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Biomedical subjects

N Cicak

Publications and source records attributed to N Cicak.

11 recordsLinked to original sources
PubMed2001

A secure locking knot for microsuturing.

Perfect balance between maximal suture strength and minimal foreign-body reactivity guarantees success, using microsurgical techniques. The proposed initial locking knot allows optimal edge approximation. It has strength, it is simple to master, and is not too bulky. The knot is kept in its first position, without danger of slipping, before securing it with an additional knot of two loops. No additional knots are necessary, because the completed knot may fail by breaking, but never by slippage.

Humans↗
PubMed2001

Treatment of defect pseudoarthroses with bone segment transport.

PURPOSE OF THE STUDY: The most severe injuries during defense war in Croatia were caused by projectiles of high kinetic energy. Shell fragments bone they break the bone, transferring bone segments into additional individual projectiles. During this process periostal and endomedullary circulation is cut off reducing to a minimum the possibility of healing, leading to defects in long bone diaphyses. These are referred to as defect pseudoarthroses and are among the most difficult problems in reconstructive surgery of the musculo-articular system. This article presents bone segment transport as a method of choice for treating defect pseudoarthrosis. MATERIAL: During the defense Croatian war, in six-years period, 62 wounded persons were treated with Ilizarov method of bone segment transport. Among them, only one was female. Average age was 33 years. METHODS: The authors performed modified Ilizarov's method as standard procedure for bone segment transport in treatment of defect pseudoarthroses. After all soft tissues are held, corticotomy in metaphysis is performed and free bone segment transport started with Ilizarov method. Physical therapy provided adequate mechanical load, essential for bone healing and restoring the functionality of injured extremity. RESULTS: In the group of treated patients, the largest bridged defect was 20 cm, and the smallest one was only 1 cm. Infection arises in 20 of 60 patients. Contracture complications were ankle contractures, knee contractures and one elbow contracture. We also found one n. peroneus palsy and one limb amputation should be performed. DISCUSSION: Ilizarov method of bone segment transport presents the only procedure that could successfully and completely treat pseudarthroses, thus avoiding necessaries for limb amputations. Requirements in this procedure are experienced and highly qualified surgical team and high motivation and compliance of the patient.

Adolescent↗
PubMed2001

[Overuse injury syndromes in the shoulder area].

The shoulder is the most movable and the most unstable joint in a human body. The glenohumeral joint is particularly vulnerable because overhead activities put tremendous stress on its static stabilizers (ligamentous labral complex) and the dynamic stabilizers (rotator cuff muscles). Overhead activities may stretch or injure the static stabilizers. Minor aberrations in mechanisms controlling stability have a significant and cumulative effect on the shoulder biomechanics, and increase the risk of injury. Impingement syndrome and glenohumeral instability are predominant injuries affecting the shoulder.

Biomechanical Phenomena↗
PubMed1999

Arthroscopic Bankart repair with extracapsular and extra-articular knot using the Mitek suture anchor.

The recurrence of instability after arthroscopic stabilization has been significantly higher than after open repair. One of the reasons for the high failure rate is the inability of arthroscopic repairs to address the plastic deformity of the capsule that occurs in the glenohumeral ligament-labrum complex. The arthroscopic technique is used to repair the torn labrum to the glenoid, but without adequate tightening of the anterior capsule, which is successfully accomplished with an open technique. This report describes the new technique of arthroscopic Bankart repair with extracapsular and extra-articular knot using suture anchors that allows tightening of the anterior capsule sufficiently as with an open Bankart procedure.

Arthroscopy↗
PubMed1999

Arthroplasty after war injuries to major joints.

From 1992 to 1995, replacement of the joint with an endoprosthesis after serious wounding and major destruction of joint elements was performed in 10 soldiers. Arthroplasty was performed on five knees, three hips, and two shoulders. The age range of the wounded soldiers was 22 to 55 years (mean, 37.7 years). Six soldiers suffered explosive injuries, and 4 were injured by gunfire. Time elapsed from the moment of wounding to the time of total joint replacement was 9 to 42 months. We decided on arthroplasty as the preferred treatment because of the presence of strong contractures and very painful movement. In 8 patients, the results of the treatment, based on a follow-up time of 36 to 48 months, were good. In 2 patients, early septic arthritis developed after arthroplasty of the knee with concomitant loosening of the endoprosthesis. Staphylococcus aureus was detected in both patients. In those 2 patients, therefore, arthrodesis of the knee with external fixation was performed.

