Aleksandar Lesic - Academia.edu (original) (raw)
Papers by Aleksandar Lesic
Acta Veterinaria-beograd, 2002
PubMed, Mar 1, 2002
Background: This article is the retrospective-comparative research of psychopathological reaction... more Background: This article is the retrospective-comparative research of psychopathological reaction of somatically traumatized people. The influence of the outside circumstances of injury (war, job, traffic accident, leisure), injured body part (torso, leg, arm) and different clinical characteristics of injury (surgery, mobile of patient, amputation, acuteness of injury, etc.) are analyzed as potentially factors of the type of the psychical reactions on physical trauma. Methods: The sample of 70 Serb patients hospitalized in the University Orthopedic Clinic (26 fighters from Bosnia-Herzego-vina and 44 Belgrade residents injured in peace time), was investigated as an experimental group. The control group contained 105 subjects from Belgrade area, 45 of whom had mental trauma experience and 60 had no trauma experience whatsoever. The subjects were tested with the following instruments: Event Effect Scale, PTSS-10 Scale, FHI, Brief Eysenck's Personality Inventory, LEAIQ, GHQ-60, General Questionnaire for Accidents. In the statistical data processing, c2 test, discrimination analysis, and calculation of linear correlation were used. Results: It was determined that the outside circumstances of injury, injured part of the body, amputation, medication and acuteness of the injury did not differentiate any of the psychopathological types of responses analyzed in the research. Conclusions: Difficult surgery and the immobility of the patient correlated significantly with the high values on the PTSD Scale i.e. the general neuroticism. The seriousness of injury correlated negatively with the intensity of family cohesiveness.
Acta Chirurgica Iugoslavica, 2015
Dur ing the hu man his tory there were many attempts to treat frac tures and in ju ries of ex tre... more Dur ing the hu man his tory there were many attempts to treat frac tures and in ju ries of ex trem ities. Since Mathijsen and his plas ter cast there was many at tempts to make im mo bi li za tion at the frac ture site, to pro tect ob tained re duc tion. Hugh Owen Thomas in vent trac tion which greatly decrease mor tal ity in the pa tients with fem o ral fractures dur ing the war. Ex ter nal fix a tion was used from the time of Malgaigne, Lambote, Parkhill in 19 th cen tury, and An der son, Hofmann, Ilizarov in 20 th century. This kind of frac ture fix a tion still has place and role in the treat ment of open, com pound frac tures, and in the pa tients with mul ti ple frac tures. Along with in ven tion of antisepsis, an ti bi ot ics, X-rays, ant met al lurgy, the in ter nal fix a tion be come widely used, from the Lane,s plate at the be gin ning of 20 th cen tury to the biogredable ma te ri als and new de signed in ternal de vices. Spe cial prob lem of hip frac ture treat ment was solved by fix a tion dated from Hey Groves, Smith Petersen, while intramedullary fix a tion of long bones was in tro duced by Kuntscher. Clin i cal and biomechanical in ves ti ga tion dur ing the 1950 and 1960 was es tab lished by mem bers of AO group. Key words: frac ture fix a tion, in ter nal fix a tion, ex ter nal fix a tion, his tory This pa per is sup ported by funs-pro ject num ber 175095 and 450005 Min is try of sci ence, Re pub lic of Ser bia.
Orthopaedic Proceedings, Mar 1, 2004
Aims: Ankle fractures are injuries with intraarticular imapct. Therefore the treatment must be ve... more Aims: Ankle fractures are injuries with intraarticular imapct. Therefore the treatment must be very precise (meticilous). Numerous and heterogenous factors insuence the late results in both conservativelly and operatively treated ankle fractures. So the aim of the study was to determine the list of prognosticaly and statistically signiþcant factors in the ankle fractures. Material and methods: 504 patients who were treated for ankle fractures for 5 year period were followed for 3 to 10 years. All fractures were clasiþed according to Lauge Hansen clasiþcation. Conservative treatment consists of reduction and plaster imobilisation for 5–7 weeks, while in operative treated patients internal þxation were performed for most fractures while in pronation dorsisexion- pilon fractures minimally internal þxation in combination with dinamical external þxation was done. Results: pronation-eversion (grade 2) fractures has the same result in both kinds of treatment, while pronation Ðeversion and pronation fractures show better results in operatively treated patients and pilon fractures with dynimical external þxation. Conclusion: the displaced fractures shoud be anatomically reduced, either by closed or open. The most decisive factors insuencing the late result in ankle fractures are: type of fracture, age, anatomical reduction, talocrural angle, size of posterior fragment, lateral shortening and condition of soft tissue.
