Bozhinovski, Zoran
Preferred name
Bozhinovski, Zoran
Official Name
Bozhinovski, Zoran
Main Affiliation
Email
zoran.bozhinovski@medf.ukim.edu.mk
17 results
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Item type:Publication, Trochlear dysplasia - congenital anomaly or biomechanical development(National Library of Serbia, 2018); ; ; Introduction. The aim of this study was to investigate the appearance of the trochlear groove in infants and to present the possible causes for the development of trochlear dysplasia as one of the most severe pathologic findings in patients with patellar instability. Material and Methods. Knee ultrasonography was performed in 200 infants, 3 to 6 months of age. The measurements were made at 30 and 60 degrees of knee flexion, in order to measure the trochlear bone and cartilaginous sulcus angle on the patellar surface of the femur and to determine the degree of trochlear dysplasia. A 7-megahertz probe was used for measurements, which was tangentially placed with the reference to the posterior femoral joint. Results. A completely flat trochlear bony sulcus angle was registered in all infants aged 3 to 6 months. The mean cartilaginous sulcus angle was between 149 ? 5.4? and 19 infants had a sulcus angle over 159?. Eleven infants with trochlear dysplasia were in breech presentation at birth. Conclusion. Our study showed that the cartilaginous part of the trochlear groove was already well developed at birth. Breech presentation of the fetus could be a predisposing factor for dysplasia of the cartilaginous part of the trochlear groove. The bony part of the trochlear groove is dysplastic in infants and it gradually gets deeper, later getting a shape of the overlying articular cartilage. The influence of the Delpech law, with lower pressure in the trochlear groove, could be the possible mechanical theory explaining the development of the trochlear dysplasia in the later stage of the childhood. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Severe digital malformations in a rare variant of fibrodysplasia ossificans progressiva(Wiley, 2019-04-22); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Severe digital malformations in a rare variant of fibrodysplasia ossificans progressiva(Wiley-Blackwell, 2019); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Developmental disorders of the hip treated at the clinic for orthopaedic diseases in a period of 10 years(2009-2018)(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2022-05-04); ; Developmental hip dysplasia includes a wide range of conditions such as subluxation, dislocation, hip instability, and teratological hip. The diagnosis was confirmed by clinical examination, ultrasound examination and anterior-posterior view radiograph (AP). Treatment varied depending on the patient's age and the degree of dysplasia: Pavlik harness, closed reduction, open reduction and corrective osteotomies. In this study 242 patients were included, of whom 198 were female patients and 44 male. All of the patients were treated with conservative treatment- closed reducation and spica casting. Left-sided dislocations were more common than right sided dislocations with predominance in the female patients. The main treatment in follow-up patients was closed reduction with or without adductor muscle tenotomy (m. add. longus). In cases with unsuccessful attempt of closed reduction, open reduction was performed with or without adductor muscle tenotomy. Depending on the residual dysplasia, patients were additionally treated with pelvic osteotomies (Salter 's inominate osteotomy), varus derotation osteotomy, valgus osteotomy, proximal femoral resection, and trochanter major transposition. 167 patients were treated with closed reduction and 3 with open reduction. The remaining patients were treated with closed reduction and additional surgery or with open reduction and additional surgery. Out of all treated patients, only 10 patients had recurrent dislocation of the hip, 7 female and 3 male patients. Closed reduction was performed again on two patients, and open reduction of the hip was performed on one patient. The average age of patients was 21.5 months. By presenting the cases in a period of 10 years, it was conclud that most cases were diagnosed later. Also, the standard closed reduction treatment was successful even after the first year in said patients. Depending on the residual dysplasia of the hip, in order to achieve better congruence of the joint, additional surgeries were performed. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Characteristic Diagnostic Clues of Metatropic Dysplasia: The Lumbothoracic Humpback with Dumbbell Appearance of the Long Bones(Walter de Gruyter GmbH, 2018-12); ; Popovski NMetatropic dysplasia (MD) is a rare skeletal dysplasia associated with heterozygous mutations in the TRPV4 gene. We describe a 28-month-old boy with knock-knees referred for metabolic investigation suspected of carrying vitamin D-resistant rickets. He has received regular vitamin D prophylaxis at the usual dose. Laboratory investigations revealed normal values for calcium, phosphorus and alkaline phosphatase. He was short (-3.5 SDS), his mental development was normal, and he started to walk at the age of 22 months. The diagnostic clue for the diagnosis of metatropic dysplasia was the presence of the hump back in the upper lumbar and lower thoracic vertebrae, in addition to a long and narrow chest. An X-ray survey of the skeleton revealed platyspondyly, dysplastic metaphyses with dumbbell appearance of the long bones, kyphoscoliosis, and narrow and elongated thorax with short ribs. This is the first patient with MD in the Republic of Macedonia. Knock-knees were the cause of his referral, as a peculiarity of his phenotype. The very presence of the hump back, and the dumbbell appearance of the long bones distinguished the MD from other bone dysplasias with similar characteristics. We believe that the presence of those two features can shorten the path to accurate diagnosis in the crowded field of overlapping skeletal dysplasias. The diagnosis of MD in this patient was further confirmed by the discovery of the mutation c.2396C>T; p.Pro799Leu (P799L) of the TRPV4 gene. