Aim To evaluate modalities of extensor tendons repair of hand and forearm in specific anatomical zones with regard to etiological factors and presence of associated injuries of adjacent anatomical structures. Methods This cross-sectional study included 279 patients referred for extensor tendon repair of hand and forearm in specific anatomical zones. Available treatment modalities were evaluated concerning etiological factors, anatomical zones, and associated injuries. Statistical significance was analysed in the occurrence of early and late postoperative complications according to anatomical zones. Results Direct repair of extensor tendon lesions was found to be the most common modality of reconstruction, 230 (93.5%), of which blade injuries were predominant, 120 (48.7%). Direct tendon repair was mostly indicated in Zone VI and Zone III, in 55 (23.9%) and 42 (18.3%) patients, respectively. Statistically, a significant correlation was confirmed between treatment modalities, injuries in specific anatomical zones, and type of etiological factor (p<0.0001). Statistical correlation was confirmed between zones of injuries and the occurrence of early and late complications (p=0.002). Conclusion Successful postoperative recovery was correlated with the recognition of functional failure in specific zones, assessment of potential associated injuries, and selection of the most optimal modality of reconstruction.

Introduction: Rhinoplasty is an esthetic and functional nasal reconstruction surgery. The elimination of physical disabilities directly affects mental health and leads to a better psychological balance. Therefore, patient satisfaction is considered a valuable measure of medical service outcomes. The objectives of this study were to evaluate subjective patient satisfaction 1 year after surgery and its influence on the quality of life.Methods: This was a clinical, retrospective, randomized, and single-blinded study in which patients were randomly questioned by the same examiner. All subjects underwent pre-operative preparation and post-operative flow at Eurofarm Centre from 2007 to 2010. The survey was conducted through anonymous questionnaires that were provided to each respondent at least 1 year after discharge from the hospital.Results: Overall, 20 (50%) patients had esthetic and 20 (50%) had functional nasal surgery. Most respondents were born between 1971 and 1980 (52.5%) and between 1981 and 1991 (40%), with the least born between 1951 and 1960 (2.5%). Regarding the education level, 27 had university degrees (67.5%), 1 had postgraduate education (2.5%), and 12 (30.0%) were secondary school graduates. In addition, 25 (62.5%) were unmarried and 15 (37.5%) were married.Conclusion: No statistically significant correlation was found between the subjective assessment of patient’s health based on eight dimensions of health assessment and variables such as type of surgery, age, level of education, and marital status 1 year after undergoing rhinoplasty. A statistically significant difference was found between the type of surgery and physical pain (p = 0.004 < 0.05, Mann–Whitney U test). Based on the research findings, we can conclude that patient satisfaction after undergoing rhinoplasty was moderately correlated positively with the quality of life (r = 0.180-0.345, p < 0.05).

We first aimed to investigate the epidemiological characteristics and clinical pattern of hospitalized paediatric burn patients in Sarajevo Canton. Second, we aimed to determine the targets for the paediatric burn prevention program. This descriptive retrospective study was carried out to analyse the demographic, etiologic and clinical data of 73 hospitalized paediatric burn patients in Sarajevo Canton over a 5-year period from January 1, 2012 to December 31, 2016. The differences between various groups were evaluated using the chisquare test. During the course of the study, 73 paediatric burns (37 boys and 36 girls; ratio 1:0.97) were hospitalized. The overall mean age was 3.0 ± 2.9 years (range: 3 months to 12.5 years). The mean total body surface area burned was 8.4 ± 8.3%. The most common causes of burns in children were scald injuries (84.9%) followed by contact with a hot object (9.6%). No children were found to have burns caused by chemicals or electricity. A total of 97.3% of paediatric burn injuries occurred at home (p<0.001), and almost all were preventable. Although the most burns were recorded in the spring months (35.6%), there was no significant seasonal variation in burns (p = 0.199). Average length of hospital stay (LOS) was 16.32 ± 12 days (range: 1 to 65 days). The findings of the current study revealed that the main cause of paediatric burns was scald occurring at home. These data can contribute to the development of a prevention program to protect the paediatric population from burns.

