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  1. AU="Dino Papeš"
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  1. Article ; Online: Intermittent claudications of the hand after supracondylar humeral fracture in a 2-year old boy

    Nora Knez / Karmen Jeričević / Luka Kelčec / Tomislav Vlahek / Dino Papeš

    Liječnički vjesnik, Vol 145, Iss Supp 2, Pp 56-

    2023  Volume 56

    Abstract: Supracondylar humeral fractures (SHF) are the most common fractures associated with concomitant neurovascular injuries in children. Pink pulseless hand (PPH) labels SHF presenting without a pulse in a wellperfused hand. Management of PPH after successful ...

    Abstract Supracondylar humeral fractures (SHF) are the most common fractures associated with concomitant neurovascular injuries in children. Pink pulseless hand (PPH) labels SHF presenting without a pulse in a wellperfused hand. Management of PPH after successful SHF reduction remains controversial. Some advocate „watchful waiting”, whereas others favor early exploration. We present a case of a 2-year-old boy with PPH and intermittent claudications 6 weeks after successful SHF reduction.
    Keywords brachial artery ; children ; neurovascular injuries ; supracondylar humeral fracture ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher Hrvatski liječnički zbor
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Mechanisms of humeral fractures in Zagreb children

    Anko Antabak / Tomislav Vlahek / Dino Papeš / Tomislav Đapić / Krešimir Bulić / Tomislav Luetić

    Liječnički vjesnik, Vol 143, Iss 5-6, Pp 174-

    2021  Volume 180

    Abstract: Humeral fractures in children are very common. In most cases hospital treatment is necessary, with complications and poor outcome sometimes occurring. To reduce the incidence of humeral fractures, it is necessary to know the mechanisms of injury and ... ...

    Abstract Humeral fractures in children are very common. In most cases hospital treatment is necessary, with complications and poor outcome sometimes occurring. To reduce the incidence of humeral fractures, it is necessary to know the mechanisms of injury and circumstances in which they occur. The aim of this paper is to analyze activities and locations related to humeral fracture occurrences. The paper analyzed 243 children treated at the University Hospital Center Zagreb for fractures of the upper arm in the period from 2015 to 2019. There were 143 (58.8%) boys and 100 (41.2%) girls. Mean age was 7.5 years (boys 7.9, girls seven years). Most children, 147 (60.5%) of them, were between ages five and nine. Left-sided fractures were more common (62%). Of 243 humeral fractures, 22 (9%) were proximal fractures, five (2%) were shaft fractures, and 216 (88%) were located in the distal humerus. Hospitalization was required in 223 patients (91.8%). Associated nerve injuries were present in 29 (12%) patients (ulnar nerve 6%, median nerve 3%, radial nerve 3%). The fractures were caused by falling in 224 patients (92.2%), traffic accident in five patients (2.1%), and direct blow in three patients (1.2%). Of same level falls, 22.4% were falls of bicycle and 13% occurred while playing football. Falls of bicycle were most common in children between ages five and nine (60%). Falls from height mostly occur from swing, slide and rampoline (60%), with falls from slide and trampoline being more common in pre-school children, and falls from swing occurring in all age groups. Injuries occurred at home in 26.7% of patients, on sports/recreation grounds in 28.8%, at school in 14.4%, and in traffic in 14% of children. The most common causes of injury were same level falls (from bicycle and during football), and falls from height (swing, slide, and trampoline).
    Keywords humeral fractures – epidemiology ; etiology ; accidental falls – statistics and numerical data ; athletic injuries – epidemiology ; accidents ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher Hrvatski liječnički zbor
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation

    Anko Antabak / Dino Papeš / Krešimir Bulić / Ivo Sjekavica / Ivana Jurca / Dražen Perkov / Tomislav Luetić

    Liječnički vjesnik, Vol 143, Iss 3-4, Pp 108-

    2021  Volume 112

    Abstract: Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of ... ...

