primjenu Tramadoluma i Metamizolum Natricuma.Aim: The aim is to determine possible advantage of application of Tramadolum, Diclofenacum and Dexamethasonum in therapy of postoperative pain after lumbar discectomy in relation to standard postoperative application of Tramadolum and Metamizolum Natricum. Methods: The research covered 46 patients with mean age of 45.29 ± 14.06. All patients underwent open lumbar discectomy. The first group, consisting of 23 patients, was treated with Tramadolum and after the surgery , and the other one, also with 23 patients, was treated with Tramadolum, Dexamethasonum and Diclofenacum. The VAS questionnaire of postoperative pain consisted of two parts: the first one, filled in by a surgeon, included clinical findings, and the second one, filled in by a patient, contained data entered by the patient on postoperative pains and painful discomforts two and eight days after the surgery, with the scale from 0 to 10. Statistical 5.0 programme was used in statistical analysis. Statistical significance of differences was determined by Student’s independent samples T-test, while significance of differences between individual samples in respect of pain and time of filling in the questionnaire was determined by Student’s dependent samples T-test. Results: The research results, not considering measurement of preoperative pain, show that the group treated with Tramadolum, Dexamethasonum and Diclofenacum experienced significantly lower pain in the leg area (p< 0.01), while pain in sacral area was somewhat lower but still with statistical significance (p = 0.03; p = 0.01) compared to the group receiving Tramadolum and Metamizolum Natricum. Conclusion: The research results confirm efficiency and advantage of combined therapy with Tramadolum, Diclofenacum and Dexamethasonum in coping with postoperative pain after lumbar discectomy compared to the therapy with Tramadolum and Metamizolum Natricum

Mehanical complications in total hip joint endoprosthesis implantation

Ugradnja totalnih endoproteza zgloba kuka praćena je određenim brojem mehaničkih komplikacija. Analizom radioloških snimaka 250 totalnih endoproteza zgloba kuka (SAS, AHS, Muller) prikazanje položaj acetabulame i femoralne komponente ugrađenih endoproteza. Mjerenjima je ustanovljeno daje nagib ugrađenih acetabula u 44,4% bolesnika iznosio 41 do 50 stupnjeva, odnosno, u 75,6% bolesnika acetabul je imao kut nagiba od 36 do 55 stupnjeva. Trup je endoproteze bio u neutralnom položaju u 84,4% bolesnika. Varusni je položaj stema nađen u 7,2% bolesnika, a valgusni položaj u 8,4% bolesnika. Usavršavanje operacijske tehnike nepobitno je glavni čimbenik pri smanjenju broja mehaničkih komplikacija prilikom ugradnji totalnih endoproteza zgloba kuka.Implantation of total hip endoprosthesis may be accompanied by a number of mechanical complications. Radiographics images of 250 total hip endoprostheses (SAS, AHS, Muller) show the positions of acetabular and femoral components of implanted endoprostheses. Measurements have shown that the decline of implanted acetabulum ranged from 41 to 50 degrees in 44.4% of patients, i. e. in 75.6% of patients the angle of acetabular decline ranged from 36 to 55 degrees. The position of endoprosthesic shaft was neutral in 84.4% of patients; 7.2% of patients had varus position of the stem of shaft, whereas 8.4% of them had valgus shaft position. Improvement in operative technique is undoubtedly the major factor contributing to a decreased number of mechanical complications in total hip joint endoprosthetic implantation

Trefoil factor family protein 3 affects cancellous bone formation in the secondary centers of ossification of mouse tibiae

Background and Purpose: Trefoil factor family (TFF) is a small family of peptides, which comprises three peptides, TFF1, TFF2 and TFF3. The primary sites of TFF expression and synthesis are mucous epithelia, with gastrointestinal mucosa being their main localization. They have a role in mucosal restitution and strengthening of the normal mucosal barrier. Although not present in healthy articular cartilage, TFF3 is expressed in osteoarthritis and septic arthritis affected cartilage and promotes cartilage degradation in such conditions. Also, TFF3 is present in endochondral ossification during embryonic development. Since this implies a role for TFF3 in the ossification process, we evaluated the histomorphometric parameters of the trabecular bone in the epiphyses of mouse tibiae from wild type mice and TFF3 knock-out mice. Materials and Methods: Tibiae of wild-type and knock-out mice were isolated, fixed in 4% paraformaldehyde, paraffin embedded and cut into 6μm sections, which were stained using Masson’s trichrome stain. Digital photographs were taken for histomorphometry of the epiphyseal cancellous bone. Results: Trabecular bone volume density, trabecular bone surface density and trabecular number were significantly decreased in TFF3 knock-out mice, when compared to wild-type mice. Trabecular separation was significantly higher in TFF3 knock-out mice, and trabecular thickness did not differ significantly. Conclusions: In addition to its impact on the cartilage degradation, our present study shows that TFF3 might also have a role in the formation of cancellous bone and its properties

