Biomedical subjects

I Bojanić

Publications and source records attributed to I Bojanić.

11 recordsLinked to original sources

PubMed2001

[Overuse injury syndromes of the knee].

Overuse injuries are frequent in the knee joint. The reason for this is that the knee joint is engaged in all sports activities. Furthermore, the joint area has numerous attachment points for muscles and tendons and numerous bursae. Another reason is that the specific joint between the patella and femur (patellofemoral joint) constitutes a part of the knee joint. Speaking in general terms, all overuse injuries in the knee joint can be divided in four groups according to the aspect: anterior aspect--patellofemoral pain syndrome, patellar tendinitis (jumper's knee), Osgood-Schlatter disease, Sinding Larson Johanson disease, stress fracture of the patella, fat pad syndrome; medial aspect--plica syndrome, semimembranosus tendinitis, pes anserinus tendinitis (bursitis), breaststroker's knee, medial retinaculitis; lateral aspect--Iliotibial band friction syndrome (runner's knee), Popliteal Tendinitis, Bicipital tendinitis; posterior aspect--fabellitis, medial gastrocnemius strain. There are numerous possible reasons for pain caused by overuse injuries around the knee joint, but two are the most frequent: patellar tendinitis (jumper's knee) and Iliotibial band friction syndrome (runner's knee). This paper gives a brief overview of overuse injuries of the knee joint including their definition, anatomy, aetiology, clinical symptoms and signs, and non-operative and surgical treatment.

Athletic Injuries↗

PubMed2001

[Anterior knee pain associated with sports and work].

Anterior knee pain is not a disease, but a syndrome with numerous causes. This paper describes its appearance in the patellofemoral joint in sportsmen and in untrained people. Chondromalacia patellae is a condition of the cartilage, not a disease, that is, it is never diagnosed alone. Relative muscular insufficiency, especially of the knee extensors, may occur in children and adolescents, as they grow rapidly. The consequence is a unbalance of active stabilizers and the disturbance of the slippery trail of patella, particularly in the presence of dysplasia of patellofemoral joint. The impingement syndrome pain occurs in sportsmen and people overloading the patellofemoral joint. Other causes of anterior knee pain should be excluded in clinical examination and slippery trail of patella, its position, and signs of instability should be determined. This paper gives an overview of patellar chondromalacia, lateral pressure syndrome, patellar subluxation, patellar acute and recurrent luxation, and idiopathic anterior knee pain. The treatment is basically conservative. Stretching exercises and the strengthening of certain groups of femoral muscles serves to regain the balance, thus normalising the slippery trail and taking off the burden from the patellofemoral joint. If conservative treatment fails, surgery is the alternative.

Athletic Injuries↗

PubMed2001

[Stress fractures].

Stress fractures are common overuse injuries, ranging between 1.1% and 3.7% of all athletic injuries. Causes are many and usually involve repetitive submaximal stress. There is a wide research evidence showing that training errors cause stress fractures in as many as 22% to 75% of cases. Intrinsic factors such as hormonal imbalance may also contribute to the onset of stress fractures, especially in women. During medical examination, it is essential always to bear in mind the possibility of stress fracture. Clinical diagnosis is therefore the basic procedure, followed by other diagnostic methods in the following order: radiology, scintigraphy, and MRI. Most stress fractures are uncomplicated and can be managed through rest and restriction from precipitating activities for 4-6 weeks. A subset of stress fractures can present a high risk for progression to complete fracture, delayed union, or nonunion. Specific sites for this type of stress fracture are the femoral neck, the anterior cortex of the tibia, the tarsal navicular, the fifth metatarsal (Jones fracture), and the great toe sesamoids. Therefore, high-risk stress fractures require aggressive treatment, and in some cases even surgical intervention is appropriate.

Athletic Injuries↗

PubMed2001

[Physical procedures in the treatment of overuse injury syndromes of the locomotor system].

