Everything included in this overview is a list of facts without analyses, which makes this a purely factual overview. The circumstances of the preparation for the foundation of the Croatian ...Dermatovenereological Society - the Croatian Medical Association (hereafter CDS-CMA) and the journal Acta Dermatovenerologica Croatica (hereafter ADC) Geopolitical changes in former Yugoslavia following 1990 and the Homeland War (1991-1995) led to new circumstances in almost all areas of social activity and the need for a restructuring and further development of professional physicians associations in our Homeland. In such new conditions, it was necessary to appropriately organize the professional work of our dermatovenerologists with the aim of founding and maintaining their professional ties to each other and to our colleagues abroad. The aforementioned appropriate organization primarily meant the founding of the Croatian Dermatological Society and the journal for Croatian dermatovenerologists, the first professional journal in the history of dermatology and venerology in our Homeland. Legal regulations for the founding of CDS-CMA and the journal ADC The legal regulations resulted from the conclusions and decisions of the 99th annual assembly of the Association of Croatian Physicians (hereafter ACP) that took place on the 26th of February 1991 (1), at which, at the suggestion of Prof. Mirko Gjurašin, PhD, the president of CMA, it was renamed to the Croatian Medical Association (CMA). Furthermore, on the basis of article 12 of the Statute of CMA, the creation and activity of professional societies of CMA was enabled, which replaced the Sections of ACP (1), and soon there appeared the Regulation of the work of the professional society of CMA. Finally, on the 30th of September 1991, CMA left the Alliance of Yugoslav Medical Societies (1). More detailed information on the aforementioned events can be found in reference 1, and the data on historical, political, national, and military aspects of the war against our Homeland can be found in the article of the esteemed member of CMA, Prof. Eduard Klain, PhD (2) and in the message by Prof. Vladimir Čajkovac, PhD (3). Preparations for the founding of CDS-CMA and ADC Ideas concerning a new founding of the Croatian Dermatological Society - CMA (hereafter CDS-CMA) and the first journal in the history of Croatian dermatovenerologists developed during 1990 and 1991. These suggestions were discussed in the meetings of the Professional college of the Department of Dermatology and Venerology at the Clinical Hospital Centre Zagreb (hereafter CHC Zagreb), and were formed at the meeting of the Professional college of the Department on the 27th of January 1992, when the Professional college provided the following suggestions, which the secretary of the Dermatovenerological Section of CMA (Primarius D. Paljan, MD, MSc) gave to the president of the Dermatovenerological section of CMA, Prof. V. Čajkovac, PhD. The suggestions were as follows: 1) for the Dermatovenerological section of CMA to leave the Association of Yugoslav dermatologists; 2) to found a Croatian Dermatological Society; 3) to found a Croatian Journal of Dermatology; and 4) to inform colleagues from clinics abroad with the state in Croatia. Of course, Prof. Čajkovac immediately agreed with all of these suggestions. Afterwards, on the 9th of October 1991, I presented the members of the Professional college of the Department of Dermatology and Venerology of CHC Zagreb and the members of the Chair of Dermatovenerology at the School of Medicine, University of Zagreb (hereafter SM Univ. of Zagreb), with the suggestions regarding the founding of the Croatian Dermatological Society - CMA and the founding of a Journal of Croatian Dermatologists (4,5). Both suggestions were accepted unanimously (4). After accepting the abovementioned suggestions, my colleagues and I undertook a number of consultations, and from the Department of Dermatology and Venerology of CHC Zagreb I sent out invitations to all the members of the Dermatovenerological Section of ACP (hereafter Section) to a meeting in the lecture room of the Clinic on Šalata, scheduled for the 29th of May 1992 (6). At that meeting, I notified the members of the Section of the decisions made at the 99th annual assembly of CMA on the 