Orthopaedic Proceedings, Mar 1, 2004
Aims: to present histologic changes of articular cartilage and meniscal allgraft after medial men... more Aims: to present histologic changes of articular cartilage and meniscal allgraft after medial meniscectomy and protective value and survival of allograft in the experimental knee model. Material and methods: Two groups (experimental and control group) of 15 new Zaeland white rabbits were operated and evaluated in three time subgroups: after 2 weeks (þrst group), after 8 weeks (second group) and after 36 weeks (thirdt group). In the experimental group after medial meniscetomy the deep frozen meniscal allograft was transplented (meniscal allografts were obtained from another group of animals). After sacriþcation the knee specimens were stained by following histohemical methods: hematoxylin-eosin (HE), Periodic Acid Shift (PAS), Van Gieson, Paff Halmi, Masson trichrom and Von Kossa and and analysed by light microscope. Results: Signiþcan difference existed beetwen 2 groups. Best results were obtained in the experimental group nd worst in control group Ð6 months after meniscectomy. During time the deep frozen meniscal allografts show signiþcant collagen remodeling, cellular and vascular ingrowth and they are able to protect the underlying cartilage. Conclusion: The deep frozen meniscal allograft appeared to function normally after transpalnation and the procedure is beneþcial Ð meniscal reconstruction or transplantation provides protection of the knee cartilage.
Acta Facultatis Medicae Naissensis, 2002
Fractures of the pylon of the tibia mostly affect ankle joint and they are frequently open fractu... more Fractures of the pylon of the tibia mostly affect ankle joint and they are frequently open fractures. Contemporary principles of the treatment of these fractures have been shown in this paper. It has been proved that minimally invasive surgical methods lead to better end ...
Srpski Arhiv Za Celokupno Lekarstvo, 2006
KRATAK SADRŽAJ Uvod Povreda tetiva šake tipa čekićastog prsta predstavqa gubitak kontinuiteta sje... more KRATAK SADRŽAJ Uvod Povreda tetiva šake tipa čekićastog prsta predstavqa gubitak kontinuiteta sjediwenih lateralnih traka eksten zornog aparata iznad distalnog interfalangnog zgloba prsta i dovodi do tipičnog fleksionog deformiteta u distalnom interfalangnom zglobu, koji se u literaturi naziva "čekićasti" prst (engl. mallet finger). Ciq rada Ciq rada je bio da se prikažu rezultati hirurškog i nehirurškog lečewa povreda ekstenzorne tetive prsti ju šake tipa čekićastog prsta a zatim uporede s rezultatima drugih autora. Metod rada Studija je bila retroprospektivna. Ispitana su 62 bolesnika lečena u Institutu za ortopedsku hirurgiju i traumatologiju i u Urgentnom centru Kliničkog centra Srbije u Beogradu od 1998. do 2003. godine. Bolesnici su nadgledani od 8,3 meseca do 71,7 meseci. Prosečno vreme nadgledawa bilo je 28,7 meseci. Tokom izvođewa studije ispitani su i beleže ni objektivni parametri: pol i starost bolesnika, dominantnost i povređenost šake, povređenost prsta, metod lečewa, komplikacije, nedostatak ekstenzije u distalnom interfalangnom zglobu, fleksija i ukupan pokret distalnog interfalang nog zgloba. Prikupqeni podaci su obrađivani primenom χ 2 testa i Studentovog ttesta. Stepen poverewa je bio za p=0,05. Rezultati Ukupan obim pokreta u distalnom interfalangnom zglobu kod nehirurški lečenih bolesnika bio je 51,9±6,6 stepeni, a kod hirurški lečenih 48,2±4,2 stepena. Nedostatak ekstenzije u distalnom interfalangnom zglobu u proseku je bio 6,5±3,3 stepena kod nehirurški, a 10,0±3,2 stepena kod hirurški lečenih ispitanika. Zakqučak Rezultati studije su potvrdili da je nehirurški način lečewa čekićastog prsta uspešniji od hirurškog.