    Abstract Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of renal injuries. They usually manifest as prolonged or intermittent secondary hematuria, but may be asymptomatic as well. Watchful waiting is the initial treatment, and around one third of patients eventually require active surgical or endovascular treatment. The two main endovascular coil embolisation methods are the “sandwich” and the “coil packing” technique, but occlusion using a stent is also possible. Traumatic prolonged hematuria caused by pseudoaneurysm of the renal segmental arterial branch, and the methods of treatment are rarely reported, especially in children. This report presents a boy in whom a blunt kidney injury lead to the formation of a pseudoaneurysm of the renal segmental arterial branch, causing prolonged hematuria. The patient was treated by endovascular embolisation through the right femoral artery, in local anesthesia and conscious sedation. A 2.7 Fr microcatheter was used to selectively enter the dominant cranial renal artery and show the pseudoaneurysm of a segmental interlobar arterial branch. A 2×4 mm coil was used to occlude the segmental interlobar arterial branch and pseudoaneurysm, with no post-procedural bleeding or significant renal segmental ischemia. Endovascular treatment offers advantages over open surgery, but has certain drawbacks as well, such as high radiation and contrast exposure. In the last few years, a minimally invasive robotic surgical procedure has been described for the treatment of intra-renal pseudoanurysm. The current worldwide trend in pediatric renal injuries treatment is the reduction in the number of nephrectomies, and a shift to non-operative and minimally invasive treatment, including endovascular procedures. University Hospital Centre Zagreb has all the specialities and capacities required for surgical and ...
    Keywords hematuria – etiology ; wounds ; nonpenetrating – complications ; kidney – injuries ; aneurysm ; false – etiology ; therapy ; renal artetry – injuries ; embolization ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher Hrvatski liječnički zbor
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Initial results of microsurgical varicocele treatment in boys and adolescents

    Dino Papeš / Stanko Ćavar / Ivana Sabolić / Miram Pasini / Ivana Jurca / Anko Antabak / Tomislav Vlahek / Aida Dalipi / Ivan Jelčić / Dora Škrljak Šoša / Tomislav Luetić

    Liječnički vjesnik, Vol 145, Iss 1-2, Pp 18-

    2023  Volume 26

    Abstract: Aim: To describe the surgical technique and present outcomes of the first 20 boys and adolescents that underwent microsurgical varicocelectomy at the Department of pediatric surgery, University Hospital Center Zagreb. According to the literature data, ... ...

    Abstract Aim: To describe the surgical technique and present outcomes of the first 20 boys and adolescents that underwent microsurgical varicocelectomy at the Department of pediatric surgery, University Hospital Center Zagreb. According to the literature data, this method has the lowest incidence of recurrence and complications. Patients and Methods: Indications for microsurgical varicocelectomy are the same as for other methods of varicocele treatment: presence of symptoms, testicular hypotrophy (affected testicle smaller >20% in volume compared to the contralateral testicle), or abnormal semen analysis in adolescent that reached the final (Tanner 5) stage of pubertal development. The diagnoses of varicocele and testicular hypotrophy were established by clinical examination, ultrasound volumetry and Doppler examination. The surgery was done through a 3–4 cm incision above the external inguinal ring. The patients were followed prospectively, with an average follow-up of 10 months (range 6–12 months). Results: Average surgery duration was 65 minutes. All patients were discharged within 24 hours after surgery, and returned to all preoperative activities within two weeks postoperatively. No recurrences were noted during follow-up, symptoms resolved in all patients operated for symptomatic varicocele, and sperm count normalized in all patients that underwent surgery for abnormal semen analysis. Regarding complications, one patient reported a transitory discomfort during ejaculation. In one patient the testicular artery was inadvertently ligated during surgery, but was immediately reconstructed with an end-to-end anastomosis. Control Doppler examinations of the spermatic cord showed a patent anastomosis with normal flow. Conclusion: Microsurgical varicocelectomy is a safe method for varicocele treatment with a high success rate and low incidence of complications.
    Keywords varicocele – complications ; diagnosis ; surgery ; microsurgery – methods ; urologic surgical procedures ; male – methods ; testis – pathology ; semen analysis ; dna fragmentacija ; infertility ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Hrvatski liječnički zbor
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Treatment of Pediatric Femoral Fractures in the City of Zagreb

    Anko Antabak / Nikolina Boršćak / Marija Čagalj / Renato Ivelj / Igor Bumči / Dino Papeš / Stanko Ćavar / Marko Bogović / Krešimir Bulić / Tomislav Luetić

    Acta Clinica Croatica, Vol 59., Iss 4., Pp 686-

    2020  Volume 694

    Abstract: Femur fractures in children can be treated with a number of operative and conservative methods. Numerous factors determine which method is optimal for a specific fracture. The aim of this research was to analyze distribution of femur fractures in ... ...