26th of February 1991, as well as of the fact that the CMA had left the Alliance of Yugoslav Physicians Societies on the 30th of September 1991 (6). Also, following the example of many other medical professions, I told the members of the Section about my suggestion regarding the founding of CDS-CMA. Therefore, on the 29th of May 1992, CDS-CMA was founded again* (6). On that occasion, a temporary Board of directors of CDS-CMA was also chosen, and Prof. Vladimir Čajkovac, who was the president of the former Dermatovenerological Section of ACP, was chosen as the president of the Board (6), while the following were chosen as members of the Board (6): Primarius Zlatka Čabrijan, MD (Rijeka), Adalbert Stašić, MSc, MD (Rijeka), Assist. Prof. Vjekoslav Stipić, PhD (Split), Primarius Boris Petričić, MD (Zadar), Prof. Ivan Dobrić, PhD (Zagreb), Assist. Prof. Teodora Gregurek-Novak,PhD (Zagreb), Primarius Jasna Lesić, PhD (Zagreb), and Primarius Aida Pašić, MD (Zagreb). Titles according to the state in 1992. *Why was CDS-CMA founded again? To understand this question, it is important to know the following: a) On the 22nd of November 1920, the Dermatological Section of the Physicians Association (7) was founded in the Hospital Sestre milosrdnice, Zagreb, Croatia (quotation from reference 7); b) this Section acted until the 19th of January 1941, when a formal session was held in the lecture room of the Clinic on Šalata under the title of the 1st (jubilee) meeting of the Croatian Dermatovenerological Society of the Croatian Medical Association, which was opened by its president, Prof. Kogoj (7); c) therefore, it is apparent that the Croatian Dermatovenerological Society of the Croatian Medical Association was founded on the 19th of January 1941, and the forerunner of the Society was the former Dermatological Section of the Physicians Association (7); the name Croatian Dermatovenerological Society of CMA has been used in professional publications since then (8); d) at the extraordinary session of the Croatian Physicians Society (probably a reference to ACP) held on the 30th of September 1945, the name of the Association of Croatian Physicians was changed to the name Croatian Medical Association, and since then the Croatian Dermatovenerological Society has appeared in professional publications under the name of the Dermatovenerological Society of the Croatian Medical Association (9); e) later the name Dermatovenerological Society - CMA was replaced with the name Dermatovenerological Section of ACP, but I am not familiar with the exact date of this change; f) the name Dermatovenerological Section of ACP existed until the 29th of May 1992, when, as it was stated above, the CDS-CMA was founded (6). NOTE: The original name of the Society founded on the 29th of May 1992 was the Croatian Dermatological Society of the Croatian Medical Association (CDS-CMA), and later this name was changed to the Croatian Dermatovenerological Society of the Croatian Medical Association (CDVS-CMA), which is the name used by the Society nowadays. The election of the Assembly and the regular Board of Directors of CDS-CMA On the 10th of July 1992, in the same lecture room in which the meeting was held on the 29th of May 1992, there was a meeting on the newly founded CDS-CMA (6). According to the book of regulations of the CMA, which was established over time, the Assembly of CDS-CMA was elected, and at the suggestion of the Assembly the following attending colleagues were elected to the regular Board of Directors of CDS-CMA, along with Prof. Vladimir Čajkovac as the president (6): Primarius Zlatka Čabrijan, MD (Rijeka), Adalbert Stašić, MD, MSc (Rijeka), Assist. Prof. Vjekoslav Stipić, PhD (Split), Primarius Boris Petričić, MD (Zadar), Prof. Ivan Dobrić, PhD (Zagreb), Assist. Prof. Teodora Gregurek-Novak, PhD (Zagreb), Primarius Jasna Lesić, PhD (Zagreb), and Primarius Aida Pašić, MD (Zagreb). Titles according to the state in 1992. Branches of CDS-CMA As we can see, colleagues from all university centers existing at the time (Osijek, Rijeka, Split, and Zagreb) were elected to the Board of Directors, in which Branches of CDS-CMA were later founded. Therefore, from the beginning of the creation of CDS-CMA, it has been our goal to found CDS-CMA with four Branches (Osijek, Rijeka, Split, and Zagreb), which is