Turkish Neurosurgery, 2015
rarely isolated, and are often combined with injuries to their adjacent structures (including ten... more rarely isolated, and are often combined with injuries to their adjacent structures (including tendons, arteries and bones). The current surgical treatments for peripheral nerve injury often fail to provide a satisfactory functional recovery (8). It is well known that minor trauma can lead to severe disability. The aim of any treatment is to achieve as full a functional recovery as possible in order to allow the individual to return to their previous job and everyday life activities. Diagnostic and treatment of peripheral nerve injuries still represent a challenge. Nerve conduction testing has little value in the acute hand injury setting, and accurate diagnoses were made through a combination of the clinical examination and from the intraoperative evaluation. Ultrasound can be used as a diagnostic tool in peripheral nerve injury. In the acute stage, █ INTRODUCTION Nerve injuries are common in trauma surgery and appear more frequently if the upper extremity is affected. Peripheral nerve injuries are common and occur in an estimated 2-3% of patients admitted to trauma centers (11). If plexus and root injuries are also include, the incidence is about 5% (11). The incidence has continued to rise over recent years mostly in relation to industrial and traffic accidents (14). Radial nerve injuries are the most commonly reported in the upper limb, followed by ulnar and median nerves (17). Lower limb peripheral nerve injuries are less common (15). The most common complete or partial transection injury is to the digital nerves (incidence 6.2 /100,000 inhabitants/year) (3), which account for 46.3% of upper extremity nerve injuries (19). These nerve injuries are AIm: The surgical management of injured digital nerves is a common part of hand trauma surgery. Despite improvements in the surgical techniques and suture material, the final outcomes of peripheral nerve repair can still be disappointing. This study investigates the outcomes following the surgical treatment of traumatic digital nerve lesions of the hand. mATERIAl and mEThODS: 150 consecutive patients with acutely digital nerve injuries were treated through by primary repair in our Unit between January 2005 and December 2009. 126 were male, 24 female (male/female ratio of 5.25:1), with an age range of 16-70 years, and a mean follow-up of 30 months. All 150 patients underwent primary epineural suture within 48 hours of their injury. Sensory recovery was assessed using the Medical Research Council scale (MCR). Sensibility testing was performed after a minimum of 12 months. Disabilities of the Arm, Shoulder and Hand scores (DASH) were used to evaluate the functional outcomes. RESUlTS: Eighteen patients (9.33%) had excellent sensibility with two-point discrimination test (S2PD) of ≤ 7 mm (S4). Forty-one patients (21.24%) achieved good sensibility (S2PD ≤ 15 mm, S3+), 76 (39.38%) achieved S3, 55 (28.50%) had poor sensibility (S2 and S1), and two patients had no sensibility (S0). The mean functional DASH score was 9.0 in our group of patients. CONClUSION: There was a significant correlation between patient age, mechanism of injury and nerve recovery, with younger patients and patients with narrow zone of injury achieving better sensory recoveries.
Injury
A mangled extremity is the most devastating limb injury and presents a challenge for the orthoped... more A mangled extremity is the most devastating limb injury and presents a challenge for the orthopedic surgeon. There are two main treatment options, reconstruction or amputation, but sometimes indications for either are not clear. There are many pro and contra arguments for both options. To make the decision easier numerous score systems have been introduced, but the final decision is based on the judgment and experience of the treating surgeon. Early extremity reconstruction appears to give better results than delayed or late reconstruction and should be the treatment of choice where possible. The goal in reconstruction of a lower extremity is to restore and maintain balance and ambulation, while restoration of an upper extremity's numerous functions is more demanding. In this paper the authors describe and suggest treatment approaches in patients with a severely mangled extremity, including assessment and treatment of all injured tissues, using defined protocols, with special attention to bone stabilization, revascularization, soft-tissue coverage and nerve reconstruction. These have a great impact on the outcome and function of the injured extremity. Rehabilitation and return to the preinjury level is slow and sometimes uncertain.
International Orthopaedics, 2020
Introduction Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The result... more Introduction Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. The purpose of this paper is to compare the surgical techniques and results of treating scaphoid nonunion (SNU) with osteoplastic xenografts of bovine origin or a vascularized autograft of the distal part of the dorsal radius. Methods We compare two groups of patients with symptomatic SNU, treated surgically with either a vascularized graft (n = 15) or a xenograft of bovine origin (n = 15). In the presurgical stage, the demographic characteristics of the patients, the time elapsed between injury and surgery, and classification of the injury (Schonberg, Herbert-Fisher, and Geissler-Slade) were recorded. One year following surgery, bone healing, total duration of the treatment, complications, the Mayo wrist score, and answers to the DASH questionnaire were analyzed. Results No statistically significant differences between the two groups of patients were observed for bone healing (86.7% vs 80%) or functional results. A highly significant difference was observed with respect to duration of the surgical intervention in favor of xenografts. Conclusion The xenograft method is simple and relatively acceptable, providing good results in terms of healing and functionality.
Injury, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Srpski arhiv za celokupno lekarstvo
Subjective and objective parameters after the treatment of malleolar fractures were studied in 11... more Subjective and objective parameters after the treatment of malleolar fractures were studied in 116 patients during a five-year-period. Nonoperative treatment was used in 48 patients and 68 patients were operated. Nonoperative treatment was successful in both supination-eversion and supination-adduction types of fractures, whereas in pronation fractures the operative treatment provided better results. The results were significantly influenced by residual lateral shortening, altered talocrural angle, talar subluxation and the size of posterior fragment. In all types of fractures but in supination-adduction type anatomical reduction and clinical findings correlated. Subjective results are sometimes influenced by factors which cannot be visualized on radiographies.
