Aim The two most commonly used implants for treatment of trochanteric fractures are the dynamic hip screw (DHS) and proximal femoral nail antirotation (PFNA). The aim of this study was to evaluate blood loss in patients with trochanteric fracture treated with DHS or PFNA. Methods This retrospective comparative study included 61 patients with trochanteric fracture, who were divided according to a surgical method into DHS and PFNA groups. In the PFNA group, a short third generation gamma-nail was used for osteosynthesis (Supernail GT, Lima Corporate, Italy), and in the DHS group a dynamic hip screw was used (Synthes, Oberdorf, Switzerland). Complete blood count with haemoglobin and haematocrit values was taken preoperatively and on the first day postoperatively and a number of red blood cell transfusions (RBC) were evaluated. Electronic medical records from 2022 were used to collect patient data. Results There were no significant differences in terms of gender and age between the groups (p=0.510 and p=0.087, respectively), as well as in the fracture type distribution (p=0.886). The duration of postoperative hospitalisation was similar between the groups (p=0.643). There was no statistically significant association between the number of RBC transfusions and fixation method (p=0.091), as well as in postoperative haemoglobin and haematocrit levels between the groups (p=0.180 and p=0.225, respectively). Conclusion Both DHS and PFNA implants are safe surgical techniques for the treatment of trochanteric fractures, with similar blood loss, number of blood transfusions and hospital stay.

Aim To determine differences between reviparin and dalteparin treatment in patients with extracapsular hip fractures treated with intramedullary nailing and their effects on perioperative blood loss and early postoperative recovery. Methods Retrospective comparative study included 68 patients with extracapsular hip fracture who were divided into dalteparin and reviparin group. Medical records were used to obtain demographic data, laboratory parameters, haemoglobin and haematocrit levels, platelet count, mortality rate and medical complications. Results Out of total 68 patients, 31 were in reviparin and 37 in dalteparin group. Mean age of patients was 70.5 (±14.4) and 76.8 (±8.4) years in reviparin and dalteparin group, respectively (p=0.071). Median values of haemoglobin levels on the first postoperative day were lower in dalteparin group compared to reviparin group (p=0.012). On the first postoperative day haematocrit values were also lower in dalteparin than in reviparin group (p=0.015). Both groups showed an increase in platelet count on the first postoperative day, but without significant difference (p=0.084). There was no statistically significant difference in intrahospital mortality between the groups (6.4% vs. 2.7%; p=0.588). One case of pulmonary embolism was detected in the dalteparin group. Conclusion Low-molecular-weight heparin is the drug of choice in patients with hip fractures for thromboprophylaxis. Due to non-antithrombin-mediated actions, reviparin and dalteparin could have different effects on perioperative blood loss. Both dalteparin and reviparin are safe and effective agents for thromboprophylaxis in patients with proximal femur fractures.

Orthopedic surgical judgment and a decision-making process in peace is a topic that has been discussed and written about for decades, but the wartime surgical judgment is something that cannot be predicted or prepared for. There is no wartime surgery class in any medical school worldwide that can prepare a surgeon for his/her work under a wartime environment applying all of their knowledge, skill and effort to achieve the best possible result for a patient. With this short note, authors would like to raise awareness on all surgical and medical staff worldwide working under wartime conditions and giving their super-human efforts to save patients.

Aim To investigate the effect of kinesiotherapy on muscle strengthening in patients with Parkinon's disease. Methods This clinical retrospective - prospective study was based on collected data from medical histories and included 40 patients, who, beside medicaments, had undergone kinesiotherapy. This study analysed age, gender, duration of the rehabilitation and estimation of the gross muscle strength at admittance and discharge using Manual Muscle Test (MMT). Results Females was slightly more represented in the total sample without significant statistical difference. After kinesiotherapy significant statistical difference in muscle strength was observed, average MMT of the upper extremities increased from 3.25±0.6 to 3.53±0.8 and on the lower extremities from 2.9±0.8 to 3.3±0.9. The analysis of the gender on the higher score of MMT showed that gender does not affect the score of MMT. Correlational analysis of the age and duration of hospitalization on the score of MMT showed that patients with longer hospitalization had better improvement. Conclusion Results of the study showed that kinesiotherapy has positive effect on muscle strength in patients with Parkinson's disease.