As a rule, the treatment of the overuse syndrome in the locomotor's system is non-surgical, and surgical treatment is needed on rare occasions. Non-surgical treatment should start as soon as possible. The first step is to half or modify sports activities. The treatment includes administration of non-steroidal anti-inflammatory drugs, physical therapy, stretching exercises, and the strengthening of affected muscles. The programme should be adapted to the patient, taking into account the localization and the degree of the injury, as well as his/her sport or work-related activities. The RICE therapeutic programme is important in the treatment of overuse syndromes, especially within the first 72 hours from the occurrence of first symptoms, as it shortens the duration of convalescence for as much as 50%-70%. Beside stabilisation of the joint with optimal loading of antagonistic muscles, stretching exercises have the leading position in prevention and treatment of overuse injuries. During rehabilitation, it is necessary to change activity, its duration and intensity. When a person successfully resumes its sports activities with full load, the rehabilitation is considered completed. No surgical or non-surgical method can warrant a hundred percent recovery for any localization of overuse injury. Prevention, education, and close co-operation between the physician, athlete, and the coach is therefore crucial and is receiving increasing attention.

Cumulative Trauma Disorders↗

PubMed1998

Stress fracture of the sixth rib in an elite athlete.

We report on a previously unreported site of rib stress fracture in an elite athlete. A 27 year old sweep rower, a National champion and an Olympic finalist, presented with a 3-day history of the left-side thoracic pain. Technetium 99m bone scintigraphy showed increased focal uptake of the radioisotope, leading to the diagnosis of stress injury of the anterolateral part of the sixth rib. The probable mechanism of this injury was that strong muscle force itself was great enough to produce a fracture. In the case of our rower, the precipitation cause was only a slight change in the rowing technique, in contrast to all other reports on such rib fractures among rowers where the primary cause was an increase in the level of strength training. The treatment included a complete rest of the affected area and upper extremities, while the cardiovascular and strength fitness was maintained. The athlete was able to resume with his standard training routine less than four weeks after the onset of the symptoms.

Adult↗

PubMed1996

Arthroscopic retrieval of metal foreign bodies from the knee joint after war wounds.

From 1991 to 1995 metal bodies were removed from 16 knee joints (in 16 patients) using arthroscopic procedures. In 14 patients the wound resulted from explosive devices and in two from rifle bullets. Nine patients had more than one wound. Arthroscopy was performed on average 8.23 months after the injury took place (ranging from 14 days to 4 years). One metal foreign body was retrieved from 13 patients, two from two and four from one patient. The size of the metal foreign bodies varied from 2 to 24 mm, with an average of 8.61 mm. Different degrees of joint damage were present in all but one patient. The metal bodies were found in the posterolateral angle by the popliteus tendon in four patients, in three of whom the metal bodies went into this position during arthroscopy.

Adult↗

PubMed1993

Musculocutaneous nerve entrapment in the upper arm.

Wasting and weakness of the biceps and brachialis muscles can occur when the musculocutaneous nerve is compressed as it passes through the coracobrachialis muscle; there may also be impairment of sensation on the lateral aspect of the forearm. In our patient, symptoms appeared after strenuous exercise which included more than 500 press-ups each day. Electromyography and telethermic examination confirmed the diagnosis. He was advised to stop his strenuous exercises and within 3 months muscle strength and sensation had returned.

Adult↗

PubMed1992

The natural history of mild idiopathic scoliosis.

The aim of the research was to monitor the natural history of mild idiopathic scoliosis in school children, primarily those with a scoliotic curve lesser than 20 degrees according to Cobb who had been treated by regular observation and sports activities. A total of 97 children, 73 girls and 24 boys, aged between 9 and 14 years were enrolled. All the children were monitored for three years and in this period they were subjected to regular examinations and to at least three X-ray examinations. There were 51 thoracal, 39 thoracolumbar and 7 lumbar cases of scoliosis. After the three year observation period thoracic scoliosis improved in 56.9% of patients, 17.7% showed no change while 25.5% of the cases deteriorated. Nonprogressive thoracolumbar scoliosis was found in 76.9% of the cases, 12.9% showed no change from baseline while in 10.3% curve progression was noticed. Nonprogressive lumbar scoliosis was observed in 4 cases, in 2 cases the condition was unaltered while in 1 case curve progression was noticed. In the whole group there were 18.6% cases of progressive scoliosis. The results of this research have confirmed that regular observation and sports activities are the best methods of treating idiopathic scoliosis with a curve lesser than 20 degrees according to Cobb.