Srpski arhiv za celokupno lekarstvo
At the beginning of 1915, several months after the World War I started, Serbia was in an extremel... more At the beginning of 1915, several months after the World War I started, Serbia was in an extremely difficult situation.The country was war-ravaged, full of sick and wounded soldiers, there was a desperate shortage of doctors, nurses and other medical personnel, and the epidemic of typhus fever exploded and violently attacked the entire country. At that time, however, a number of both foreign allied medical missions and individual volunteers, from various countries, mostly from Great Britain, came to Serbia to help. Among them mostly were women, and they were of enormous support to Serbia in that grave situation. It is estimated that there were more than 600 foreign women volunteers in Serbia at that time and that 22 of them died there. Dr. Elizabeth Ross was one of those brave volunteers who came to Serbia early in 1915. That noble Scottish lady doctor was born in 1878 and finished her medical studies at the University of Glasgow in 1901. After graduation she worked in various place...
Srpski arhiv za celokupno lekarstvo
The first children's hospital in Serbia, as an exclusive paediatric intitution, was founded i... more The first children's hospital in Serbia, as an exclusive paediatric intitution, was founded in a deserted military barrack in Studenieka Street, near the Military Hospital, in January 1919. The founder was Dr. Katherine MacPhail, a young Scottish lady doctor, who came to Serbia for the first time in January 1915, with the first "Scottish Women's Hospital". After that, she worked as a volunteer during the First World War in France and on the Thessalonica Front. In the spring of 1919, the hospital was given an open pavilion in Topcider, which worked only during the summer months till 1924. In November 1919, the hospital was moved to a new building in Knez Milos Street, and then named The Anglo-Serbian Children's Hospital. In February 1920, a new annex, called "Villa Bravacić", was opened in Dubrovnik, which was active till 1922. In this hospital, the first Training School for Serbian Nurses was opened in 1921, and in February of that year, the hospital ...
Srpski arhiv za celokupno lekarstvo
Dr. Laza K. Lazarević (1851-1890) left a profound imprint on Serbian medicine and literature for ... more Dr. Laza K. Lazarević (1851-1890) left a profound imprint on Serbian medicine and literature for 11 years of his medical and literary work. Laza K. Lazarević is considered the progenitor of Serbian realistic psychological story. He studied medicine in Berlin (1872-1879). He fought in Serbian-Turkish wars and remained active in the medical corps. As a physician, he worked in Belgrade, where he was the chief of the internal medicine ward and founder of the first geriatric institution in this part of Europe. In 1880, he described, in the Serbian Archives, a sign that is today called after him in neurology, the "Lazarević sign". In 1888, he became a member of the Serbian Royal Academy. He was an active member of the Serbian Society of Physicians.
Vojnosanitetski pregled. Military-medical and pharmaceutical review
Vojnosanitetski pregled. Military-medical and pharmaceutical review
Medicinski pregled, 1993
We present a pilot seria of 18 patients with acute anterior dislocation of the shoulder joint fol... more We present a pilot seria of 18 patients with acute anterior dislocation of the shoulder joint following simple trauma. All the patients underwent conservative treatment using a standard Kocher technique. In the majority of cases muscular spasm and pain rendered through neurological examination difficult to perform. All patients were, therefore, submitted to extensive electrodiagnostic procedure which revealed a nerve injury on half of them. Such high incidence was, probably, due to the increased age (17 out 18 patients were over 40 years old), and rather traumatic reduction procedure. The axillary nerve was the most frequently affected (38.8%), either alone or in combination with musculocutaneus nerve. Comparing to previous reports in the literature, we found musculocutaneus nerve lesion in a rather high number of patients (22%). Extensive electrodiagnostic study is therefore recommended when further treatment and prognosis of anterior dislocation of the shoulder are taken in consid...
American Journal of Infection Control, 1994
Occupational exposure to blood and body fluids is a serious concern of health care workers and pr... more Occupational exposure to blood and body fluids is a serious concern of health care workers and presents a major risk of transmission of infections such as human immuno-deficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The aim of this study was to determine the frequency and circumstances of occupational blood and body fluid exposures among health care workers. Cross-sectional study was conducted in three university hospitals in Belgrade. Anonymous questionnaire was used containing data about demographic characteristics, self-reported blood and body fluid exposures and circumstances of percutaneous injuries. Questionnaire was filled in and returned by 216 health care workers (78.2% of nurses and 21.8% of doctors). 60.6% of participants-health care workers had sustained at least one needlestick injury during their professional practice; 25.9% of them in the last 12 months. Of occupational groups, nurses had higher risk to experience needlestick injuries than doctors (p = 0.05). The majority of the exposures occurred in the operating theatre (p = 0.001). Among factors contributing to the occurrence of needlestick injuries, recapping needles (p = 0.003) and decontamination/cleaning instruments after surgery (p = 0.001) were more frequent among nurses, while use of a needle before intervention was common among doctors (p = 0.004). Only 41.2% of health care workers had reported their injuries to a supervisor in order to obtain medical attention. 50.2% of health care workers were vaccinated with three doses of hepatitis B vaccine. There is a high rate of needlestick injuries in the daily hospital routine. Implementation of safety devices would lead to improvement in health and safety of medical staff.
