Publications (9)4.26 Total impact
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Article: Unrecognized fracture of the posteromedial process of the talus--a case report and review of literature.
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ABSTRACT: In this report, we present a rare case of an initially unrecognized fracture of the posteromedial process of the talus sustained in a seldom reported position of dorsiflexion and supination of the foot. Fractures of the posteromedial process of the talus are very rare and represent an important diagnostic problem. Difficult x-ray visualization makes these fractures often misdiagnosed as ankle sprains. Complications due to this kind of fractures can include serious consequences such as avascular osteonecrosis, tarsal tunnel syndrome, post-traumatic osteoarthritis, or chronic pain. Timely diagnosis represents an important factor in the development of these conditions. A heightened awareness in examining ankle traumas with specific patient history details is of great importance. The most common mechanism of injury includes dorsiflexion and pronation of the foot. However, in an increasing number of cases alternative mechanisms have been described, all including high-energy impacts. Our patient sustained a fracture of the posteromedial process of the talus in dorsiflexion and supination with high-energy impact due to a 3-m fall. The patient was treated with excision of the fragment six months after the injury, and 18 months after the surgery the patient returned to his normal daily activities with significantly less pain in the posteromedial part of the ankle.Acta clinica Croatica 09/2010; 49(3):315-20. · 0.25 Impact Factor -
Article: [Diagnostic imaging in assessment of rheumatic diseases].
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ABSTRACT: Rheumatic diseases represent one of the most common health problems for which patients visit the doctor. This fact imposes the need for verification of clinical symptoms and clear presentation ofpathomorphyology changes primarily because of the best methods of treatment selection. A wide range of diagnostic imaging modalities are available today: conventional radiography, conventional myelography, computed tomography (CT), CT myelography, magnetic resonance imaging (MRI), MR or CT artrography, spinal cord angiography, ultrasound and scintigraphy, and combined radiological methods and scintigraphy (PET-CT). Each of the above methods has its own importance, advantages and limitations. Sometimes a method excludes the other, and often support each another in setting the final diagnosis. For the proper choice of radiological imaging methods that will give us insight into the problem, a good knowledge of their capabilities, and a clear clinical inquiry are necessary. But most of all, good cooperation of clinicians and radiologists who should be diagnostic team responsible for that sets the indication for radiological examination is essential.Reumatizam 01/2009; 56(2):81-8. -
Article: Arthroscopy and microfracture technique in the treatment of osteochondritis dissecans of the humeral capitellum: report of three adolescent gymnasts.
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ABSTRACT: The aim of this paper is to report on three cases of symptomatic osteochondritis dissecans of the humeral capitellum in adolescent gymnasts, two females and one male. In all the cases arthroscopic surgery was performed. During arthroscopy, loose osteochondral fragments were removed, the defect was debrided and microfractures were performed. All the three patients regained the full range of motion of the affected elbow, and returned to the high-level gymnastics within a period of 5 months. At 12 months follow-up, all the three patients remained symptomless and were participating in high-level gymnastics. A combination of arthroscopy and the microfracture technique is a reliable method with excellent short-term results in the treatment of the osteochondritis dissecans of the elbow.Knee Surgery Sports Traumatology Arthroscopy 06/2006; 14(5):491-6. · 2.21 Impact Factor -
Article: Comparison of conventional spin-echo and fast spin-echo magnetic resonance imaging with fat suppression [correction for suppresion] in cruciate ligament injury.
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ABSTRACT: To compare the quality and diagnostic reliability of conventional spin-echo and fast spin-echo with fat suppression magnetic resonance (MR) imaging in the evaluation of cruciate ligament injury. Thirty-five patients with internal knee injury and positive clinical signs of cruciate ligament injury were examined by using an Elscint Prestige 2T MR scanner. Findings of conventional and fast spin-echo with fat suppression MR sequences were evaluated and compared with each other and with arthroscopic findings. In all patients, arthroscopy was performed within 2 months after the MR examination. Analysis of anterior cruciate ligament injury with conventional spin-echo sequence showed 81.8% sensitivity. The sensitivity of fast spin-echo sequences with fat suppression was 96.9%. According to the type of the anterior cruciate ligament injury, the sensitivity of fast spin-echo sequences with fat suppression was higher than that of conventional spin-echo sequence (85.7% and 66.7%, respectively) for partial rupture, but the sensitivity of both sequences for complete rupture was the same (100% both). Fast spin-echo with fat suppression sequence can be used routinely in clinical practice for the assessment of acutely injured knees as the substitute for conventional spin-echo sequence without decreased diagnostic reliability.Croatian Medical Journal 05/2004; 45(2):195-201. · 1.80 Impact Factor -
Article: [Osteochondritis dissecans of the ankle].
