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The aim of this research was to investigate the effects of different exercises on the development of tennis players' agility. The electronic database PubMed was used to search and collect relevant studies in the field of agility in tennis. This study was conducted based on the PRISMA statement. A total of 361 participants were included in this study. Twelve studies met the criteria in order to be included in this study. The results showed that the effect was statistically significant after each exercise program (high-intensity interval training, court tennis training, neuromuscular warm-up, sport-specific training, plyometric training, neuromuscular and performance training). The exercise programs lasted from 5 - 12 weeks with a weekly frequency of three times for 45 to 90 minutes. The results, obtained in this way, indicate a sensitive period for the development of agility in this age group, i.e. junior tennis players. The analyzed areas of agility assessment, frontal and lateral agility observed on the basis of agility assessment tests, were singled out.

Background/Aim. Cephalomedullary and extramedullary methods are used for the internal fixation of trochanteric fractures. The usage of the third generation Gamma Nail (GN) is a gold standard in this kind of treatments. Self-dynamisable Internal Fixator (SIF) is an extramedullary implant for trochanteric fractures’ treatment. The aim of this study was to compare these two methods regarding operation time and intraoperative fluoroscopy time. Methods. A total of 89 patients with a surgical treatment of a trochanteric fracture were included in this study. There were two groups of patients – GN group (43 patients) and SIF group (46 patients). Results. Average operation times were 67.5 min (GN group) and 56.0 min (SIF group). Average intraoperative fluoroscopy times were 84.8 s (GN group) and 36.7 s (SIF group). The difference between the groups was statistically significant for both of the given parameters (p < 0.05). The correlation between operation time and intraoperative fluoroscopy time was confirmed in the SIF group (p < 0.05; r = 0.405), while it was not confirmed in the GN group (p > 0.05). There was a higher variability in the GN method than in the SIF method regarding the duration and type of repeated surgical maneuvers followed by X-ray checks. Conclusion. The number of planned surgical interventions per day could depend on the type of trochanteric fracture internal fixation (intramedullary or extramedullary). Certain additional analyses including radiation dose assessment are desirable to clarify if shorter intraoperative fluoroscopy time in the SIF method can have the influence regarding intraoperative X-ray protection clothing. If there is the need to activate dynamization in long femoral axis after initial static fixation in that axis, the SIF method provides its spontaneous activation several weeks after the surgery without the need neither for additional surgery nor for additional intraoperative fluoroscopy

Introduction/Objective. Angular stability and dynamic fixation are key factors to successful healing of femoral neck fractures. The objective was to evaluate the efficacy of internal fixation of femoral neck fractures with two parallel self-tapping antirotation screws (SAF) compared to standard, three cannulated cancellous screws (CCS) fixation. Methods. In total 100 fractures were retrospectively analyzed, divided in two groups in which two SAF screws were used in parallel (n = 50) or three standard screws in an inverted triangle configuration (n = 50). The groups were compared with operation time, time of consolidation, femoral neck shortening, Harris hip score and reoperation rates. Results. SAF parallel fixation group of patients achieved consolidation rate of 86% compared to 74% in CCS fixation group, without statistically significant difference between the examined groups (p > 0,05). Dynamization of implants was significantly positively correlated with the fracture healing time in both examined groups (SAF: r = 0.324, p = 0.025; CCS: r = 0.572, p = 0.001), with significantly shorter healing time in SAF patients – on average 15 weeks (15.02 ± 1.44) in relation to the CCS group of patients – 19 weeks (19.81 ± 2.94) (χ2/z = 7.048, p < 0.001). There was no statistically significant difference in the Harris hip score and reoperation rate among the study groups (χ2 = 2.44, p = 0.487; χ2 = 0.500, p = 0.696). Conclusion. Our results suggested that dual parallel fixation is simpler, less invasive and it demands less performance time. It is not inferior to fixation with three screws, from the point of biomechanics, possible complications, healing and functional recovery.