how the Society is structured even today. NOTE: Since there were no representatives from Osijek at the meeting held on the 10th of September 1992, the Assembly suggested that the president of CDS-CMA-Osijek Branch enter the Board of Directors after the Branch is founded (6). The election of the president, vice president, secretary, and treasurer of CDS-CMA Through a secret ballot, the members of the Assembly elected the following from among the members of the Board of Directors to a term of four years (6): Prof. Vladimir Čajkovac, PhD as the president of the Board of Directors of CDS-CMA (on the basis of the accepted work program), Prof. Ivan Dobrić, PhD and Assist. Prof. Vjekoslav Stipić, PhD as the vice president of the Board, Primarius Zlatka Čabrijan, MD and Assist. Prof. Teodora Gregurek-Novak, PhD as secretaries, and Primarius Aida Pašić, MD as the treasurer of the Board of Directors of CDS-CMA. The founding of the ADC and its organizational overview from Vol 1, No 1 to Vol 4, No 2 At the aforementioned meeting of CDS-CMA held on the 10th of July 1992 (6), I presented my suggestions from the 9th of October 1990 (4), which were accepted by the members of the Professional college of the Clinical Hospital Centre Zagreb and the members of the Department of Dermatovenerology of the School of Medicine,
Brojna su propitivanja potrebe rutinskog odstranjenja metalnog implantata nakon saniranja prijeloma kosti. Pretežita indikacija za odstranjenje jest slabljenje mehaničkih svojstava i pucanje ...implantata prije cijeljenja kosti. Cilj ovog istraživanja bio je ispitati mehanička svojstva osteosintetske pločice izrađene od standardnoga kirurškog čelika u simuliranim biološkim uvjetima. U istraživanju smo koristili implantate nehrđajućeg čelika 316L i pohranili ih kroz godinu dana u simuliranome biološkom mediju (engl. SBF – simulated body fluid). Analizirano je 48 pločica standardnoga kirurškog čelika podijeljeno u četiri skupine. Jedna je kontrolna. Ostale su bile uronjene u otopine različitih pH vrijednosti. Uronjene pločice testirane su nakon godinu dana, a kontrolna odmah na početku istraživanja. Tijekom godinu dana analizirala se promjena mikrostrukture uronjenih pločica skenirajući elektronskim mikroskopom (SEM) u pet navrata, a kontrolna grupa samo jednom. Na pločicama koje su bile u biološkim simuliranim uvjetima, bez obzira na pH medija, značajno je veći broj jamičastih korozija kod mjerenja nakon šest mjeseci i godinu dana. Nakon godinu dana pohrane u medijima različite pH mjerene su vrijednosti mehaničkog, statičkog i dinamičkog opterećenja pločica. Niti jedno načinjeno mehaničko testiranje nije pokazalo statistički značajnu razliku između kontrolne skupine pločica i onih koje su bile u biološki simuliranim uvjetima kroz godinu dana. Nepromijenjena mehanička svojstava istraživanih implantata, unatoč značajnim promjenama mikrostrukture nastale kao posljedica jamičaste korozije u biološki simuliranim uvjetima, otklanjaju vjerojatnost slabljenja pločice kao i indikaciju za njezino odstranjenje u tom vremenskom razdoblju.
•Coolant from bone drills with open type internal cooling does not disperse into the intramedullary canal outside of the borehole.•It is not expected that drilling with open type internally cooled ...drills has influence on intramedullary space.•It is safe to use drills with open type internal cooling for bone and joint surgery.
Internally cooled bone drills with an open system, conduct coolant directly to the point of contact of cutting surface of the drill and the bone and lower the temperature at the drilling site. During bone drilling with internally cooled drills of open type, there is a possibility that coolant enters the intramedullary canal and has an adverse effect on intramedullary pressure. In this research, the intramedullary distribution of the coolant during and after drilling was analyzed.
Specially constructed open type internally cooled medical steel drills were used. Experimental studies were conducted on the porcine femoral bone diaphysis. Coolant (saline) was mixed with water-soluble contrast agent and x-ray images of the distribution of coolant during and after drilling were taken with different regimes of drilling (drill rotational speed from 1300 rpm to 5000 rpm, and coolant flow rate from 0,6 l/min to 1,35 l/min).
