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    The effect of the ankle syndesmosis reduction quality on the short-term functional outcome following ankle fractures
    (Elsevier BV, 2021-09)
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    Bakota, Bore
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    Arsovski, Oliver
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    A few radiographic techniques have been proposed to evaluate ankle syndesmosis reduction. The purpose of this study was to analyze post-operatively with CT-scanning the quality of ankle syndesmotic reduction. Moreover, to assess the impact of quality of syndesmotic reduction to functional outcome.
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    Results of Arthroscopic Treatment of Chronic Patellar Tendinopathy
    (Walter de Gruyter GmbH, 2020-09)
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    Background: The surgical treatment of chronic patellar tendinopathy could be open or arthroscopic. A general agreement on the best surgical treatment option is still lacking. Purpose: The aim of our study was to evaluate the clinical results after a minimally invasive arthroscopic treatment of chronic patellar tendinopathy including a resection of the lower patellar pole. Methods: The study included 14 patients with a mean age of 26 years and chronic patellar tendinopathy refractory to non-operative treatment of more than 6 months. All patients underwent arthroscopic debridement of the adipose tissue of the Hoffa’s body posterior to the patellar tendon, debridement of abnormal patellar tendon and resection of the lower patellar pole. Preoperative and postoperative evaluation was undertaken using clinical examination, magnetic resonance imaging (MRI) and the Lysholm and Victorian Institute of Sport Assessment-Patella (VISA-P) scores. Return to sports and postoperative complications were also assessed. The mean follow-up was 12.2 ± 0.9 months. Results: All 14 patients continued with sport activities, but only 12 of them (85.7%) achieved their pre symptom sporting level. The median time to return to preinjury level of activity was 3.9 ± 0.8 months. Patients showed a major improvement in the mean Lysholm score from 51.1 ± 3.8 to 93.4 ± 4.2 (p=0.001) and in the mean VISA-P score from 42.1 ± 3.5 to 86.7 ± 8.4 (p=0.001) There were no postoperative complications. Conclusion: We found that this arthroscopic technique gives reduced morbidity and satisfactory outcome resulting in significantly faster recovery and return to sports in patients with chronic patellar tendinopathy.
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    Лимитирана калибрирана интрамедуларна фиксација во третманот на отворените скршеници на дијафизата на тибијата
    (Македонско здружение на ортопеди и травматолози = Macedonian Association of orthopedics and traumatology, 2006-08)
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    Ј. Савески
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    Item type:Publication,
    Percutaneous Screw Fixation of Distal Tibia Fractures – Functional Results in Sixteen Patients
    (Scientific Foundation SPIROSKI, 2014-06-15)
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    Arsovski, Oliver
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    <jats:p>INTRODUCTION: An important feature of distal tibia fractures is the relevance of the soft tissue coverage. In order to maintain good functional outcome, several operative techniques have been established. Among them, percutaneous screw fixation has the advantage of causing less biological damage of the soft tissues with lower rates of complications.MATERIAL AND METHODS: We reviewed 16 patients with distal tibia fracture. Operative treatment consisted of indirect reduction and percutaneous fixation of the tibia followed by cast immobilization for approximately 3-4 months. Minimum follow up period was 12 months. Functional outcome was evaluated using Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society ankle-hindfoot score (AOFAS).RESULTS: Twelve out of 16 fractures healed within 6 months of the injury. In 3 cases, delayed union was evident, but the fractures healed in less than nine months. There was one case of malunion, two cases of superficial skin infections, two cases of DVT and two cases of gross swelling. According to OMAS score, the functional result was excellent in 7 (43.75%), good in 5 (31.25%) and fair in 4 (25%) patients.CONCLUSION: Percutaneous screw fixation can be a safe and effective method for operative treatment of distal tibia fractures.</jats:p>
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    Fate of the syndesmotic screw--Search for a prudent solution
    (Elsevier BV, 2015-11)
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    Bakota, Bore
    Ankle fractures are common injuries. Since the recognition of the importance of syndesmotic injury in ankle fractures, much of the scientific work has been focused on concomitant syndesmotic injury. Despite the invention of novel devices for restoration and maintenance of the congruent syndesmosis following syndesmotic injury, the metallic syndesmotic screw is still considered to be the "gold standard". The aim of this study was to compare the clinical results in patients who retained the syndesmosis screw with those in whom the screw was removed following open reduction and internal fixation of the malleolar fracture associated with syndesmosis disruption.
