Traumatic wounds make them one of the most common reasons for an emergency department visit. Foreign objects embedded in the musculoskeletal system through penetrating injury are a common problem, with more than a third missed in the initial clinical evaluation. Wood, glass, and metal accounted for 95 percent of the foreign bodies (FBs) seen. In 38 percent of patients the diagnosis is missed by the initial treating physician, in many cases because no X-ray of the injured area was taken. This case report aims to present a young girl who sustained a wound from glass in the popliteal fossa of her right leg. No X-ray examination was performed and the wound was sutured. Subsequently foreign bodies - pieces of glass - were removed on two occasions.

Introduction: The best treatment for intertrochanteric fractures remains controversial. Many methods have been recommended. Aim: We aimed to assess the results of osteosynthesis using the Proximal Femoral Nail Antirotation (PFNA) system. Patients and Methods: We retrospectively analyzed 113 consecutive patients with intertrochanteric fractures treated with PFNA. Fractures were classified in accordance with the AO/OTA classification system into the groups A1, A2 and A3. The postoperative quality of fracture reduction was described as good, acceptable or poor. The location of the blade within the head was recorded as per the Cleveland method. Tip-apex distance (TAD) was used as a method for evaluating screw position. Pre-fracture and postoperative functional level were evaluated by the new mobility score (NMS). Results: The average age at the time of surgery was 75.9 years. The majority, 75 (66.3 %), were unstable fracture types. The reduction was good in 67 (61.4 %) cases. Of the 24 deaths, 19 patients had comorbidities (p < 0.001). The number of deaths in the first 6 months was significantly higher than in the next 6 months (p = 0.001). The mean TAD was 25.6 mm. The Cleveland zone centre-centre was the most common placement of the blade, accounting for 33 (29 %) of the cases. Reoperation was required in four patients. There were four patients with cut-out. The pre-facture mean value NMS was 8.6 (SD 1.1) and the postoperative mean value was 4.3 (SD 3.6). Conclusion: We concluded that PFNA offers biomechanical advantages, but the best position of the blade is still unknown.

Introduction: Degenerative disc disease is one of the most common reason for low back pain in a physical active population. The shape of the spine, especially reduction of lordosis, may have an important role in ethiology of lumbar disc degeneration. The aim of this study is to assess is there any differences within genders when evaluate lumbar spine and pelvic parameters in patients with a DDD. Materials and Methods: A prospective survey has been conducted in the Spine surgery department of Civil Hospital in Strasbourg (Service du Rachise, L'Hopital Civil, Strasbourg, France) during the period between January 1th, 2005 and December 31st, 2008. We have analyzed x rays and spino-pelvic parameters of 63 patients among of 80 patients with degenerative disc disease (DDD) of lumbar spine in which total disc arthroplasty (TDA) have been performed at one level. Standing lateral full spine x rays has been done before surgery and at final follow-up 3 years later. Following parameters were analyzed: lumbar lordosis (L1-S1), intervertebral angle, anterior and posterior disc height, sacral slope, pelvic tilt and pelvic incidence. Results : Mean follow-up time was 44 months. 45 females and 18 males patients with a mean age of 41,38 year were evaluated. The preoperative values of lumbar lordosis and sacral slope was significantly higher in a females with a DDD at L4-L5 segment. The same result has been seen and after the surgery. There have not been statistical differences these values between genders with DDD at L5-S1 segment, nor preoperatively, nor postoperatively. Conclusion : Although reduction of lordosis is pointed out as an important role for DDD we have not found that in our study that may suggest that DDD has complex etiology.

Material and methods: Our study has a qualitative design. Data was collected between March and September 2013 through face-to-face interviews using open-ended questions. A qualitative content analysis method was used for analysis and interpretation of data in accordance with the Graneheim and Lundman method (2004). The participants were eight women and seven men, aged between 50 and 86 years (mean 71.4), emigrated from Bosnia and Herzegovina and diagnosed with diabetes mellitus type 2 in Sweden. They had lived in Sweden between 10 and 18 years.

Introduction: Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. Material and methods: We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6±11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). Results and discussion: The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p=0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2±7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6±5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p=0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p=0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p=0.0001). Conclusion: PFNA is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation, which allows early full weightbearing mobilization of the patient.

Objective – We present a case of osteoarthritis in a ten day old newborn who underwent aspiration and drainage on the fifth day after admission instead of on the first day . The aim of this case report is to describe the importance of a team approach and clinical management algorithms for the successful treatment of septic arthritis in newborns. Case report – We describe a 3580 g male baby, who underwent aspiration and drainage on the fifth day after admission to our Unit for septic arthritis of the right knee. After the surgical drainage of the joint, local signs of inflammation began to improve. Microbiological analysis did not reveal the causative agent. Conclusion – Septic arthritis requires early diagnosis, prompt administration of antibiotics and rapid removal of pus by surgical treatment, due to the possible development of serious and irreversible damage, and even lethal outcome. A team approach with treatment guidelines of septic arthritis in newborns is mandatory.

ABSTRACT Introduction: Fracture of the femoral shaft is a common fracture encountered in orthopedic practice. In the 1939, Küntscher introduced the concept of intramedullary nailing for stabilization of long bone fractures. Intramedullary nailing has revolutionized the treatment of fractures. Material and methods: The study included 37 male patients and 13 female patients, averaged 39±20,5 years (range, 16 to 76 years). Results and discussion: There were 31 left femurs and 21 right femurs fractured. 46 fractures were the result of blunt trauma. Low energy trauma was the cause of fractures in six patients, of which five in elderly females. 49 fractures were closed. Healing time given in weeks was 19,36 ± 6,1. The overall healing rate was 93,6%. There were three (6,25%) major complications nonunion. There were one (2%) delayed union, one (2%) rotational malunion and no infection. The shortening of 1 cm were in two patients. Antercurvatum of 10 degrees was found in one patient. There was no statistically significant reduction of a motion in the hip and knee (p<0.05). There was statistically significant in the thigh (knee extensors) muscle weakness (p<0.001). Conclusion: Intramedullary nailing is the treatment of choice for femoral shaft fractures.

INTRODUCTION Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. MATERIAL AND METHODS We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6 +/- 11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). RESULTS AND DISCUSSION The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p = 0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2 +/- 7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6 +/- 5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p = 0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p = 0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p = 0.0001). CONCLUSION PFNA is an excellent device for osteosynthesis as it can be easily inserted. Moreover, it provides stable fixation, which allows early full weightbearing mobilization of the patient.

Single metastases of the brain treated from January 1989 do December 1992 at the Neurosurgical Clinic in Sarajevo have been presented. Our approach and selection of patients have also been showed. We have compared our work with current neurosurgical treatment of metastases of the brain. The lung have been the source of the single brain metastases in 67%. Anaplastic carcinoma have been the most common pathohistological diagnosis. Metastases have been found in the cerebrum in 80% cases. Percent of the males patients have been 67%. The most frequently, patients have been ages 40-59. The single brain metastases with good general condition of the patient have been operative treatment indication. Operative mortality have been 12%. All patients have been treated by radiotherapy after operating. Contrast-enhanced CT of the brain have used to make preoperative diagnosis.