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Medial subtalar dislocation: Case report
Manojlovi? Radovan,Star?evi? Branislav,Tabakovi? Dejan,TuliGoran
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1004252m
Abstract: Introduction. Subtalar dislocation (SI) is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.
Forearm reconstruction after loss of radius: Case report
Manojlovi? Radovan,TuliGoran,Kadija Marko,Vu?eti? ?edomir
Srpski Arhiv za Celokupno Lekarstvo , 2013, DOI: 10.2298/sarh1302100m
Abstract: Introduction. Osteomyelitis of the radius resulting in the radial clubhand is a very rare condition and few studies have been published about its prognosis and treatment. Case Outline. This is a case report of hematogenous osteomyelitis of the radius with a complete loss of the radius leaving only the distal radial metaphysis to carry the carpus. In order to achieve best functional results, four-step operative protocol was performed for reconstruction; lengthening of the forearm by external fixator, radioulnar transposition to create a one-bone forearm, plate removal and transposition of brachioradialis to the extensor pollicis longus as well as proximal row carpectomy. After nine years of the last operation, the function of the elbow and hands is good with acceptable cosmetic result. The forearm is 5 cm shorter and there has been a persistent mild limitation of palmar flexion. Conclusion. Creation of the one-bone forearm normalizes the elbow and wrist function, corrects forearm malalignment, and improves forearm growth potential.
The treatment of subtrochanteric fractures
Vu?eti? ?edomir S.,Duli? Borislav V.,Vuka?inovi? Zoran S.,TuliGoran D?.
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1108540v
Abstract: Subtrochanteric fractures of the femur have a special place because of a significant number of complications following treatment. Powerful loading forces asymmetrically acting to this bone segment, as well as poor vascularization interfere with bone union. There are basically two current approaches in the fixation of subtrochanteric fractures; the first involves a plate with a compression screw and another one is intramedullary (IM) nail, with two options: centromedullary (standard interlocking femoral nail) and cephalomedullary femoral nail with two modifications, reconstructive and trochanteric. All IM nails may be used by open technique or closed minimal invasive method. IM nailing is favoured in view of a shorter operative time, shorter hospitalisation and complications. Indirect fracture reduction and knowledge of biology of bone fracture may result in full success without any bone graft.
Legal aspects of medical errors
Vu?eti? ?edomir S.,Vuka?inovi? Zoran S.,TuliGoran D?.,Duli? Borivoje V.
Acta Chirurgica Iugoslavica , 2011, DOI: 10.2298/aci1101107v
Abstract: Healing people and medical care are together highly organized technological system with significant expert, ethical and legal regulative. Taking medical care is very sensitive area and it interfears deep into one’s integrity, so the law is necessary in this area as a regulator. The aim of work is to show medical errors from legal aspects and clinical practice. Errors, negligent conduct during the medical treatment and bad results of medical treatment are categories that can easily be switched or can sublime themselves into the same thing. That is why correct differentiation of medical errors and viewing every way of medical errors appearance is necessary.
Missed opportunities for prevention of hip fracture in older patients
Dubljanin-Raspopovi? Emilija,Deni?-Markovi? Ljiljana,TuliGoran,Graji? Mirko
Vojnosanitetski Pregled , 2012, DOI: 10.2298/vsp1205420d
Abstract: Background/Aim. Osteoporotic fractures are a major cause of morbidity in the population. Therefore, fracture prevention strategies should be a major concern, and one of the priorities in the primary health care system. The aim of the study was to assess fracture and fall risk factors, and fracture risk level in patients with acute hip fracture, and to evaluate if there had been adequate osteoporosis treatment prior to fracture in this group of patients. Methods. Fracture and fall risk factors were assessed in 342 patients, ≥ 65 years old, hospitalized due to acute hip fracture at the Clinic for Orthopedic Surgery and Traumatology, Clinical Centre of Serbia in a 12-month period. Fall risk factors were assessed with the Fracture Risk Assessment (FRAX ) algorithm, and patients were classified in respect to fracture risk level. Results. Hip fracture occurred in the majority of the patients in the high risk group (74.2%), where no additional bone mineral density testing was needed. Less than 10% of the patients had a diagnosis of osteoporosis before injury, while less than 2% were treated. Cognitive impairment (95.3%), visual impairment (58.2%), lower index of daily activities (51.8%), and depression (47.1%) were the most frequently observed fall risk factors. Conclusion. The results of our investigation reveal insufficient identification of clinical fracture risk factors in the primary care setting, inadequate treatment of osteoporosis and, consequently, ineffective prevention of hip fractures in the geriatric population. The introduction of FRAX into clinical practice enables more effective acknowledgment of patients with elevated fracture risk, even if bone density measurement is not available. The results of this study have a special significance for everyday clinical practice, because they impose a need for reviewing the existing approaches to osteoporosis prevention, and precise definiment of hip prevention strategies.
The Basis of Distinction Between Qualitative and Quantitative Research in Social Science: Reflection on Ontological, Epistemological and Methodological Perspectives
F Tuli
Ethiopian Journal of Education and Sciences , 2011,
Abstract: This article examines methodological issues associated with qualitative and quantitative research. In doing this, I briefly begin by outlining the philosophical and conceptual framework that informed the two research methodologies and discusses how ontological and epistemological issues were translated in to specific methodological strategies and influence researchers methodological decision. My purpose in writing this article is not to promote one methodology over the other rather to describe and reflect on the differences between the two research methodologies from Ontological, Epistemological and Methodological Perspectives and how they will be selected for research.
Understanding Undergraduate Students Practicum Experience: A Qualitative Case Study Of Jimma University
F Tuli
Ethiopian Journal of Education and Sciences , 2010,
Abstract: The purpose of this study was to examine the pre-service teachers’ perspectives of practicum experience as a tool of learning to teach by using qualitative research methods. Data were collected through interview from twenty four purposively selected information rich participants’ ranging in diversity. The data were analyzed thematically by using verbatim quotes. The findings indicated that the participants perceived practicum as an important tool of learning to teach because it promoted the development of teaching experience and prepared them for the real world of work. The analysis revealed that theory practice connection, competency and confidence development and socialization as a successful experience of the practicum program and inadequate budget, assessment centered experience, inadequate support and secondary school student misbehavior as the most stressful experience of student teacher practicum experience. Finally, the finding indicated that provision of adequate fund, close supervision of the program, building strong partnership with the schools are what the participant thought could be improved and given due attention. The need to provide adequate support, rethinking assessment mechanism, provision of adequate fund, strengthening university-school partnership and close supervision are, thus, found to be the dimensions identified as points that need interventions.
Education for Sustainable Development: A Global Agenda for the 21st Century
F Tuli
Ethiopian Journal of Education and Sciences , 2009,
Abstract: It is beyond the shadow of doubt that the environment is endangering the very survival of the human being and the living thing in general by showing its various manifestation and adverse facets in the form of extremity of climatic condition and others because of our (human) action to the environment. In response to this, there is a growing body of literature which argues that the problem should be approached with education. Therefore, this review paper describes briefly the environmental problem, sustainable development and the role that education play in combating the environmental problem by linking education with sustainable development.
The art of retirement for orthopedic surgeons
Tuli Surendra
Indian Journal of Orthopaedics , 2009,
TKS-The gentle molder
Tuli Surendar
Indian Journal of Orthopaedics , 2008,
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