Acta Veterinaria-beograd, 2002
PubMed, Mar 1, 2002
Background: This article is the retrospective-comparative research of psychopathological reaction... more Background: This article is the retrospective-comparative research of psychopathological reaction of somatically traumatized people. The influence of the outside circumstances of injury (war, job, traffic accident, leisure), injured body part (torso, leg, arm) and different clinical characteristics of injury (surgery, mobile of patient, amputation, acuteness of injury, etc.) are analyzed as potentially factors of the type of the psychical reactions on physical trauma. Methods: The sample of 70 Serb patients hospitalized in the University Orthopedic Clinic (26 fighters from Bosnia-Herzego-vina and 44 Belgrade residents injured in peace time), was investigated as an experimental group. The control group contained 105 subjects from Belgrade area, 45 of whom had mental trauma experience and 60 had no trauma experience whatsoever. The subjects were tested with the following instruments: Event Effect Scale, PTSS-10 Scale, FHI, Brief Eysenck's Personality Inventory, LEAIQ, GHQ-60, General Questionnaire for Accidents. In the statistical data processing, c2 test, discrimination analysis, and calculation of linear correlation were used. Results: It was determined that the outside circumstances of injury, injured part of the body, amputation, medication and acuteness of the injury did not differentiate any of the psychopathological types of responses analyzed in the research. Conclusions: Difficult surgery and the immobility of the patient correlated significantly with the high values on the PTSD Scale i.e. the general neuroticism. The seriousness of injury correlated negatively with the intensity of family cohesiveness.
Acta Chirurgica Iugoslavica, 2015
Dur ing the hu man his tory there were many attempts to treat frac tures and in ju ries of ex tre... more Dur ing the hu man his tory there were many attempts to treat frac tures and in ju ries of ex trem ities. Since Mathijsen and his plas ter cast there was many at tempts to make im mo bi li za tion at the frac ture site, to pro tect ob tained re duc tion. Hugh Owen Thomas in vent trac tion which greatly decrease mor tal ity in the pa tients with fem o ral fractures dur ing the war. Ex ter nal fix a tion was used from the time of Malgaigne, Lambote, Parkhill in 19 th cen tury, and An der son, Hofmann, Ilizarov in 20 th century. This kind of frac ture fix a tion still has place and role in the treat ment of open, com pound frac tures, and in the pa tients with mul ti ple frac tures. Along with in ven tion of antisepsis, an ti bi ot ics, X-rays, ant met al lurgy, the in ter nal fix a tion be come widely used, from the Lane,s plate at the be gin ning of 20 th cen tury to the biogredable ma te ri als and new de signed in ternal de vices. Spe cial prob lem of hip frac ture treat ment was solved by fix a tion dated from Hey Groves, Smith Petersen, while intramedullary fix a tion of long bones was in tro duced by Kuntscher. Clin i cal and biomechanical in ves ti ga tion dur ing the 1950 and 1960 was es tab lished by mem bers of AO group. Key words: frac ture fix a tion, in ter nal fix a tion, ex ter nal fix a tion, his tory This pa per is sup ported by funs-pro ject num ber 175095 and 450005 Min is try of sci ence, Re pub lic of Ser bia.
Orthopaedic Proceedings, Mar 1, 2004
Aims: Ankle fractures are injuries with intraarticular imapct. Therefore the treatment must be ve... more Aims: Ankle fractures are injuries with intraarticular imapct. Therefore the treatment must be very precise (meticilous). Numerous and heterogenous factors insuence the late results in both conservativelly and operatively treated ankle fractures. So the aim of the study was to determine the list of prognosticaly and statistically signiþcant factors in the ankle fractures. Material and methods: 504 patients who were treated for ankle fractures for 5 year period were followed for 3 to 10 years. All fractures were clasiþed according to Lauge Hansen clasiþcation. Conservative treatment consists of reduction and plaster imobilisation for 5–7 weeks, while in operative treated patients internal þxation were performed for most fractures while in pronation dorsisexion- pilon fractures minimally internal þxation in combination with dinamical external þxation was done. Results: pronation-eversion (grade 2) fractures has the same result in both kinds of treatment, while pronation Ðeversion and pronation fractures show better results in operatively treated patients and pilon fractures with dynimical external þxation. Conclusion: the displaced fractures shoud be anatomically reduced, either by closed or open. The most decisive factors insuencing the late result in ankle fractures are: type of fracture, age, anatomical reduction, talocrural angle, size of posterior fragment, lateral shortening and condition of soft tissue.