An x-ray images showed that coolant did not spread from the borehole and has not spread intramedullary with any combination of coolant flow and drill rotation regimes.
Coolant does not disperse into the intramedullary canal outside of the borehole in given flow ranges (0,6–1,35 l/min) and drill rotational speed regimes (1300–5000 rpm). Open type internally cooled can safely be used for bone drilling.
•Intramedullary interlocking nailing with a compression screw is an alternative method of fixation for treating adult forearm fractures.•Twenty-one patients with forearm shaft fractures underwent ...intramedullary interlocking nailing procedures.•Several complications arose including one nonunion, one ruptured extensor pollicis longus tendon, and one transitory radial nerve palsy.•Intramedullary interlocking nailing for treating adult forearm fractures results in good clinical outcomes with reliable union rates.
The aim of this study was to evaluate the clinical and radiological results of adult forearm fractures treated with interlocking intramedullary nailing.
This retrospective study included 21 patients who were treated with intramedullary interlocking nailing for forearm fractures between January 2010 and September 2017. All patients were treated with intramedullary forearm nails designed to allow interfragmentary compression. The medical records and radiographs of all patients were evaluated. Fractures were classified according to the AO/OTA classification system by analyzing the radiographs. Union time, union rate, clinical outcome, and complications were evaluated.
Primary intramedullary osteosynthesis was performed in 17 patients with forearm shaft fractures. The average union time was 10 weeks (range, 8–16 weeks) in the primary osteosynthesis cohort. Secondary intramedullary osteosynthesis was performed in four patients following the removal of plates and screws due to nonunions. For this group of patients, bone union took an average of 17 weeks (range 8–24 weeks). The overall union rate was 95.24% in the 21 forearm fractures which were treated with an intramedullary interlocking nail with a compression screw that allows interfragmentary compression to be obtained. Overall complications included one nonunion, one postoperative rupture of the extensor pollicis longus tendon, and 1 postoperative transitory radial nerve palsy.
Intramedullary interlocking nailing with a compression screw is an alternative method of fixation for treating adult forearm fractures and provides good clinical outcomes with reliable union rates.
A single-centre cross-sectional study was performed to investigate the potential association between the presence of sarcopenia and fracture patterns in patients with a proximal femoral fracture. We ...identified all consecutive patients who were admitted due to proximal femoral fracture. The patient’s demographic data and the presence of sarcopenia were assessed. The presence of sarcopenia was investigated preoperatively according to EWGSOP2 criteria using the SARC-F questionnaire and the hand grip strength test. According to the presence of sarcopenia, two groups were formed and analysed. We identified 70 patients who matched the inclusion criteria and were analysed in this study. In the sarcopenic group, there was a significantly higher proportion of extracapsular fractures (63.6 % vs. 26.9 %; p = 0.00298, z = 2.9684) with an increased proportion of pertrochanteric fractures (52.3 % vs. 23 %; p = 0.0164, z = 2.396) compared to the non-sarcopenic group. Also, we observed a significant difference in the proportions of femoral neck fractures between two analysed groups (36.4 % vs. 73.1 %; p = 0.0029, z = -2.9684). It is important to screen for sarcopenia and apply comprehensive geriatric care to all hip fracture patients, especially those with pertrochanteric fracture patterns.
The aim of this study was to describe a surgical technique and report on patient-based functional outcomes and complications following open reduction and internal fixation in patients with scapular ...fractures.
The study comprised 14 patients who were treated with open reduction and internal fixation (ORIF) of a scapular fractures between September 2010 and July 2018. Surgical indications were as follows: medial/lateral displacement greater than 20 mm; shortening greater than 25 mm; angular deformity greater than 40°; intra-articular step-off greater than 4 mm; and double shoulder suspensory injuries (including fracture of the clavicle, coracoid or acromion with displacement greater than 10 mm). All patients underwent X-ray examination (true AP, Y scapular view) and computed tomography (CT) scans. Fractures were classified according to the revised (AO/OTA) classification system. Functional outcomes were measured using Constant-Murley scores.