Introduction/Objective. There are extramedullary and intramedullary methods of trochanteric fractures’ internal fixation with implants having a lag screw. The objective of this study was to examine the difference in impact of these fixation types on final hip function and health-related quality of life. Method. There were 75 patients treated for a trochanteric fracture, using self-dynamisable internal fixator (SIF group), as an extramedullary method, or gamma nail (GN group), as an intramedullary method. These patients were called for the evaluation of Harris Hip Score (HHS) and SF-12 questionnaire at least two years after surgery. The SF-12 questionnaire has dual expression – physical component score (PCS) and mental component score (MCS). Results. There were no significant differences between the SIF group and the GN group regarding HHS, PCS, and MCS. Positive correlation was confirmed between HHS, PCS, and MCS, with the strongest relation between HHS and PCS. Negative correlation was confirmed between age and HHS. Conclusion. There was no difference in final hip function and health-related quality of life between SIF and GN methods in trochanteric fractures treatment (p > 0.05). These parameters of outcome were confirmed to have positive interrelation (p < 0.05). Both submuscular presence of extramedullary implant with dimensions of SIF and the need for bone reaming in cephalomedullary fixation were considered not to have significant impact in HHS and SF-12 scores after trochanteric fractures treatment by internal fixation. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice]

Introduction/Objective. Fracture malunion is still a major problem in orthopaedic practice. The external fixation of tibial fracture malunion has become popular in recent years. The objective of this work was to evaluate clinical results in tibial shaft malunion treatment based on unilateral external fixation method. Methods. The patients with tibial shaft malunion have surgically been treated by unilateral Mitkovic external fixation system. Malunion deformities were corrected by “one stage” technique, using Mitkovic-CD type external fixator, or gradually, using Mitković-V type external fixator. This retrospective study included 15 patients with tibial shaft angular malunion. The main type of malunion was valgus deformity, in 10 patients, and varus deformity, in five patients. Results. The mean healing time was 89.66 days (range 50–125). There were no complications in the present study. The follow-up time after surgery was three years. Final functional results were excellent in 13 cases and good in two cases. Conclusion. This unilateral external fixator system was successfully used in the treatment of tibial shaft malunion, with good results and low complications rate. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice]

Acetabular fractures represent severe injuries that mostly occur in car accidents, or after falling from greater heights, most often in the working male population. Acetabular fractures are present in our clinical practice and their treatment requires good education and surgical training. Surgical experience is one of the prerequisites for achieving good treatment results, since these fractures are accompanied by numerous complications. In order to acquire knowledge and skills in this field of surgery, it is necessary to have a national center for education at one of the medical faculties in Serbia. All dislocated acetabular fractures (≥ 2 mm) require early surgery, anatomical reduction, and stable internal fixation of acetabular fracture. Acetabular fracture-dislocation requires urgent reduction of the dislocated femoral head. The anatomic reduction of the fracture is related to the time of definitive bone fixation of the fracture. Fourteen days after the fracture, anatomic reduction is more difficult to achieve. In addition to the factors that positively affect the results of treatment, there are negative factors as well, which result in poor outcomes. They are directly correlated to the initial trauma that occurs at the time of injury. Fracture comminution, large dislocation (> 20 mm), injury of the femoral head, posterior dislocation of the hip, impaction, traumatic or iatrogenic sciatic nerve palsy – these are all factors that negatively affect the outcome and are responsible for complications, as opposed to positive factors.

Introduction. Femoroacetabular impingement is the result of the pathological conditions in the osseous acetabulum and/or the proximal femur. One of its causes is a non-anatomically healed femoral neck fracture. Case report. A male, aged 51, with a subcapital left femoral neck fracture was treated conservatively. The fracture healed 9 months later and although the patient was walking on crutches he suffered from pain in the left groin. The X-ray images showed the valgus and the retroposition of the left femoral head. The patient was operated on and intraoperatively the thickness and a bone prominence in the anterosuperior femoral neck area in the line of the previous fracture were found, which was pressing and spreading beneath the acetabular labrum, thus squeezing the acetabular cartilage. The labrum lesion which was found was the result of the mechanical pressure of the existing femoral neck deformity during the hip movements. Irretrievably damaged part of the labrum was resected and the anterosuperior femoral headneck osteochondroplasty was done. One year after the surgery, the patient had no pain, he walked without limping, the impingement test was negative, the radiological parameters were adjusted and there were no signs of the avascular necrosis of the femoral head. Conclusion. The femoral neck fracture should be treated adequately with the full anatomical position and the proper internal fixation. If the deformity occurs as the result of a treatment, it should be removed as soon as possible to prevent the osteoarthritis of the hip.