Aim : The aim of this paper is to demonstrate the conservative treatment of knee osteoarthritis by the selected parameters. Methods of the study : The study included 74 patients, both genders, aged between 52-73 years with clinical and radiological signs of osteoarthritis of the knee. Patients were divided in two groups. The first group - patients with osteoarthritis of the knee without comorbidity treated with nonsteroid antireumatics and physical therapy and the other group - patients with osteoarthritis of the knee and cardiovascular comorbidity treated Paracetamol tablets 2xl, lighter opiate in the evening, outpatient physical therapy and individual exercises at home. Results : Findings showed that the total sample was more represented in women than men. Statistically, more frequent (p <0.05) sleeping pain occurred in subjects with comorbidity - 73.7% compared to subjects without comorbidity - 55.6%. The duration of physical therapy was statistically significant (p <0.05) longer in the comorbidity group and was 13.3 ± 1.8 (10-15 days) compared to the noncomorbid group at 11.5 ± 1 , 9 days (range 10-15 days). After 4 months, the VAS score was slightly lower in the noncomorbid group and was 3.9 ± 0.5 (range 7.8-9.4) versus the comorbidity group - 4.3 ± 1.7 (range 3 , 1 to 9.7). Conclusion : Osteoarthritis is a chronically degenerative disease of the elderly population. New findings from the pathophysiology of osteoarthritis, as well as the knowledge about the risks of non-steroidal antireumatics, give priority to physical therapy, analgetics and topical drug administration. Osteoarthritis therapy trend is the maximum self-reliant involvement of patients in a permanent treatment program. Keywords: knee osteoarthritis, conservative treatments

Aim To demonstrate the effects of early diagnosis of overuse syndrome in the wrist on healing, pain intensity and quick recovery to daily work and sport activities. Methods This clinical retrospective study included 60 patients of both sexes aged from 22 to 44 years, with pain in the wrist and clinical signs of creeping tenosynovitis. Patients were divided into two groups: the first group - persons doing sports activity, and the second group - patients who did not deal with sports activities. Results Females in 31 (51.7%) cases compared to males with 29 (48.3%) were slightly more represented in the total sample. Patients with injuries due to sports activities had previously reported to the physician and the diagnosis was set at an average of 3.1±0.9 days after the first symptoms (the range of 2-5 days), compared to the patients of the second group whose diagnosis was set at an average of 4.7±1.1 days after the first symptoms (p<0.05). Conclusion Patients involved in sports activities were more motivated for faster recovery, they had earlier doctor's examination with rapid reduction of subjective symptoms during intensive physical therapy.

Parkinson's disease (PD) is a progressive neurological disease with tremor, bradykinesia, akinesia and rigidity. These symptoms significantly hamper the performance of activities of daily living (ADL), which are necessary for normal functioning of every individual. Exercise therapy is part of physical medicine which is using movements and strength of muscles to aim healing, improvement of health, preventing disabilities and acomplishing higher grade of funcitionality. Often exercise therapy is combined with other therapies of physical medicine. The aim is to examine effects of exercise therapy on ADL in patients with Parkinson's disease. There were 40 examinees who had exercise therapy. In the conducted study there was increased representation of female gender, with no statistically significant difference in representation. Average age of examinees was 73,9±11,6 years and duration of hospitalization in group of examinees was 27,1±12,2 days. Comparation of average values between Barthel index (BI) as patients were admitted and released shows that Barthel index was increased from 10,7±6,3 when patients were admitted to 12,45±6,2 which was statistically significant. Statistical analysis showed that difference between genders is not statistically significant (p>0,05), meaning that influence of gender isn't important when Barthel index was measured. Corelation analysis of age and duration of hospitalization on Barthel index showed that non of monitored parametar has not statistically significant influence on improvement of Barthel index. Exercise therapy shows statistically significant improvement in activities of daily living, measured with Barthel index.

Introduction: Infections occurring in the wound as a consequence of the surgery represent the surgical field infections (SFI). Tibia diaphysis fractures are common due to its exposure to the external force. Clinical signs include: pain, swelling, lower leg deformity and skin changes. Tibia in the lower extremities has an eccentric position - from the front inner side it is covered only with the skin and from the back and the outer by muscle mass. The most common pathogens are: Staphylococcus aureus, Coagulase negative Staphylococcoc aureus or S. Epidermitis, Escherichia coli, and other. For the fracture fusion process, it is important that the skin and subcutaneous tissue above the fracture are well supplied with the blood. The American Association of Anesthesiologists defined the so-called ASA score, based on which all patients are divided into five categories according to health status before surgery. Goal: The goal of the study is to demonstrate the influence of risk factors on the occurrence of infection following osteosynthesis of tibial diaphysis, comparing emergency surgical interventions with elective. Material and methods: The study was conducted at the Clinic for Orthopedics and Traumatology of the Clinical Center of Sarajevo University during 2015 and 2016, with a total of 68 patients. Results: The age of the patient as risk factor is evident in our study, because deeper infections have had patients at the age over 60 with accompanying diseases such as Diabetes mellitus. Most of the hospitalized patients had a good health status prior to surgery, or they had ASA 1 or ASA 2 score. Surgical field infections were more common in men than in women, but the difference was not statistically significant (p>0.05). Patients who are operated as an elective surgery have longer hospitalization and more frequent surgical field infection. Also, infections are more common among smokers.