Orthopaedic Proceedings, Mar 1, 2004
Aims: to present histologic changes of articular cartilage and meniscal allgraft after medial men... more Aims: to present histologic changes of articular cartilage and meniscal allgraft after medial meniscectomy and protective value and survival of allograft in the experimental knee model. Material and methods: Two groups (experimental and control group) of 15 new Zaeland white rabbits were operated and evaluated in three time subgroups: after 2 weeks (þrst group), after 8 weeks (second group) and after 36 weeks (thirdt group). In the experimental group after medial meniscetomy the deep frozen meniscal allograft was transplented (meniscal allografts were obtained from another group of animals). After sacriþcation the knee specimens were stained by following histohemical methods: hematoxylin-eosin (HE), Periodic Acid Shift (PAS), Van Gieson, Paff Halmi, Masson trichrom and Von Kossa and and analysed by light microscope. Results: Signiþcan difference existed beetwen 2 groups. Best results were obtained in the experimental group nd worst in control group Ð6 months after meniscectomy. During time the deep frozen meniscal allografts show signiþcant collagen remodeling, cellular and vascular ingrowth and they are able to protect the underlying cartilage. Conclusion: The deep frozen meniscal allograft appeared to function normally after transpalnation and the procedure is beneþcial Ð meniscal reconstruction or transplantation provides protection of the knee cartilage.
Acta Facultatis Medicae Naissensis, 2002
Fractures of the pylon of the tibia mostly affect ankle joint and they are frequently open fractu... more Fractures of the pylon of the tibia mostly affect ankle joint and they are frequently open fractures. Contemporary principles of the treatment of these fractures have been shown in this paper. It has been proved that minimally invasive surgical methods lead to better end ...
Srpski Arhiv Za Celokupno Lekarstvo, 2006
KRATAK SADRŽAJ Uvod Povreda tetiva šake tipa čekićastog prsta predstavqa gubitak kontinuiteta sje... more KRATAK SADRŽAJ Uvod Povreda tetiva šake tipa čekićastog prsta predstavqa gubitak kontinuiteta sjediwenih lateralnih traka eksten zornog aparata iznad distalnog interfalangnog zgloba prsta i dovodi do tipičnog fleksionog deformiteta u distalnom interfalangnom zglobu, koji se u literaturi naziva "čekićasti" prst (engl. mallet finger). Ciq rada Ciq rada je bio da se prikažu rezultati hirurškog i nehirurškog lečewa povreda ekstenzorne tetive prsti ju šake tipa čekićastog prsta a zatim uporede s rezultatima drugih autora. Metod rada Studija je bila retroprospektivna. Ispitana su 62 bolesnika lečena u Institutu za ortopedsku hirurgiju i traumatologiju i u Urgentnom centru Kliničkog centra Srbije u Beogradu od 1998. do 2003. godine. Bolesnici su nadgledani od 8,3 meseca do 71,7 meseci. Prosečno vreme nadgledawa bilo je 28,7 meseci. Tokom izvođewa studije ispitani su i beleže ni objektivni parametri: pol i starost bolesnika, dominantnost i povređenost šake, povređenost prsta, metod lečewa, komplikacije, nedostatak ekstenzije u distalnom interfalangnom zglobu, fleksija i ukupan pokret distalnog interfalang nog zgloba. Prikupqeni podaci su obrađivani primenom χ 2 testa i Studentovog ttesta. Stepen poverewa je bio za p=0,05. Rezultati Ukupan obim pokreta u distalnom interfalangnom zglobu kod nehirurški lečenih bolesnika bio je 51,9±6,6 stepeni, a kod hirurški lečenih 48,2±4,2 stepena. Nedostatak ekstenzije u distalnom interfalangnom zglobu u proseku je bio 6,5±3,3 stepena kod nehirurški, a 10,0±3,2 stepena kod hirurški lečenih ispitanika. Zakqučak Rezultati studije su potvrdili da je nehirurški način lečewa čekićastog prsta uspešniji od hirurškog.