Introduction/Objective. Subtrochanteric fractures are unstable, tending to a varus, antecurvatum, and shortening deformity. The aim of this paper was to compare operation time and fluoroscopy time between different internal fixation methods in the treatment of subtrochanteric fractures. Method. The prospective study of the group of 27 patients with a subtrochanteric fracture treated by the SIF (selfdynamisable internal fixator with a trochanteric unit) method had been done. Operation time and fluoroscopy time values from this group were compared to the same parameters data from the literature for intramedullary (IM) nails, proximal femur locking plates (PF-LCP), dynamic condylar screws (DCS), and the 95°-angled blade plate. Results. In the SIF group, operation time was 62.2 (25–140) minutes and fluoroscopy time was 43 (20–95) s. Average operation time from the literature data was: 102.1 (43–181) minutes for IM nail, 94.2 (75–129) minutes for PF-LCP, 105.3 (70–166) minutes for DCS and 221.5 (171–272) minutes for blade plate. Average fluoroscopy time from the literature data was: 109.6 (34–250) seconds for IM nail, 102.3 (47–180) seconds for PF-LCP, 238 seconds for DCS. Operation time and intraoperative fluoroscopy time were higher in IM nail, PF-LCP, DCS and blade plate comparing to SIF method (p < 0.05). Conclusion. The above mentioned difference could be explained by a degree of required accuracy in the initial operative technique maneuvers, by used number of screws and by the type of the fracture reduction performance in different fixation methods. Operation time during IM nailing of subtrochanteric fractures sometimes can be shorter than average operation time in SIF method, what could be explained by the skill of the surgeon to perform as fast closed reduction for insertion of guide wire. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice]

Background/Aim. Fitmore® hip stem belongs to the group of short stem prostheses with the metaphysar stabilization, with its shape and form that protects the bone mass in the greater trochanter region and the distal part of the femur. The aim of this paper was to present the early postoperative results in patients with implanted Fitmore® hip stem and point out some of the advantages. Methods. A series of 10 patients with implanted Fitmore® hip stem, was included in this study. The average age of the patients was 54.5 (48–65) years. There were 5 women and 5 men. The total monitoring time was 16 months. To rate the condition of the hip joint we used The Western Ontario and Mc Master Universities Arthritis Index (WOMAC) score. We also monitored the degree of hip pain, hip flexion, heterotopic ossification and indentation in the stem of the prosthesis. Results. After 12 months of monitoring 9 (90%) of the patients had no pain in the thigh region, and only 1 (10%) experienced mild pain. The hip flexion rose from the average 89° to postoperative 114°. WOMAC score rose as well, from 49 to 94 average points. Indentation in the stem was registered 3 months after the operation in 2 (20%) of the patients – in one of the patients the indentation was 3 mm and in the other patient 5 mm. After the 16-month monitoring, the results were excellent. The monitoring period was short though it should be continued and the results should be presented after 5 and then after 10 years. Conclusion. Early results of the implantation Fitmore stem showed good bone ingrowth with excellent functional result.