Adult↗
PubMed1999

[Humero-scapular periarthritis--a diagnosis which does not need to be used].

The periarthritis humeroscapularis (PHS) diagnosis has been used for over a century. In our country, the term PHS is customary and unavoidable in everyday practice. It has been used by everyone, from general practitioners to specialists--physiatrists, radiologists, and orthopaedists. The purpose of this study is to show the inappropriateness of the PHS diagnosis and to point to other clinical conditions with a clear anatomical structure and adequate treatment method.

Diagnosis, Differential↗
PubMed1998

Hill-Sachs lesion in recurrent shoulder dislocation: sonographic detection.

In a prospective study 61 patients with recurrent anterior shoulder dislocation were evaluated by sonography, radiography, and surgery to determine the value of sonography in the detection of a HillSachs lesion. The group consisted of 57 male and four female patients with an average age of 27 years. Hill-Sachs lesion was found in 54 (88%) shoulders of the 61 surgically treated patients. Using surgical findings as the gold standard, we found sonography to be 96% (52 of 54 cases) sensitive, 100% specific (seven of seven cases), and 97% (59 of 61 cases) accurate in the diagnosis of HillSachs lesion. The average size of the lesion measured by sonography was 19.2 mm long, 16.0 mm wide, and 4.1 mm deep. The lesion was of small or medium size (up to 6 mm deep) in 88% of patients. Results of our study show that sonography is a valuable imaging technique in the diagnosis of Hill-Sachs lesion. It produced only two false-negative results when compared with surgical findings.

Adolescent↗
PubMed1995

Idiopathic osteonecrosis of the humeral head.

According to the frequency of occurrence, osteonecrosis of the humeral head ranks immediately after osteonecrosis of the femoral head. Experimental and clinical studies have indicated one or more mechanisms acting alone or in combination and causing necrosis of the bone. Rare cases in which the cause of osteonecrosis remains unknown, are referred to as the idiopathic form of humeral head osteonecrosis. The authors discuss the most recent advances in the etiopathogenesis of osteonecrosis, classification of humeral head osteonecrosis, and the methods of treatment. Three patients are described: two suffering from the idiopathic form and one with osteonecrosis of the humeral head related to an unidentified process affecting the condyles of the knee and both calcanei, and characterized by condensation of the bone.

Humans↗
PubMed1992

Ultrasonographic guidance of needle placement for shoulder arthrography.

We describe a technique using high resolution ultrasonography for needle placement for shoulder arthrography employing the posterior approach, which to our knowledge has not been reported previously. Twenty-four patients with clinical suspicion of rotator cuff lesion underwent shoulder arthrography under sonographic control. Patients ranged in age from 26 to 72 years (mean, 57 years). Accuracy of the needle placement using this technique was 100%. There were no injuries to adjacent structures and no extravasation outside the joint. Although fluoroscopic control of needle placement during shoulder arthrography is the technique of choice, sonographic control using the posterior approach may be useful in certain situations (e.g., if the patient is concerned about radiation dose or if there is soft tissue injury at the anterior of the shoulder.

Adult↗
PubMed1988

Talc granulomatosis in the rat: the relationship between osteoblast insufficiency and adjacent bone marrow hyperplasia.

Bone loss in talc granulomatosis is paralleled by hyperplasia of bone marrow in the rat. To test the hypothetical relation between those two phenomena, bone matrix osteoinduction was employed as a model in which bone formation and bone marrow appearance are separated in time. Implantation of demineralized bone matrix to normal rats was followed by three talc injections (one weekly), starting 1 week after matrix implantation. Implants of demineralized bone and [3H]thymidine-labeled tibial metaphyses from talc-injected and normal rats were analyzed histologically and evaluated for alkaline and tartrate-resistant acid phosphatase activity on days 7, 14, 21, and 30 after matrix implantation. Analysis of tibial autoradiographs showed a marked growth arrest and bone marrow hyperplasia in talc-injected rats 7 days after first talc injection. Alkaline phosphatase activity in homogenates of bone implants was low in talc-injected rats on day 14 after implantation. Moreover, histology of the bone implants showed numerical and functional inhibition of osteoblasts on the same day, causing marked growth delay. Bone marrow appeared as late as day 21 after bone matrix implantation. We conclude that hyperplasia of the adjacent bone marrow is not the cause of bone loss in talc granulomatosis, but rather its compensatory consequence.

Animals↗