Turkish Neurosurgery, 2015
rarely isolated, and are often combined with injuries to their adjacent structures (including ten... more rarely isolated, and are often combined with injuries to their adjacent structures (including tendons, arteries and bones). The current surgical treatments for peripheral nerve injury often fail to provide a satisfactory functional recovery (8). It is well known that minor trauma can lead to severe disability. The aim of any treatment is to achieve as full a functional recovery as possible in order to allow the individual to return to their previous job and everyday life activities. Diagnostic and treatment of peripheral nerve injuries still represent a challenge. Nerve conduction testing has little value in the acute hand injury setting, and accurate diagnoses were made through a combination of the clinical examination and from the intraoperative evaluation. Ultrasound can be used as a diagnostic tool in peripheral nerve injury. In the acute stage, █ INTRODUCTION Nerve injuries are common in trauma surgery and appear more frequently if the upper extremity is affected. Peripheral nerve injuries are common and occur in an estimated 2-3% of patients admitted to trauma centers (11). If plexus and root injuries are also include, the incidence is about 5% (11). The incidence has continued to rise over recent years mostly in relation to industrial and traffic accidents (14). Radial nerve injuries are the most commonly reported in the upper limb, followed by ulnar and median nerves (17). Lower limb peripheral nerve injuries are less common (15). The most common complete or partial transection injury is to the digital nerves (incidence 6.2 /100,000 inhabitants/year) (3), which account for 46.3% of upper extremity nerve injuries (19). These nerve injuries are AIm: The surgical management of injured digital nerves is a common part of hand trauma surgery. Despite improvements in the surgical techniques and suture material, the final outcomes of peripheral nerve repair can still be disappointing. This study investigates the outcomes following the surgical treatment of traumatic digital nerve lesions of the hand. mATERIAl and mEThODS: 150 consecutive patients with acutely digital nerve injuries were treated through by primary repair in our Unit between January 2005 and December 2009. 126 were male, 24 female (male/female ratio of 5.25:1), with an age range of 16-70 years, and a mean follow-up of 30 months. All 150 patients underwent primary epineural suture within 48 hours of their injury. Sensory recovery was assessed using the Medical Research Council scale (MCR). Sensibility testing was performed after a minimum of 12 months. Disabilities of the Arm, Shoulder and Hand scores (DASH) were used to evaluate the functional outcomes. RESUlTS: Eighteen patients (9.33%) had excellent sensibility with two-point discrimination test (S2PD) of ≤ 7 mm (S4). Forty-one patients (21.24%) achieved good sensibility (S2PD ≤ 15 mm, S3+), 76 (39.38%) achieved S3, 55 (28.50%) had poor sensibility (S2 and S1), and two patients had no sensibility (S0). The mean functional DASH score was 9.0 in our group of patients. CONClUSION: There was a significant correlation between patient age, mechanism of injury and nerve recovery, with younger patients and patients with narrow zone of injury achieving better sensory recoveries.
Injury
A mangled extremity is the most devastating limb injury and presents a challenge for the orthoped... more A mangled extremity is the most devastating limb injury and presents a challenge for the orthopedic surgeon. There are two main treatment options, reconstruction or amputation, but sometimes indications for either are not clear. There are many pro and contra arguments for both options. To make the decision easier numerous score systems have been introduced, but the final decision is based on the judgment and experience of the treating surgeon. Early extremity reconstruction appears to give better results than delayed or late reconstruction and should be the treatment of choice where possible. The goal in reconstruction of a lower extremity is to restore and maintain balance and ambulation, while restoration of an upper extremity's numerous functions is more demanding. In this paper the authors describe and suggest treatment approaches in patients with a severely mangled extremity, including assessment and treatment of all injured tissues, using defined protocols, with special attention to bone stabilization, revascularization, soft-tissue coverage and nerve reconstruction. These have a great impact on the outcome and function of the injured extremity. Rehabilitation and return to the preinjury level is slow and sometimes uncertain.
International Orthopaedics, 2020
Introduction Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The result... more Introduction Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. The purpose of this paper is to compare the surgical techniques and results of treating scaphoid nonunion (SNU) with osteoplastic xenografts of bovine origin or a vascularized autograft of the distal part of the dorsal radius. Methods We compare two groups of patients with symptomatic SNU, treated surgically with either a vascularized graft (n = 15) or a xenograft of bovine origin (n = 15). In the presurgical stage, the demographic characteristics of the patients, the time elapsed between injury and surgery, and classification of the injury (Schonberg, Herbert-Fisher, and Geissler-Slade) were recorded. One year following surgery, bone healing, total duration of the treatment, complications, the Mayo wrist score, and answers to the DASH questionnaire were analyzed. Results No statistically significant differences between the two groups of patients were observed for bone healing (86.7% vs 80%) or functional results. A highly significant difference was observed with respect to duration of the surgical intervention in favor of xenografts. Conclusion The xenograft method is simple and relatively acceptable, providing good results in terms of healing and functionality.
Injury, 2020
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Srpski arhiv za celokupno lekarstvo
Subjective and objective parameters after the treatment of malleolar fractures were studied in 11... more Subjective and objective parameters after the treatment of malleolar fractures were studied in 116 patients during a five-year-period. Nonoperative treatment was used in 48 patients and 68 patients were operated. Nonoperative treatment was successful in both supination-eversion and supination-adduction types of fractures, whereas in pronation fractures the operative treatment provided better results. The results were significantly influenced by residual lateral shortening, altered talocrural angle, talar subluxation and the size of posterior fragment. In all types of fractures but in supination-adduction type anatomical reduction and clinical findings correlated. Subjective results are sometimes influenced by factors which cannot be visualized on radiographies.