Trefoil factor family protein 3 affects cancellous bone formation in the secondary centers of ossification of mouse tibiae

Background and Purpose: Trefoil factor family (TFF) is a small family of peptides, which comprises three peptides, TFF1, TFF2 and TFF3. The primary sites of TFF expression and synthesis are mucous epithelia, with gastrointestinal mucosa being their main localization. They have a role in mucosal restitution and strengthening of the normal mucosal barrier. Although not present in healthy articular cartilage, TFF3 is expressed in osteoarthritis and septic arthritis affected cartilage and promotes cartilage degradation in such conditions. Also, TFF3 is present in endochondral ossification during embryonic development. Since this implies a role for TFF3 in the ossification process, we evaluated the histomorphometric parameters of the trabecular bone in the epiphyses of mouse tibiae from wild type mice and TFF3 knock-out mice. Materials and Methods: Tibiae of wild-type and knock-out mice were isolated, fixed in 4% paraformaldehyde, paraffin embedded and cut into 6μm sections, which were stained using Masson’s trichrome stain. Digital photographs were taken for histomorphometry of the epiphyseal cancellous bone. Results: Trabecular bone volume density, trabecular bone surface density and trabecular number were significantly decreased in TFF3 knock-out mice, when compared to wild-type mice. Trabecular separation was significantly higher in TFF3 knock-out mice, and trabecular thickness did not differ significantly. Conclusions: In addition to its impact on the cartilage degradation, our present study shows that TFF3 might also have a role in the formation of cancellous bone and its properties

Advantages of Modified Osteosynthesis in Treatment of Osteoporotic Long Bones Fractures – Experimental Model

In surgery of fractured long bones, a patient suffering from osteoporosis represents constant challenge to a surgeon and applied material and instruments that need to destroy as little as possible of an already damaged bone. One potential way of increasing the contact surface between the implants and osteoporotic bone is injection of bone cement (methyl-metacrilat, Palakos) into a prepared screw bed. This method of osteosynthesis was therefore subjected to experimental research to prove that application of modified osteosynthesis using bone cement in treatment of fractures in osteoporotic patients has advantage over the standard method of osteosynthesis because this modified method enables significantly greater firmness and stability of the osteosynthesis, which is the essential precondition of a successful fracture healing. The research was carried out on six macerated cadaveric preparations of a shin bone from the osteological collection from Institute for Anatomy, School of Medicine, University »J. J. Strossmayer«. All samples of long bones were artificially broken in the middle part of the diaphysis and then standard osteosynthesis and modified osteosynthesis with screws filled with bone cement were performed on the samples. Results show that under identical static action of the moment of torsion in the modified osteosynthesis torsion angle deviation is lower than in the standard osteosynthesis. In modified osteosynthesis with bone cement the first results for angle of torsion deviation greater than 0.2 degrees were noticed after 120 minutes, while in the standard method of osteosynthesis they were noticed already in the first minute

Morphometric Analysis of the Sternum

Sternum has a great clinical significance, considering that median sternotomy is the most common surgical approach used in cardiac surgery. The aim of this study is to standardize the sternum according to size, shape and sex and to obtain ranges of the »standard sternum«. The study was done on 55 male and 35 female sterna of the average age of 65. Complex morphometric analysis of breadth, length and thickness of the sterna were performed on sternal segments which were defined by costal notches. Morphometric analysis shows that the general sternum structure in the females and in the males is equal. The standard dimensions of female and male sternum were determined. Standardization according to shape suggests that there is one standard sternum shape present in more than 2/3 of analysed samples of both sexes

Numerical Analysis of Standard and Modified Osteosynthesis in Long Bone Fractures Treatment

The fundamental problem in osteoporotic fracture treatment is significant decrease in bone mass and bone tissue density resulting in decreased firmness and elasticity of osteoporotic bone. Application of standard implants and standard surgical techniques in osteoporotic bone fracture treatment makes it almost impossible to achieve stable osteosynthesis sufficient for early mobility, verticalization and load. Taking into account the form and the size of the contact surface as well as distribution of forces between the osteosynthetic materials and the bone tissue numerical analysis showed advantages of modified osteosynthesis with bone cement filling in the screw bed. The applied numerical model consisted of three sub-models: 3D model from solid elements, 3D cross section of the contact between the plate and the bone and the part of 3D cross section of the screw head and body. We have reached the conclusion that modified osteosynthesis with bone cement resulted in weaker strain in the part of the plate above the fracture fissure, more even strain on the screws, plate and bone, more even strain distribution along all the screws’ bodies, significantly greater strain in the part of the screw head opposite to the fracture fissure, firm connection of the screw head and neck and the plate hole with the whole plate and more even bone strain around the screw