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MENISCAL TEARS(Faculty for Physical Education, 2016); ; ; Meniscus is the most commonly injured structure in the knee joint. Meniscal tear patterns incude vertical tears, oblique, complex and horizontal. Aim: The aim of this study is to present the distribution of different types of meniscal tears diagnosed and treated with arthroscopy. Material and methods: Between 2013 and 2015, at the University clinic for orthopaedic surgery, 137 patients with meniscal tears and averageage of26 t 15yearswerediagnosedandtreatedwitharthroscopy.Results:Out of137patients with meniscal tear, 109 (79.6%) patients had medial meniscal tear and 28 (20.4%) had lateral meniscal tear. Male female ratio was 3:1. Distribution of vertical, oblique, horizontal and complex medial meniscal tear was 16 (14.7%), 83 (76.1%), 6 (5.5%) and 4(3.7%6)respectively. Distribution of vertical (longitudinal and radial), oblique, horizontal and complex lateral meniscal tear was 5 (17.9%), 18 (64.3%), 2 (7.1%) and 3 (10.7%) respectively. Conclusion: Arthroscopy is essential for diagnosis and treatment of meniscal tears. In our study, medial meniscus is more frequently injured than lateral meniscus and horizontal meniscal tears appear less then oblique and vertical meniscal tears. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The Influence of Anterior Cruciate Ligament Remnant on Postoperative Clinical Results in Patients with Remnant Preserving Anterior Cruciate Ligament Reconstruction(Scientific Foundation Spiroski (publications), 2017-08-15); ; ; ; BACKGROUND:Anterior Cruciate Ligament (ACL) remnants have important biomechanical, vascular and proprioceptive function.AIM:To determine the influence of the ACL residual remnants after partial and complete ACL ruptures on postoperative clinical results in patients with remnant preserving ACL reconstruction. PATIENTS AND METHODS:The studyincluded66 patients divided into two groups. In patients from the investigationgroupremnant preserving ACL reconstructionwas performed, in patients from the control group single bundle ACL reconstruction was performed. The results were assessed by Rolimeter measurements, Lysholm and Tegner scores and proprioception evaluation. RESULTS:The mean side-to-side difference of anterior tibia displacement(mm)was improved from 4.4± 1.06 to 0.4± 0.7in the investigation group, andfrom 4.6 ±0.68 to 1.9± 0.64 in the controlgroup (p < 0.001).Difference in the angles in which the knee was placed by the device and the patient has improved from 1.5 ± 0.96° to 0.5 ± 0.53° in theinvestigation group and from 1.8 ± 0.78° to 1.3 ± 0.97° in the control group (p <0.05). Tegner and Lysholm scores showed no difference between the groups.CONCLUSION:Preservation of the ACL residual bundle provides a better knee stability and proprioceptive function.IntroductionArthroscopic reconstruction of the anterior cruciate ligament (ACL) is one of the most commonly performed procedures in orthopedic surgery. Although there is an improvement in surgical techniques there is still graft failure rate of 3% to 12% of the cases [1]. The main factors which have influence on the results after ACL reconstructionscan be separated into two groups: biomechanical and biological [2]. According to the studies [3]in 50 % of the patients with ACL injury, arthroscopic examination carried out prior to ACL reconstruction reveals the presence of ACL residual remnants. In patients with complete ACL rupture these remnants have non anatomic femoral insertion on the intercondylar notch or posterior cruciate ligament (PCL). Sometimes a partial rupture of the anteromedial (AM) or posterolateral (PL) bundle of the ACL canbe observed. In their article [4]Kazusa et al. gave the most detailed classification of the ACL residual remnants. Recently, the importance of the ACL remnant has been recognized in terms of its biomechanical, vascular and proprioceptive functions. The ACL remnantsattached to the lateral wall of the intercondylar notchcontribute to anteroposterior knee - Some of the metrics are blocked by yourconsent settings
Item type:Publication, USAGE OF DIFFERENT TYPES OF ANESTHESIA IN ORTHOPEDIC PATIENTS TREATED WITH DAY CASE SURGERY(MIT University Skopje, 2016); ; ; ; Introduction: Orthopedic patients treated with day case surgery expect rapid recovery, high postoperative satisfaction and low postoperative pain and complications. Aim: The aim of our study is to report the annual frequency of the day case surgeries in our clinic, as well as to point out the types of orthopedics surgical procedures used. Material and methods: Between 2013 and 2015, at the University clinic for orthopedic surgery, patients were selected for day case surgery on hands and feet. Local anesthesia, intravenous regional anesthesia or peripheral nerve blocks were used for different types of operations. Results: In 3 years period, we operated 5124 patients, 1143 of them were treated as day case surgery. We found that our day case surgery rate was 22%. Out of 1143 patients, 657 (57%) were operated under local anesthesia, 237 (21%) with intravenous regional anesthesia and 249 (22%) with peripheral nerve blocks. 645 were females and 498 were males with average age of 47 ± 15 years. The procedures performed under local anesthesia were; 399 (35%) release of carpal tunnel, 171 (15%) release of trigger finger, 84 (7%) release of de Quervain’s and 3 (0.3%) minimal invasive suture of Achilles tendon rupture. Procedures performed with intravenous regional anesthesia were; 156 (14%) excision of fascia palmaris in Dupuytren contracture and 81 (7%) excision of ganglion of the wrist. Operations performed with peripheral nerve blocks were; 171 (15%) correction of hallux valgus deformities and 78 (7%) bunion deformities. Conclusion: The rate of day case surgery in our clinic is low. We use local anesthesia, intravenous regional anesthesia and peripheral nerve blocks for hand and foot operations. Day case surgery can offer a number of advantages for patients; it can minimize the costs, reduces the surgery waiting time and lowers the postoperative complications. - Some of the metrics are blocked by yourconsent settings
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