Treatment of dislocated and complex fractures of the acetabulum is a challenge for the orthopedic surgeon, characterized by a high percentage of complications with poor functional results. Fractures are often accompanied by associated injuries. We present 48 subjects with 51 acetabulum fractures, treated from 2015-202, within 3 weeks of injury, age varies between 19-71 years, majority were male 70%, follow-up 16-30 months. All subject treated with a Stoppa approach and fixation with a suprapectineal plate, an additional surgical approach was used in 18 cases. According to the Judet and Letournel fracture classification, we had both column 13; anterior column 5 and with posterior hemi-transverse 7; T type 11; transverse 9 and with posterior wall 6. The most common major associated injuries, in a total of 26 (54%) subjects, were injuries to the spine, pelvis, lower leg, head, abdomen and chest. For functional results we using the Merle D'Aubigne score, 65% of patients had an excellent result. Matta radiographic postoperative assessment of fracture reduction with anatomical position is 75%. The reoperations rate were 8%. Complications included infections 8.35%, deep vein thrombosis 6.25%, pulmonary embolism 6.25%, obturator nerve lesion 2%, inguinal hernia 2%, hip osteoarthrosis 8.35%, heterotipoc ossification 8.35%. The Stoppa approach provides good bone visualization with the possibility of reduction and fixation for most complex fractures, especially in the lamina quadrilateralis, sacrum and anterior pelvic ring. Also additional surgical approach is required for fixation of some types of posterior column and wall fractures, iliac wing or sacrum fractures.

Ovaj prikaz slučaja pruža istoriju pacijentkinje, visine 118 cm, sa ahondroplazijom koja je bila podvrgnuta bilateralnoj totalnoj artroplastici kuka korišćenjem Fitmore stema.Prema našim saznanjima, ovo je najniži odrasli pacijent koji je podvrgnut totalnoj bilateralnoj artroplastici kuka na svetu. Takođe smo otkrili značajno izvijanje femoralnih dijafiza i u koronalnoj i u sagitalne ravni. Nakon operacije, pacijent nije imao pritužbi na operaciju, hod se značajno poboljšao, povećao se opseg pokreta oba kuka. Kod pacijenata sa ahondroplazijom koji razviju krajnji stadijum osteoartritisa kuka, postoji jedinstven izazov za hirurge, uključujući izbor dizajna implantata, dimenzionisanje, pozicioniranje i meka tkiva balansiranje. Verujemo da bi upotreba kratkih femoralnih stemova mogla predstavljati prihvatljivu hiruršku strategiju u lečenju pacijenata sa ahondroplazijom.

Introduction: Pediatric-specific pathologies such as slipped capital femoral epiphysis, coxa vara or Legg-Calve´-Perthes disease can lead to three-dimensional complex deformities of the proximal femur. 3D planning and patient-specific guides may provide a solution for optimal correction of these deformities.

Methods: A total of 42 proximal femoral osteotomies have been performed with GPS in our department since 2020. Osteotomies performed in conjunction with acetabular dysplasia correction were excluded. Fifteen proximal femoral osteotomies (in 14 patients) were included. 3D reconstruction from a low-dose lower limb CT scan allowed angular measurement of deformities and surgical planning using patient-specific guides. Postoperative clinical and radiological outcomes were evaluated.

Results: The etiologies of deformities included: sequelae of slipped capital femoral epiphysis (3), coxa vara and breva (3), exostotic disease (2), fibrous dysplasia (2), and malunion (2). The average age was 12 years (ranging from 8 to 16). The average surgery duration was 186 minutes (ranging from 125 to 241). The mean radiation dose was 206 mGy/cm².² The average follow-up was 18 months (ranging from 6 months to 2 years). The anatomical goal (<5° difference from the target) was achieved in 96% of cases in the frontal plane, 100% for sagittal subtrochanteric corrections, and incompletely (60%) for transverse corrections of epiphysiolysis sequelae.

Discussion and Conclusion:
Radiographic results assessed using standard imaging were satisfactory. However, a postoperative comparative three-dimensional study would be desirable.
3D modeling allows for a better understanding of anomalies, guiding the corrections to be proposed. GPS faithfully translate these corrections during the surgical intervention.