AIM: Successful flexor tendon reconstruction is inevitably connected with local tissue equillibrium and satisfactory joint mobility. The etiologic factors and levels of the flexor tendon injuries determine the selection of the available operative modalities. Postoperative physical therapy prevents contracture formations and has influence on the definitive postoperative outcome. METHODS: We have evaluated postoperativne results after flexor tendon repair in 116 cases during five-years period. We have used Microsoft Excel program and IBM statistics SPSSv 21 or 22. RESULTS: Noticable correlation between the type of etiologic factor and the modality of flexor tendon repair has been evaluated. The flexor tendon injuries caused by sharp objects (58.62%) had been treated mostly by primary repair (82.4%). Extensive destruction of tendon tissue caused by the other types of the etiologic agents have represented the indicaton for tenoplasty, which have been applied mainly in Zone II  (40.4%), the most frequently zone of tendon injury in our research (40.52%), with primary and secondary repair CONCLUSION: There is a very clear correlation between the etiologic factor and the level of the flexor tendon injury with selection of the appropriate operative modality.

Peroneal palsy with loss of active dorsal flexion in foot can be surgically treated by anterior transfer of tibialis posterior tendon. Two techniques are available, classic and modified Barr's technique of the anterior transfer of tibialis posterior tendon, with different place of tendon's reinsertion. The aim of the study is evaluation of the degree of active dorsal flexion in foot, and appearance of varus position and hipercorrection of the foot, by comparing the results of the two operative techniques. The study included 40 patients with peroneal irreparable palsies, divided into two equally sized groups. The first group was treated by classic Barr's technique. The other group of patients was treated by modified Barr's technique. The group treated by modified Barr's technique exhibited better functional results. Active dorsal flexion achieved between 950 (in 35% cases) and 900 (in 50% cases), while varus position and hipercorrection of the foot were absent. In the second group of 20 patients, treated by classic Barr's technique, 800 (40%) and 900 (25%) of active dorsal flexion, indicated worse functional postoperative results. Active dorsal flexion of 700 achieved by this method in two cases (10%), represents unsatisfactory functional result. Varus position of the foot was recorded in 5 cases (25%) and hipercorrection in 4 cases (20%). Modified Barr's technique is surgical method with better functional and postoperative results in treatment of irreparable peroneal palsy.

We present a management, of posttraumatic posterior heel defects through a study carried out in 50 cases from January 1995 to January 2008 at the Plastic and reconstructive and Orthopedic – traumatology Clinic of the University Clinic Center Sarajevo. Isolated injuries (injuries only over the posterior heel) were present in 39 patients (78%) and combined injuries (injuries to posterior heel and surrounding regions) in 11 patients (22%) Patient’s data including age, sex, side of injury, mode of injury, extent of injury (isolated or combined), if combined whether involving the weight-bearing part of heel, type of wound, management of wound, wound healing time and complications were noted. Criteria that were used for the selection of method of reconstruction in our study are; size of defect, location of the defect, complexity of the injury i.e. exposed bone or tendoachilles, extent of the zone of trauma. Pre-operative Doppler study was done in all patients. We covered these with various flaps depending upon the defect size, its exact location, associated injuries, extent of zone of trauma, and complexity of the defect. The aim was to select the most suitable method for soft tissue coverage for posterior heel reconstruction. On long-term follow-up of the patients, we did not find any recurrent ulceration in the patients having isolated posterior heel injuries. In patients having combined injuries, two in which cross-leg flap was done, patients had episodes of trophic ulceration that were treated with conservative management with dressings and modification of footwear.

INTRODUCTION the lower extremity requires an understanding of the ways in which such reconstruction differs from that of the upper extremity. The weight-bearing requirements are the most obvious difference. The difference between the cutaneous coverage on the plantar surface on the foot and that on the dorsum has important implication for reconstruction of defects in these areas. There are few operative techniques for reconstruction of the posttraumatic heel defects, in our study we have been compared two techniques, free microvascular flap and reverse supramaleolar fasciocutaneous flap. AIM the aim of the study is evaluation of the appearance of stress ulcers as late complications of the heel reconstruction, comparing these two methods. MATERIAL AND METHODS in testing were included 50 patients with posttraumatic heel defects, of different etiology, divided in two groups. The first group of 25 patients with posttraumatic heel defects has been treated by microvascular free flap. The other group of 25 patients with posttraumatic heel defects has been treated by reverse supramaleolar fasciocutaneous flap. DISCUSSION according to our results, there are significant differences between proportions of patients with and without of late complications of free microvascular flap comparing with reverse supramaleolar fasciocutaneous flap. CONCLUSION stress ulcers, as result of continuous pressure on weight-bearing area, have been evaluated by using both operative methods. Reverse supramaleolar fasciocutaneous flap is good alternative method for heel reconstruction.