Browsing by Author "Mičeta, Lazar (57226307878)"

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.

Introduction Haglund’s deformity represents a reactive enlargement of the posterosuperior aspect of the calcaneus and often causes pain that can significantly disturb everyday activities. If the patient’s condition does not improve after six months of non-surgical treatment, surgical treatment could be taken into consideration. Although Haglund’s deformity is successfully treated by endoscopic calcaneoplasty with a two-portal technique, we decided to apply a slightly newer technique – arthroscopic surgery with a three-portal technique. Case outline A patient with clinically and radiographically confirmed Haglund’s deformity was operated on using arthroscopic calcaneoplasty with a three-portal technique. The postoperative recovery was uneventful and full weight-bearing was allowed after four weeks. A complete return to sports activities was allowed after four months. Conclusion Arthroscopic calcaneoplasty with the three-portal technique proved to be a safe and cost-effective surgical method in the treatment of Haglund’s deformity. There is still not enough data in the literature regarding this type of surgical treatment, but the good postoperative functional results are extremely encouraging since this surgical technique enables faster recovery and fewer postoperative complications. © 2022, Serbia Medical Society. All rights reserved.

Introduction. Chopart joint dislocation (CJD) represents a rare injury that is often initially unrecognized. Because of this, but also because of the increased morbidity it leads to, and due to poor treatment outcomes, this injury represents a significant clinical problem. Case report. We present two patients with overlooked CJD admitted to our institution within one year. The first case was a 63-year-old male, who suffered an injury after falling down the stairs, while the second case was a 33-year-old female injured in a traffic accident. Both patients were initially treated under the diagnosis of foot and ankle sprain. Upon their admission and subsequent computed tomography diagnostics, overlooked pure CJD was diagnosed in both patients. They both underwent open reduction and internal fixation of the Chopart joint using K-wires. Six weeks after the surgery, the K-wires were removed, a below-knee orthosis was applied for walking, and partial weight-bearing was allowed with a gradual increase to full weight-bearing over the next six weeks. Physical therapy was initiated. After the six-month follow-up, both patients were successfully rehabilitated, with a final American Orthopaedic Foot and Ankle Society score of 76 out of 100 for the female patient and a score of 84 out of 100 for the male patient. Conclusion. Despite the delayed diagnosis and postponed operative treatment, the functional outcomes of pure CJD treated by open reduction and percutaneous K-wiring can be satisfactory. Additional studies are required to gain a better insight into the prevalence and causative factors of the possible complications in such a treatment approach to the mentioned injury. © 2025 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction/Objective Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund’s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund’s syndrome, employing the three-portal technique. Methods This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion The endoscopic approach and the use of the three-portal technique in resolving Haglund’s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery. © 2023, Serbia Medical Society. All rights reserved.