    Abstract Femur fractures in children can be treated with a number of operative and conservative methods. Numerous factors determine which method is optimal for a specific fracture. The aim of this research was to analyze distribution of femur fractures in children living in the urban communities of Zagreb and Zagreb County by localization, type and frequency of treatment methods used according to age and fracture mechanism. The research included 103 children aged up to 18 years, treated for femur fractures at the Zagreb University Hospital Centre and Zagreb Children’s Hospital. Data were collected from these institutions and a retrospective study covered the 2010-2015 period. The cause of fracture and diagnosis were coded with the help of the International Statistical Classification of Diseases and Related Health Problems. Operative treatment was applied in 55% of cases, which is contrary to previous researches. The highest incidence of femur fractures was recorded in the 0- to 4-year age groups, accounting for 49.1% of all fractures. These fractures mostly occurred due to falls and were more often treated with non-operative methods. All other age groups were mostly treated with operative methods. Coxofemoral immobilization and traction were used as non-operative methods, whereas flexible intramedullary nailing was the most frequently used operative method. The treatment depended on age, complexity of the fracture, fracture type, fragment displacement, and associated injuries. The cause was also an important factor on choosing the treatment method. Nonoperative treatment was mostly used for fractures caused by falls (64.71% of cases due to falls) and operative treatment was mostly used for fractures caused by traffic accidents (79.4% of cases due to traffic accidents). It is a wide-known opinion that the best treatment for femur fractures in children is non-operative treatment. However, recent studies have shown that the use of operative methods in femur fracture treatment is growing. Our cohort of children treated during a five-year period (2010- 2015) also underwent operative treatment more often than non-operative one. Two non-operative and eight operative methods were used. With such a large number of methods, it is clear that there is no unique method for all fractures. However, it is clear that the trend of using operative treatment is connected to the perennial trend of considerable sociodemographic and socioeconomic changes in urban settings such as Zagreb. Lifestyle changes directly affect the prevalence of femur fractures among children, as well as approach to treatment choice. General opinion is that most of fractures that occur at an early age can be treated with non-operative methods. Our research on femur fractures in children confirmed this rule. The youngest age group that had the highest incidence of fractures (49.1% of all fractures) was treated with non-operative methods in 75% of cases. Operative methods prevailed in other age groups. Similar results have been published by other authors. In conclusion, nearly half of all femur fractures (49.1%) occurred at a young age (0-4 years). Diaphysis fractures were most common. Most of the fractures that occurred during the 2010-2015 period were treated with operative methods, mostly in children aged 5-9 years. Out of eight different operative methods, elastic stable intramedullary osteosynthesis was most frequently used (60%). Coxofemoral immobilization and traction were used as non-operative methods.
    Keywords Femur ; Fracture ; Child ; Treatment ; Medicine ; R
    Subject code 630
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Results of Clavicle Fracture Treatment in Children

    Anko Antabak / Nikša Matković / Lana Stanić / Judith Adrianne Deutsch / Dino Papeš / Robert Karlo / Ivan Romić / Nino Fuchs / Tomislav Luetić

    Acta Clinica Croatica, Vol 54., Iss 3., Pp 345-

    2015  Volume 350

    Abstract: Treatment of clavicle fracture is principally outpatient. Operative treatment is accompanied by the need for more x-rays and possible complications. Fractures with absolute indications for operative treatment occur only sporadically and these indications ...

    Abstract Treatment of clavicle fracture is principally outpatient. Operative treatment is accompanied by the need for more x-rays and possible complications. Fractures with absolute indications for operative treatment occur only sporadically and these indications are relatively clear, but children often undergo surgery because of relative indications (shortening, fragment displacement, multifragmentary fractures), which are open to debate. In a retrospective study on 256 children, of 44 (17%) patients that received operative treatment only one 17-year-old boy had an absolute indication for surgical intervention. Other indications were fragment distraction (22 mm on average), age, associated injuries, and multifragmentary fracture. The placement of K-wire of appropriate thickness is often difficult, since the wire tends to bend and break, and patients have to undergo two additional operations of plate and screw fixation and later removal. In this retrospective study, we considered the advantages of using titanium or an elastic steel pin. All patients had favorable outcome, although some experienced numbness around the operation scar (4.5%), skin infections around the wire (15%), and/or the implanted K-wire damage (7%).
    Keywords Clavicle – injuries ; Fractures ; bone – surgery ; bone – therapy ; Child ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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