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ABSTRACT: The aim of this study was to determine the efficacy of the microfracture method in the treatment of symptomatic osteochondral lesion of the talus. 24 patients operated by the mentioned method were prospectively followed-up. Standard radiological treatment was performed in all patients, ankle CT was performed in 10 patients, and MR was performed in 8 patients. Patients' subjective satisfaction with operation was assessed by SANE and Martin's score, while the objective function was assessed by AOFAS and Freiburg's score. The mean preoperative AOFAS score was 53 (from 31 to 61), while the mean postoperative AOFAS score was 87.5 (from 81 to 100). Postoperative Freiburg's score was 89.5 (from 76 to 100). The distribution of treatment outcomes was evaluated by the Martin's score and it revealed excellent, good and satisfying results in 94.5% patients, while the distribution of outcomes by the SANE questionnaire revealed excellent and good result in 91.8% patients. The arthroscopy of the ankle with microfractures is safe, cheap and effective method in the treatment of osteochondral lesions.Lijec̆nic̆ki vjesnik 129(6-7):191-9. -
Article: [Novelties in pathophysiology, radiology diagnostics and conservative treatment of painful spine conditions and deformities].
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ABSTRACT: Spinal pain, especially chronic low-back pain is one of the most prominent health and healthcare problems. Better understanding of pain pathophysiology and more precise visualization using modern imaging techniques help us to focus our intervention and obtain better outcome. In most patients with spine conditions symptoms and function resolve with conservative treatment. In this article we report on novelties in pathophysiology of spinal pain, magnetic resonance imaging and conservative treatment options (medications, therapeutic exercise, physical therapy and orthoses) of painful spine conditions and scoliosis. Apart from being informative, together with the corresponding article about novelties in invasive/surgical treatment, this special focus article on recent developments in this area can be used as an aid in decision making when approaching these patients.Lijec̆nic̆ki vjesnik 133(3-4):116-24. -
Article: SINOVIJALNA HONDROMATOZA
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ABSTRACT: Synovial chondromatosis is an uncommon benign disorder of the synovial membrane of joints, tendon sheaths, or bursae characterized by the formation of multiple cartilaginous nodules or osseus loose bodies. It is usually a monoarticular disease, and 33 different localizations have been described until now. The aim of this review article is to present the newest knowledge on the etiology, diagnosis, differential diagnosis, and management of synovial chondromatosis. Malignant transformation to chondrosarcoma is an unusual but possible complication. It is closely connected with recurrence rate and usually occurs many years after surgical treatment. More specific details related to surgical treatment of most often affected joints, i.e. shoulder, elbow, hip, knee, and ankle are reported as well at the end of this review article.Lijecnicki vjesnik; Vol.132 No.3-4. -
Article: [Synovial chondromatosis].
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ABSTRACT: Synovial chondromatosis is an uncommon benign disorder of the synovial membrane ofjoints, tendon sheaths, or bursae characterized by the formation of multiple cartilaginous nodules or osseus loose bodies. It is usually a monoarticular disease, and 33 different localizations have been described until now. The aim of this review article is to present the newest knowledge on the etiology, diagnosis, differential diagnosis, and management of synovial chondromatosis. Malignant transformation to chondrosarcoma is an unusual but possible complication. It is closely connected with recurrence rate and usually occurs many years after surgical treatment. More specific details related to surgical treatment of most often affected joints, i.e. shoulder, elbow, hip, knee, and ankle are reported as well at the end of this review article.Lijec̆nic̆ki vjesnik 132(3-4):102-10. -
Article: 20 GODINA NAKON REKONSTRUKCIJE STRAŽNJE UKRIŽENE SVEZE UMJETNIM LIGAMENTOM GORE-TEX: PRIKAZ SLUČAJA
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ABSTRACT: Twenty years ago the Gore-Tex expanded polytetrafluoroethylene (PTFE) prosthetic ligament was used as feasible salvage procedure in patients with failed, multiply operated knees, or knees with gross instability. At the Department of Orthopaedic Surgery we operated 13 patients and replaced the posterior cruciate ligament (PCL) with the Gore-Tex prosthetic ligament. Recently we had opportunity to evaluate clinical, arthroscopic, magnetic resonance imagining (MRI) and patohystologic (PH) findings in patient F. K. twenty years after the reconstruction. Due to osteoarthritic changes arthroscopic toilette of the knee was performed. On that occasion arthroscopic evaluation and biopsies for microscopic examination were carried out. MRI performed prior to arthroscopy revealed tidy continuity and volume of PCL with advanced arthritic changes of knee. MRI findings were consistent to clinical findings of good knee stability. Arthroscopy revealed the Gore-Tex prosthetic ligament completely coated with thicken synovial membrane i.e. fibrosis. Partial removal of the synovial membrane showed continuity of characteristic PTFE strands. The continuity of PCL was established by the probe. After that, few pieces of synovial membrane from sheath of PCL and from other parts of synovial membrane of the knee were taken. One PTFP strand of artificial PCL was collected as well. Patohystological findings clearly excluded inflammatory reaction in synovial membrane of the knee. Furthermore, synovial membrane of Gore-Tex prosthetic ligament sheath was found to contain mature fibrotic tissue with multinuclear giant cells and fragments of foreign polarizing material. This case report demonstrated good biocompatibility and good knee stability twenty years after replacement of the PCL with the Gore-Tex prosthetic ligament in patient with gross instability. It is interesting to mention that there was no deterioration of PTFE strands.Croatian Sports Medicine Journal (hsmv@kif.hr); Vol.22 No.1.
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Institutions
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2004–2006
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University of Zagreb
- School of Medicine (MEF)
Zagreb, Grad Zagreb, Croatia
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