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    Evaluation of functional and radiologic outcome after conservative treatment of distal radius fractures
    (Macedonian Association of Anatomists and Morphologists, 2011)
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    Our experiences in the treatment of open fractures of the tibia diaphragm of grade III with an external fixator
    (Македонско лекарско друштво = Macedonian medical association, 2004)
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    Saveski J
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    IMPLEMENTATION OF FOCUSED ASSESSMENT WITH ULTRASONOGRAPHY IN TRAUMA PATIENTS IN UNIVERSITY SURGICAL EMERGENCY DEPARTMENT
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University in Skopje, R.N.Macedonia, 2023)
    Brzanov, Nikola
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    Introduction: This article discusses the importance of trauma assessment in healthcare settings and the role of focused assessment with sonography in trauma (FAST) scans as a diagnostic tool. Trauma remains a significant health concern worldwide, leading to high mortality and morbidity rates, particularly in the younger population. Identifying risk factors for death is crucial for improving trauma patient’s outcomes. Objective: The objective of the study is to implement FAST assessments in an inner-city emergency department and examine their impact on the treatment of adult trauma patients. Material and Methods: The study took place in an urban trauma center and included patients over 18 years old who were presented with trauma, excluding pregnant females, unstable patients and those without consent. FAST scans were performed using ultrasound machines, assessing various abdominal and thoracic views. Results: The results revealed a high sensitivity of 94.4% and a specificity of 85.71% for FAST scans, making them a valuable tool for detecting abdominal free fluid in trauma patients. The most of trauma patients in the study were men aged between 25 and 55, with falls, traffic accidents and assaults being the primary causes of blunt trauma. Commonly affected organs included the lungs, liver and spleen. FAST scans were found to be particularly useful for hypotensive patients, helping in triage decisions. While FAST scans demonstrated high sensitivity and specificity, the study suggests that patients with negative results should be observed and may benefit from follow-up scans, as small amounts of free fluid can be challenging to detect. Conclusion: In conclusion, FAST scanning offers several advantages as a diagnostic tool for trauma assessment including its accessibility, affordability, repeatability, noninvasiveness and quick setup. It complements traditional methods like CT scans, especially in cases of hypotensive patients. Despite their limitations, FAST scans play a significant role in improving the management of trauma patients, helping healthcare professionals to make informed decisions about patients’ care. To fully investigate the potential of FAST scans in trauma situations, additional research is required.
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    Surgical treatment of AO/OTA 31 A1, A2, A3 proximal femoral fractures and functional outcome in patients 6 months after surgery
    (Medical faculty, Ss Cyril and Methodius University in Skopje, 2020)
    Gavrilovski A
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    Illie RMM
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    Todorova T
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    Item type:Publication,
    The Ilioinguinal Approach versus the Anterior Intrapelvic Approach to the Acetabulum: A Review
    (Scientific Foundation SPIROSKI, 2013-12-15)
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    Kaftandziev, Igor
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    Nikolov, Ljupco
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    <jats:p>The ilioinguinal approach (IIA) to the acetabulum has been used as a golden standard for fifty years to treat “anterior†acetabular fractures. Since its introduction by Hirvensalo and Cole, the anterior intrapelvic approach (AIPA) has been adopted by some surgeons, whilst others remain devoted to the IIA. IIA is routinely used in the Republic of Macedonia. The aim of this study is to present a review of literature for two different anterior approaches for the treatment of acetabular fractures used in modern day surgery, focussing on AIPA and its priorities and comparing it to IIA.We performed a search, mainly electronically, and retrospective analysis of existing literature. We have identified and selected two representative and well-systematized papers for IIA, and six for AIPA. We presented the advantages and disadvantages, priorities and weaknesses of both approaches separately, comparing complications, risks and results. Based on the facts presented regarding the advantages of AIPA with a focus on visualization, accessibility and biomechanical justification, the approach should be implemented in our everyday practice and we are comfortable in stating this preference, especially due to the fact that upon comparison of the complication rate there is no significant difference between the two approaches.</jats:p>