Srpski arhiv za celokupno lekarstvo
At the beginning of 1915, several months after the World War I started, Serbia was in an extremel... more At the beginning of 1915, several months after the World War I started, Serbia was in an extremely difficult situation.The country was war-ravaged, full of sick and wounded soldiers, there was a desperate shortage of doctors, nurses and other medical personnel, and the epidemic of typhus fever exploded and violently attacked the entire country. At that time, however, a number of both foreign allied medical missions and individual volunteers, from various countries, mostly from Great Britain, came to Serbia to help. Among them mostly were women, and they were of enormous support to Serbia in that grave situation. It is estimated that there were more than 600 foreign women volunteers in Serbia at that time and that 22 of them died there. Dr. Elizabeth Ross was one of those brave volunteers who came to Serbia early in 1915. That noble Scottish lady doctor was born in 1878 and finished her medical studies at the University of Glasgow in 1901. After graduation she worked in various place...
Srpski arhiv za celokupno lekarstvo
The first children's hospital in Serbia, as an exclusive paediatric intitution, was founded i... more The first children's hospital in Serbia, as an exclusive paediatric intitution, was founded in a deserted military barrack in Studenieka Street, near the Military Hospital, in January 1919. The founder was Dr. Katherine MacPhail, a young Scottish lady doctor, who came to Serbia for the first time in January 1915, with the first "Scottish Women's Hospital". After that, she worked as a volunteer during the First World War in France and on the Thessalonica Front. In the spring of 1919, the hospital was given an open pavilion in Topcider, which worked only during the summer months till 1924. In November 1919, the hospital was moved to a new building in Knez Milos Street, and then named The Anglo-Serbian Children's Hospital. In February 1920, a new annex, called "Villa Bravacić", was opened in Dubrovnik, which was active till 1922. In this hospital, the first Training School for Serbian Nurses was opened in 1921, and in February of that year, the hospital ...
Srpski arhiv za celokupno lekarstvo
Dr. Laza K. Lazarević (1851-1890) left a profound imprint on Serbian medicine and literature for ... more Dr. Laza K. Lazarević (1851-1890) left a profound imprint on Serbian medicine and literature for 11 years of his medical and literary work. Laza K. Lazarević is considered the progenitor of Serbian realistic psychological story. He studied medicine in Berlin (1872-1879). He fought in Serbian-Turkish wars and remained active in the medical corps. As a physician, he worked in Belgrade, where he was the chief of the internal medicine ward and founder of the first geriatric institution in this part of Europe. In 1880, he described, in the Serbian Archives, a sign that is today called after him in neurology, the "Lazarević sign". In 1888, he became a member of the Serbian Royal Academy. He was an active member of the Serbian Society of Physicians.
Vojnosanitetski pregled. Military-medical and pharmaceutical review
Vojnosanitetski pregled. Military-medical and pharmaceutical review
Medicinski pregled, 1993
We present a pilot seria of 18 patients with acute anterior dislocation of the shoulder joint fol... more We present a pilot seria of 18 patients with acute anterior dislocation of the shoulder joint following simple trauma. All the patients underwent conservative treatment using a standard Kocher technique. In the majority of cases muscular spasm and pain rendered through neurological examination difficult to perform. All patients were, therefore, submitted to extensive electrodiagnostic procedure which revealed a nerve injury on half of them. Such high incidence was, probably, due to the increased age (17 out 18 patients were over 40 years old), and rather traumatic reduction procedure. The axillary nerve was the most frequently affected (38.8%), either alone or in combination with musculocutaneus nerve. Comparing to previous reports in the literature, we found musculocutaneus nerve lesion in a rather high number of patients (22%). Extensive electrodiagnostic study is therefore recommended when further treatment and prognosis of anterior dislocation of the shoulder are taken in consid...
American Journal of Infection Control, 1994
Occupational exposure to blood and body fluids is a serious concern of health care workers and pr... more Occupational exposure to blood and body fluids is a serious concern of health care workers and presents a major risk of transmission of infections such as human immuno-deficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The aim of this study was to determine the frequency and circumstances of occupational blood and body fluid exposures among health care workers. Cross-sectional study was conducted in three university hospitals in Belgrade. Anonymous questionnaire was used containing data about demographic characteristics, self-reported blood and body fluid exposures and circumstances of percutaneous injuries. Questionnaire was filled in and returned by 216 health care workers (78.2% of nurses and 21.8% of doctors). 60.6% of participants-health care workers had sustained at least one needlestick injury during their professional practice; 25.9% of them in the last 12 months. Of occupational groups, nurses had higher risk to experience needlestick injuries than doctors (p = 0.05). The majority of the exposures occurred in the operating theatre (p = 0.001). Among factors contributing to the occurrence of needlestick injuries, recapping needles (p = 0.003) and decontamination/cleaning instruments after surgery (p = 0.001) were more frequent among nurses, while use of a needle before intervention was common among doctors (p = 0.004). Only 41.2% of health care workers had reported their injuries to a supervisor in order to obtain medical attention. 50.2% of health care workers were vaccinated with three doses of hepatitis B vaccine. There is a high rate of needlestick injuries in the daily hospital routine. Implementation of safety devices would lead to improvement in health and safety of medical staff.