Browsing by Author "Jovanović, Želimir (56697982400)"

Introduction/Objective Sprains account for 85% of all ankle injuries. Syndesmosis injuries occur in 1–18% of patients with ankle sprains and are more common in contact sports involving forced foot dorsiflexion. Methods In our study, we compared 30 patients treated with dynamic fixation for acute syndesmotic injury with patients treated with rigid fixation. The criteria for comparison were: American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, visual analogue scale (VAS), EuroQol five-dimension questionnaire (EQ-5D), range of motion, complications and reoperations. Results The mean AOFAS score for patients treated with rigid fixation was 88.6, while the mean score for patients treated with dynamic fixation was 91.6. The mean VAS score for rigid fixation was 83.5, while it was 85.8 for dynamic fixation. Infection as a complication of rigid fixation was present in two patients (11.8%), while it was absent in the dynamic fixation group. The need for implant removal occurred in two patients treated with rigid fixation (11.8%) and in one patient treated with dynamic fixation (7.7%). Conclusion Based on our results and the results reported by other authors, we prove that there is a lower incidence of problems related to implants and the need for the implant removal with dynamic fixation, based on the results of AOFAS score, we notice better and faster recovery with dynamic fixation as well. © 2024, Serbia Medical Society. All rights reserved.

Introduction Calcaneus fractures are rare but potentially debilitating injuries. Most of them are displaced intraarticular fractures, whose management is among controversial issues. There is no consensus on whether to operate or not. The most often chosen surgical treatment is open reduction and internal fixation as the primary method. Failure of this surgery often needs secondary subtalar arthrodesis as definitive management, so primary subtalar arthrodesis in cases with severe comminution represents definitive treatment in one stage with good functional results. Case outline We present a case of a 54-year-old male patient with a severely comminuted (Sanders type IV) bilateral calcaneus fracture. After the withdrawal of local swelling and disappearance of fracture blisters, the patient was operated on using one-stage bilateral subtalar arthrodesis with percutaneous screw fixation and bone grafting performed through a mini-open sinus tarsi approach. The early postoperative period was uneventful. The patient did not walk for the first seven postoperative weeks, after which rehabilitation was continued with partial weight bearing with a gradual increase of weight-bearing to full over the next five weeks, after which walking aids were completely phased out. Three years after surgery, the patient has no symptoms and has a close-to-normal gait. Conclusion Although this type of injury has traditionally been treated with open reduction and internal fixation, we believe that primary subtalar arthrodesis with bone grafting through a mini-open sinus tarsi approach can benefit patients with severe comminution of calcaneus, allowing good functional results and patient satisfaction, with fewer postoperative complications and faster definitive recovery. © 2024, Serbia Medical Society. All rights reserved.