Background/Aim. Progressive erosive changes in cartilage and bone in rheumatoid arthritis (RA) ultimately lead to joint deformities and disability which may be early, severe and permanent. Consequently, there is the reduction of functional ability and changes in the quality of life. The aim of this study was to estimate the impact of disease activity on functional status of patients with RA. Methods. A prospective investigation included 74 patients with RA who were treated in the Rheumatology Clinic of the “Niška Banja” Institute. Assessment of functional status (capacity) was measured by the Health Assessment Questionnaire (HAQ) with the values from 0 to 3 that patients fill out on their own. The patients were then divided into three groups: the group I with the HAQ values from 0.125 to 1.000, the group II with the values from 1.125 to 2.000 and the group III with the values from 2.125 to 3.000. Disease activity was measured by Disease Activity Score (DAS28). The assessment also included sedimentation rate (SE) influence, IgM rheumatoid factor (RF) and C-reactive protein (CRP) positivity, age, and disease duration. Results. The patients with the most severe functional damage estimated by the HAQ - the group III, had the highest values of DAS28 SE (7.4 ± 0.8) compared to the group II (6.5 ± 1.2) and the group I (3.4 ± 1.2). The group III also showed the highest values of DAS28 CRP (7.1 ± 0.8) compared to the group II (6.7 ± 0.8) and the group I (3.6 ± 0.4). Compared with the patients with small and moderate functional damage, the patients in the group III had positive IgM RF and CRP as well as higher SE values more frequently and the difference was statistically significant. In the univariate logistic model, the tested parameters of DAS28 SE, DAS 28 CRP, SE, RF and CRP represent significant predictors of functional disability. The most significant factors that increase the odds of patient having the most severe functional damage include DAS28 SE which increases the odds by 5.5 times (OR = 5.450, 95% CI = 3.211-7.690, p = 0.001), DAS28 CRP by 5.1 times (OR = 5.111, 95% CI = 2.123-10.636, p < 0.01), and the presence of increased CRP (OR = 5.219, 95% CI = 1.305-18.231, p = 0.019) by 5.2 times. Conclusion. Functional status evaluated by the HAQ is a standard for assessment of RA due to its convenience and good correlation with parameters of disease activity. The most significant factors that increase the odds that the patient has the greatest functional damage are DAS28 SE, DAS28 CRP and the presence of CRP.

Introduction. Surgical treatment is the treatment of choice in patients with symptoms and radiological signs of femoroacetabular impingement. Objective. Our experience and early results of surgical treatment of patients with signs of femoroacetabular impingement and early hip osteoarthritis are reported. Methods. The results of treatment of 21 patients aged 23-54 years with different types of femoroacetabular impingement are presented. Safe open surgical dislocation of the hip was performed in all patients. Before and after surgery, the WOMAC score was performed, clinical and radiographic data of the operated hips were evaluated and t-tests were used for statistical analyzes of data. Results. The WOMAC score improved from 70.5 points ( range 56.3 to 89.8 points) to 90.3 points (range 70.3 to 100 points) at one year of follow-up (p

Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint. [Projekat Ministarstva nauke Republike Srbije, br. III41017]

Introduction. Traumatic hand amputation is a very severe and rare injury. Replantation and revascularization surgery requires the existence of specialized centres and well-educated teams of microsurgeons. In places where there are no such specialized centres for this kind of surgery, traumatic hand amputation is a major concern and quite a challenge, and a successfully performed replantation is a great accomplishment. Case Outline. We report a case of a successfully survived replanted hand in a 35-year-old male patient with unfortunately bad end result of the treatment. The patient with the amputated left hand (disarticulation) had a surgery 4 hours after injury. The urgent surgical procedure required a debridement, the excision of the first row of the carpal bones, external fixation of the wrist, vascular anastomoses, nerve repair, tenorrhaphy, skin sutures and decompression skin incisions. The successful operation did not have a successful post-operative course due to the patient’s psychiatric problems and lack of rehabilitation at the psychiatric institution where the treatment was continued. Conclusion. Successful surgical performance can unfortunately be ruined due to inadequate further treatment course or the wrong selection for such a demanding surgery. The survival of the amputated hand can be achieved surgically, but achieving refunctioning does not always depend on surgery. It also depends on the very patient, his motivation, rehabilitation, as well as on the proper selection for such a demanding and complex surgical procedure.