Adolescent↗

PubMedDate not supplied

Stress fractures in figure skaters.

In 1987, during two great skating contests--the Universiade in the Tatra Mountains and the Gold Pirouette in Zagreb--a total of 42 world class skaters were asked through a questionnaire if they had ever in their career suffered from a stress fracture. Of the 42 skaters, 9 had stress fractures. Four stress fractures occurred during preseason training (two fibular, one second metatarsal, and two fourth metatarsal stress fractures). Increased mileage was reported by three skaters and the fourth had done too much speed training on hills. Five stress fractures occurred during the season (one tibial and two tarsal navicular stress fractures and two stress fractures of the base of the fifth metatarsal). In all cases, the fracture occurred in the take-off leg. All of the subjects were competitive figure skaters with a daily training period of 3 to 8 hours, six times a week. The time from the onset of symptoms to definite diagnosis ranged from 2 to 10 weeks. Of the nine injured skaters, eight were treated conservatively and one skater with Jones' fracture was treated surgically. All of the skaters were able to resume a preinjury level of activity 3 to 7 months after treatment began. In conclusion, it may be emphasized that stress fractures in figure skaters are not rare and should, therefore, always be considered as a possibility.

Adolescent↗

PubMedDate not supplied

[The female athlete triad].

This review offers some basic information on a syndrome described in 1992 as the female athlete triad. The increasing participation of women in competitive sports has led to significant accumulation of knowledge about potential pathological conditions due to strenuous exercise. Participation in sports that emphasize specific body image, psychological constitution of young female athletes and significantly lower daily calory intake cause the development of disordered eating, especially anorexia nervosa. Anorexia in combination with intensive training induces menstrual disorders, exercise-associated amenorrhea being the most important one. Low serum estrogen concentrations, as well as insufficient daily calcium intake have negative influence on bone mineral density, and the athletes have greater risk of developing osteoporosis and stress fractures. We described the diagnostic and therapeutic procedures necessary to detect and treat this syndrome. Education of physicians, female athletes and their coaches, as well as the screening during the annual examination, remain the most important measures of prevention.

Amenorrhea↗

PubMedDate not supplied

[Arthroscopy as a diagnostic and surgical method].

The use of the arthroscopic technique has dramatically changed and still does the orthopedic surgery. Arthroscopy has developed as a diagnostic method, particularly in the knee joint. In 1970 the era of surgical arthroscopic procedure has begun, again on the knee joint. The possibilities of surgical arthroscopies of the knee are best described by L. L. Johnson when he said for fun, but today almost true, that practically all surgeries except that of the knee endoprosthesis may be done by means of arthroscopy or, if performed together with it, are much more better. Following arthroscopy in the knee, arthroscopies of other joints of the human body have developed in the same way, first the diagnostic and then the surgical one. Today, arthroscopy is being used even in the temporomandibular joint and those of the spine. However, arthroscopy is currently most usually applied in the knee, shoulder, elbow and upper leg joints. Although arthroscopy means in the literal sense looking into the joints, today it is not limited only to joints. We shall mention arthroscopy of the carpal canal of wrist. With the development of MRI the use of diagnostic arthroscopy will be certainly reduced, but the surgical arthroscopy will be subjected to further developments. The authors report on the experience of the Department of Orthopedics, Medical School University of Zagreb in applying diagnostic and surgical arthroscopies, stressing the basic understandings being significant for general practitioners.

Arthroscopy↗