Introduction: Quality of life if a crucial factor in pertrochanteric fractures treatment, being influenced directly by hip function in the injuried limb. This study is about intramedullary and extramedullary fixation comparing of pertrochanteric fractures regarding health related quality of life (HRQL) and hip function, at least two years after surgery. Material and Methods: Internal fixation methods compared in the serious of 82 patients with AO/OTA A1 and A2 trochanteric fractures were intramedullary fixation (IM group), and Selfdynamisable Internal Fixator, as an extramedullary method (SIF group). Hip function was determined by Harris Hip Score (HHS) and HRQL was assessed by SF-12 questionaire, containing its mental (MCS) and physical (PCS) component score. Results: Average scores in IM group were: 67.8 PCS, 71.1 MCS and 75.1 HHS. Average scores in SIF group were: 61.4 PCS, 65.3 MCS and 71.6 HHS. There was not significant difference between the groups regarding three followed parameters (p>0.05). There was the correlation between all parameters (p<0.05). Conclusion: Final functional outcome in pertrochanteric fractures treatment are expected to be similar between intramedullary nailing and Selfdynamisable Internal Fixator methods. The influence of hip function on health related quality of life was confirmed as significant.

Background: The aim of this study is to establish weather is it necessary to perform a interportal capsular closure in isolated labral rupture hip arthroscopy repairs in patients without any FAI pathology. Methods: This retrospective study started in 2019 till 2023 and was conducted on patients with isolated labral rupture without femoro-acetabular impingement. HIip arthroscopy labral repair was performed by using interportal capsulotomy. Patients were devided in two groups acording capsular repair. Results: Twenty patients (15 female, 5 male patients) with isolated labral ruptures had capsular repair (group A) , 20 patients ( 10 females, 10 male) had unrepaired capsule (group B). The average age for both groups ( 37 years ). Respectively mean follow-up was 1 year for both groups. Patients were evaluated 6 months after the operation and one year after by using Harris Hip Score. Patients in the repair group (A) after 6 months had better scores post-operative (93.2) than in unrepaired group (83.8). One year after surgery, hip score was better in repair group (99.4(A)), but with a less significant margin (92.4 (B)). Conclusions: The results show evidence that there is better to perform an capsular closure after interportal capsulotomy because it show superiority regarding unrepaired capsulotomy regarding first 6 months postoperatively.

The number of cases of revision hip arthroplasty is constantly increasing. One of the biggest challenges in this surgery is solving bone defects of the acetabulum. According to the German hip endoprosthesis registry, aseptic loosening of the acetabular component is one of the most common reasons for revising primary hip arthroplasty. Bone defects can vary in both, size and location. In order to adequately classify the defect, it is necessary to perform conventional X-ray and a computerized tomography. The Paprosky classification is most commonly used. This study includes patients operated on between July 2021 and December 2023. There were 30 patients, of whom 22 (73%) were women and 8 (27%) men. The average age of the patients was 67,9 years, and average follow-up time were just over three months. The surgeries were performed by 14 surgeons, all using a posterolateral hip approach, with augmentation done using Gription® TF augment. Acetabular defects were represented as follows: Paprosky IIb in 9 (30%) cases, type IIc in 5 (16%) cases, type IIIa in 12 (40%) cases, and type IIIb in 4 (14%) patients. The osseointegration of the acetabular component and metal augment was observed in 29 (97%) patients, while one patient showed a linear radiolucent line up to 2mm. Complications were observed in 5 (16%) patients, with 3 (9%) experiencing prosthesis dislocation and 2 (6%) developing infection. It can be said that adequate use of metal augments allows good establishment of biomechanical conditions in the hip joint while solving various acetabular bone defects.

Introduction: Accurate measurement of femoral anteversion is essential for preoperative planning of hip reconstructive surgery and treatment of lower limb deformities. Beside clinical assessment (cFA), several methods of radiological femoral anteversion measurements (rFA) can be used. However, the relevance of both clinical and radiological methods is still challenged. The development of three-dimensional modelling allows for greater precision in morphological measurements (3D-FA).
The objective of this study is to look for a correlation between these three measurements method.

Methods: Clinical femoral anteversion measurements were performed on 26 ambulatory diplegic subjects (52 measurements) before multi-stage surgery. Radiological measurements were performed on 17 subjects (22 measurements) before surgical hip reduction. Using low-dose CT scans and 3D preoperative modeling, 3D-FA was measured using CREO Parametric 6.0 software based on geometric primitives. The measurements are compared in a paired manner using Wilcoxon tests, correlation analysis, and graphically using the Bland and Altman method (significance p<0.05).

Results: cFA and rFA show significant differences compared to 3D-FA measurements of 3.40 ± 10.23° and 9.95 ± 7.63°, respectively. cFA and rFA show strong correlations (R=0.66; p<0.05) and very strong correlations (R=0.96; p<0.05) with 3D-FA values, respectively.

Discussion and conclusion: In comparison to 3D measurement, cFA assessment present a range of errors comparable to those reported in the literature for CT scans or EOS, while showing higher correlations. rFA measurement has a very strong correlation with 3D measurement but seems to overestimate it by about 10 degrees.