Introduction. Acetabular fractures are severe injuries, generally caused by high-energy trauma, most frequently from traffic accidents or falls from heights. Fractures of the extremities, head injuries, chest, abdomen and pelvic ring injuries are most commonly associated injuries. Objective. The purpose of this study was to evaluate the results of open reduction and internal fixation of acetabular fractures. The open anatomical reduction of the articular surface combined with a rigid internal fixation and early mobilisation have become the standard treatment of these injuries. Methods. We conducted a retrospective analysis of 22 patients of average age 43.13 years. The patients were treated by open reduction and internal fixation at the Orthopaedic Clinic of Niš from 2005-2009. The follow-up was 12 to 60 months, with the average of 21.18 months after surgery. Results. All injured patients were operated on between 4 and 11 days (5.7 days on the average). According to the classification by Judet and Letournel, 15 (68.18%) patients had an elementary acetabular fracture, whereas 7 (31.82%) patients had associated fracture. A satisfactory postoperative reduction implying less than 2 mm of displacement was achieved in 19 (86.36%) patients. The radiological status of the hip joint, determined according to Matta score, was excellent in 15 (68.18%) patients, good in 4 (18.18%) patients and moderate in 3 (13.63%) patients. According to Merle d’Aubigné Scale, the final functional results of the treatment of all operated patients were excellent in 12 (54.54%) patients, good in 7 (31.81%) patients and moderate in 3 (13.63%) patients. Conclusion. Surgical treatment of dislocated acetabular fractures requires an open reduction and a stable internal fixation. Excellent and good results can be expected only if anatomical reduction and stable internal fixation are achieved.

Background/Aim. Besides the conquasant fractures, open tibia shaft fractures belong to the group of the most severe fractures of tibia. Open tibia shaft fracture is one of the most common open fractures of long bones. They most frequently occur as a result of traffic accidents caused by the influence of a strong direct force. Methods. Within the period from January, 2000 to December 31, 2005. at the Clinic for Orthopaedics and Traumatology, Clinical Center Nis, 107 patients with open tibial fractures were treated. We analyzed 96 patients with open tibial fracture. In the series analyzed, the male sex was prevalent - there were 74 men (77.08%). The mean age was 47.3 years. The youngest patient was 17 years old, while the oldest patient was 79. According to the classification of the Gustilo et al. in the analysed group there were 30 (31.25%) open tibial fractures of the I degree, 31 (32.29%) of the II degree, 25 (26.05%) of the III A degree, 8 (8.33%) of the III B degree and 2 (2.08%) of the III C degree. In 95 of the patients the treatment of open tibia shaft fractures consisted of the surgical treatment of wound and the external fixation of the fractured bone using "Mitkovic" type external fixator with a convergent method of pin applications. One primary amputations had been done in patients with grade IIIC open tibial fracture with large soft tissue defect. Results. Of the 96 open tibial fractures available for follow-up, 73 (76.04%) healed without severe complications (osteitis, pseudoarthrosis, valgus malunion and amputation). Ther were nine (9.38%) soft tissue pin track infections and six (6.25%) superficial wound infections. The mean time of union was 21 (14-36) week. Among severe local complications associated with open tibial fractures, in eight patients (8.33%) was registered osteitis, and in nine patients (9.38%) fracture nonunion and the development of pseudoarthrosis. Three of the patients (3.13%) had more than 10 degree valgus malunion. In one patients (1.04%) deep pin track infection developed. Two patients (2.08%) had below the knee amputation (one primary in patient with type III C open fracture and one secondary after the development of deep infections). Conclusion. Surgical treatment of wounds, external fixation, leaving the wounds open and performing necessary debridements, adequate drug therapy administration are essential for obtaining good results in patients with open tibial shaft fractures.

Background/aim: In the prevention of periarticular heterotopic ossification (HO), a common complication after total hip arthroplasty (THA), nonsteroidal antiinflammatory drugs (NSAID) and irradiation are used. Some theories presume that local hypoxia of the soft tissue causes HO. The aim of this study was to investigate if the early use of pulsed electromagnetic fields (PEMF) could prevent this ossification since it accelerates the circulation and oxigenation of soft tissue. Methods. The study included three groups of the patients with primary THA. The group C consisted of 66 patients/79 hips who had only kinesitherapy in postoperative rehabilitation. The group B consisted of 117 patients/ 131 hips who had PEMF and interferential current (IC) which, on average, started on the 14th day after the surgery combined with the standard kinesitherapy. The group A consisted of 117 patients/131 hips who had PEMF from the third postoperative day and IC from, on average, the 14th postoperative day with the standard kinesitherapy. The classification of HO was done on a standard AP roentgenograms of the hips, taken at least one year after the surgery. Results. The overall HO was seen in 50.63% of the group C patients, in 43.51% of the B group and in 16.67% of the group A. Severe HO (III and IV class according to Brooker) was seen in 26.58% of the group C patients and in 6.10% of the group B, but none in the group A. Conclusion. According to the obtained results an early treatment with PEMF could prevent severe HO and reduce the overall HO.