Seven patients had glenoid fossa fractures, six patients had scapular body fractures and one patient had an acromion process fracture. All glenoid fossa and scapular body fractures were exposed via the Judet approach. Eleven of 14 patients were given Constant-Murley scores at the final follow-up examination; three patients were lost to follow-up. The mean follow-up after injury was 44 months (range, 6–92 months). We found infraspinatus muscle hypotrophy in four patients. The mean Constant-Murley score was 93.45 (±8.93) for the injured arm and 98.36 (±2.91) for the uninjured arm. The mean score between the injured and uninjured arm was 4.91(±6.49), which is an excellent functional outcome according to the Constant-Murley score.
Open reduction and internal fixation of displaced scapular fractures is a safe and effective treatment option that results in a reliable union rate and good-to-excellent functional outcome.
To determine the impact of an earthquake during COVID-19 lockdown on fracture admission at a tertiary trauma centre in Croatia.
A case-control study was performed at the tertiary trauma centre ...registry. Two different periods were studied. The case group included a period during COVID-19 lockdown right after the earthquakes until the end of the confinement period in Croatia. And the control group corresponded to the equivalent period in 2019. We identified all consecutive patients who were admitted due to urgent care requirements for the musculoskeletal trauma. Patient's demographic data and admitting diagnoses were assessed. Data were analyzed by statistical procedures using the program MedCalc statistical software version 16.4.3.
We identified 178 emergency admissions due to musculoskeletal trauma. During the COVID-19 lockdown and post-earthquake period, there was a drastic reduction in total admissions (359 vs. 662; p < 0.0001) with an increased proportion of trauma admissions within the emergency admissions (34.9% vs. 26.5%; p = 0.02926, Z = −2.1825). Furthermore, in the case group there was a significant increase in hospital admissions due to ankle/foot trauma (11 vs. 2, p = 0.0126) and a trend towards a decrease in the admissions due to tibia fractures (5 vs. 12, p = 0.0896), however without statistical significance. Also, an increased proportion of women within the group of femoral fractures in both case group (81.6% vs. 52.6%, p = 0.00194, Z = 3.1033) and the control group (82.3% vs. 60.5%, p = 0.0232, Z = 2.2742) was observed. In both analyzed periods, the osteoporotic hip fracture was the most common independent admitting diagnosis.
It is crucial to understand how natural disasters like earthquakes influence the pattern of trauma admissions during a coexisting pandemic. Accordingly, healthcare systems have to be prepared for an increased influx of certain pathology, like foot and ankle trauma.
Bilateral elbow dislocation associated with bilateral distal forearm fractures is extremely rare, therefore its optimal treatment, complications, and outcomes remain unclear. We present an ...illustrative case with a 2‐year follow up of a patient who sustained a complex injury of the upper extremity and underwent combined surgical and conservative treatment.
Due to the limited information regarding complex bilateral injuries of the arm, its optimal therapy remains unclear. The major treatment goal should be a joint stabilization and early mobilization to optimize the chances of good functional recovery.
Bone drilling causes focal temperature rise due to metal-to-bone contact, which may result in thermal osteonecrosis. Newly constructed internally cooled medical drill of an open type decreases ...temperature rise at a point of metal-to-bone contact although standard sterilization of such a drill could be inadequate due to bacteria retention within the drill lumen. The aim of this pilot study was to examine the effectiveness of sterilization and to propose sterilization recommendations for internally cooled open type bone drills. Unused internally cooled medical steel bone drills were tested. Drills were contaminated with
,
sp., beta-hemolytic
sp.,
sp. and methicillin-resistant
and then incubated for 24 hours at 37 °C. Afterwards, drills were autoclaved for 15, 20 and 30 minutes at 132 °C and 2.6 bar. When 15-minute sterilization was used, one out of 16 drills was contaminated with
, while the other 15 drills were sterile. Extended cycle sterilization in autoclave lasting for 20 and 30 minutes resulted in 100% sterility of all drills tested. In conclusion, lumened drills should be exposed to extended sterilization times in autoclave. Minimal recommended time for sterilization of lumened drills is 20 minutes.
PDF