Aim. To present the possibility of a successful use of external skeletal fixation in treating the open and closed tibial shaft fractures with Mitković’s external fixator. Methods. External fixation was used in 115 patients with 118 fresh tibial shaft fractures, 82 males (71.3%) and 33 females (28.7%), average age 43.92 years (16−84). Open tibial shaft fractures were present in 37 (31.36%). All the fractures were treated with Mitković’s external fixator type M 20. Results. The results of external fixation were excellent or good in 94.07% of the cases, and bad in 5.08%. Pin tract infection appeared in 7 (5.93%) patients. In only 3 cases an external fixator was removed and treatment continued with the functional braces. Nonunion occurred in 6 (5.08%) patients, of which 4 were with open fractures (2 Gustilo type IIIB, 1 Gustilo type IIIA, 1 Gustilo type II) and 2 with the segment fractures. Compartment syndrome was observed in 1 (0.85%) patient with closed fracture. Malunion was found in 2 (1.69%) patients. Conclusion. External fixation of tibial shaft fractures is a simple and effective method to enable the safe healing of fractures, early mobilization of the patients, early weight-bearing, as well as early rehabilitation. Fixation of tibial shaft fractures was unilateral with convergent pins orientation, and there was also a possibility of compression and distraction.

Various methods can be applied for treatment of knee deformity. One of them is open wedge osteotomy and callus distraction by means of the external fixator. This paper presents the results of treatment of 16 patients with knee arthrosis associated with varus and valgus deformities (10 varus and 6 valgus deformities). Open wedge osteotomy of the varus deformity was performed in the proximal tibia, and in case of the valgus deformity in the distal part of the femur. The patients who were operated on had a knee varus larger than 10 degrees and a knee valgus larger than 12 degrees. Prior to open wedge osteotomy and application of the external fixator, knee arthroscopy was performed (meniscectomy, cartilage drilling and shaving, debridement, the extraction of loose bodies). After one-year follow-up, the final outcome of the treatment was positive in all patients. The treatment alleviated the pain in these patients. The method is minimally invasive and relatively easily applied. Mitkovic's external fixator type M20-CD-V allows for continuous callus distraction with simultaneous correction of the varus or valgus knee deformity.

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.

The objective of this research was to analyze and elucidate the sagittal spinal posture status in older elementary school children, considering their gender and grade differences. The study involved 484 school children (252 males and 232 females) from grades V to VIII, assessed for sagittal spinal posture using the Formetric 4D System. The analysis, employing the Chi-squared test of independence along with the Z-test, did not reveal significant grade-related differences (p < 0.52) in the incidence of normal sagittal alignment or diagnosed outliers. However, within grade levels, no significant difference was observed for male participants (p < 0.80), while a significant difference was identified for females (p < 0.01). Examining gender differences across grades, a disparity was noted only among seventh graders concerning normal spine alignment and outlier existence (p < 0.01), favoring male participants. Regardless of the grade, a significant gender difference emerged in the location of diagnosed outliers: kyphosis (M = 108 vs. F = 72), lordosis (M = 5 vs. F = 14), kypholordosis (M = 18 vs. F = 66), and flatback outlier of the lumbar spine (M = 27 vs. F = 11). These findings suggest potential adjustments to the curriculum and highlight the need to tailor physical education instruction based on this study's outcomes. Consequently, these results imply the importance of a differentiated approach in preventing sagittal plane outliers of the spine in adolescent children. [ABSTRACT FROM AUTHOR]

Proper posture, characterized by the appropriate alignment of the cervical, thoracic, and lumbar segments of the spine, enables these regions to maintain their normal curvature. Body composition is recognized as one of the factors that can influence overall postural alignment of the spine. The objective of this study was to determine the influence of the parameters of body composition on the prevalence of postural disorders in the sagittal plane. The cross-sectional study was conducted on 152 children of both genders (78 boys), at a mean age of 11 years ± 6 months. In order to evaluate postural disorders, the Formetric 4D System, a tool manufactured by Diers, Schlangenbad, Germany was used. Based on its output data, the following variables were obtained: hyperkyphosis, hyperlordosis, kypholordosis, flatback, and normal alignment of the body in the sagittal plane. The evaluation of body composition parameters was conducted using the InBody 770 device. To determine how body composition influences the postural status of the spinal column, a discriminant analysis was employed. The results showed that approximately 65.8% of children exhibit various types of postural disorders when assessing the alignment of the spine in the sagittal plane. The most prevalent disorder observed was hyperkyphosis, affecting 34.2% of the subjects, followed by kypholordosis at 16.4%. Moreover, the results demonstrated that body composition significantly influences body posture (p = 0.004). An increase in fat mass corresponds to a deviation from normal body posture, whereas an increase in the percentage of skeletal muscle mass and fat-free mass is associated with a reduction in postural abnormalities in the sagittal plane. Considering the results, it is clear that body composition parameters serve as more reliable predictors of the influence on body posture compared to simply calculating the body mass index. Furthermore, it can be concluded that there are consistent patterns of influence by specific body composition parameters, including fat mass, percentage of skeletal muscle, and fat-free mass, on body posture among children from various climates. These results underscore the significance of implementing strength exercises in children, particularly during periods of rapid growth and development, as a means of preventing and correcting postural disorders. [ABSTRACT FROM AUTHOR]

Copyright of Facta Universitatis: Series Physical Education & Sport is the property of Facta Universitatis, Series Physical Education & Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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The explosive power of the lower extremities is a very important feature in many sports activities that require the usage of maximum muscle strength, and is most often manifested in vertical jumps. During the performance of vertical jumps, leg muscles, the so-called extensors, are activated, and play a role in maintaining the proper arch of the foot. In this regard, the aim of this study is to determine the differences in the explosive leg power among the young school-age male children, with or without flat feet condition. The sample consisted of 48 students with an average age of 11. The following tests are used for the evaluation of explosive leg power: squat-jumps, squat-jumps with preparation, squat-jumps with preparation and arm swing. The plantography was used to evaluate the collapse of the arch, with the interpretation of the plantographic patterns using the method devised by Russian authors. The applied Ttest results have shown that, statistically, students with flat feet have significantly lower results on all three tests; in other words, they scored lower values for the explosive power of the leg muscles. Considering the results of various studies that support the confirmation and the rejection of the claims according to which a normal arched foot has an impact on explosive leg power, it could be concluded that new research needs to be conducted in which the participants should be equalized in certain morphological parameters such as height and body weight. In addition, participants should be equalized in active participation in sports as one of the possible factors affecting the activation, as well as muscle strength, when performing tests for the assessment of explosive leg power. [ABSTRACT FROM AUTHOR]

The number of candidates for total hip replacement (THR) is steadily increasing. Judging by the clinical results and implant longevity, THR is one of the most common and most successful orthopedic interventions of all times. Material, design, surgical techniques and subsequent rehabilitation continue to evolve. Choice of the prosthesis and fixation technique depends on the patients' bone structure and joint stability and their individual characteristics, such as age, weight and level of activity. Rehabilitation after THR is as important as the surgery. Rehabilitation protocols vary with the type of endoprosthesis. There is some controversial evidence about the differences in the surgical approach, the role of the preoperative education and exercises, as well as the implementation of the most efficient rehabilitation protocol. Despite many uncertainties and dilemmas, most studies have shown that majority of patients are satisfied with their arthroplasty results. [ABSTRACT FROM AUTHOR]