Transtrochanteric fractures of the femur are amongst the most common lower extremity injuries in the elderly. The gold standard for the stabilization of these fractures is intramedullary osteosynthesis with different types of nails. This type of osteosynthesis falls under the category of minimally invasive techniques, which enables safe and stable osteosynthesis with a small number of complications. With the development of osteosynthesis techniques, the number of complications has greatly decreased, and vascular complications are particularly rare. They most commonly occur during the application of the distal screw and its penetration into the superficial femoral artery. Complications resulting from the damage to blood vessels located in the proximal part of the thigh are described much less frequently . This case report aims to present a rare complication after osteosynthesis of a fracture of the proximal end of the femur, which was caused by the displacement of the lesser trochanter.

Introduction: In response to the COVID-19 pandemic, hospitals in Serbia were recommended to stop performing elective procedures. This suspension led to the abandonment of a large number of hip and knee arthroplasties. The impact of this on the physical and mental health of patients has yet to be investigated.
Method: A survey was developed to assess patients' pain, anxiety, physical function, and economic ability to undergo hip or knee arthroplasty. The study included 319 patients who had to have elective hip and knee arthroplasty canceled between March 2020 and March 2021.
Results: Patients were not worried about the uncertainty of when their surgery might be rescheduled. Patients waiting for total hip replacement were significantly more anxious than patients with total knee arthroplasty. Only 68% of patients understood and agreed with public health measures to control infections, while 33% of patients planned to delay as soon as possible. Younger patients were more concerned about financial concerns and concerns about job security. Older patients were less concerned about contracting COVID-19 during a future hospitalization.
Conclusion: Patients with hip and knee arthritis continue to suffer from pain in the final stages of the disease. They were worried about the COVID-19 pandemic. Only 33 percent of patients wanted to be operated on as soon as possible. Age and the type of degenerative disease affect their causes of anxiety about future surgery. Older adults show high levels of resilience to stressors such as COVID-19 and delayed health care, which manifests in lower levels of anxiety.

Introduction:
Necrotizing fasciitis is a rare and severe bacterial infection causing tissue necrosis in dermal and subcutaneous layers. Early recognition is crucial for prognosis, often determined by prompt surgical intervention. This study aims to evaluate diagnostic and treatment timelines among hospitalized necrotizing fasciitis patients.

Materials and methods:
A retrospective single-center study covering five years (2019-2023) was conducted. Clinical, bacteriological data, diagnostic and treatment delays, and complications were analyzed.

Results:
Twenty-two patients were included, predominantly male with an average age of 60 years. Most cases involved the upper limb (60%). The mean diagnostic delay was 7 days. All patients underwent surgical excision and dual antibiotic therapy. Surgical revision was required in 75% of cases, with one-third experiencing unfavorable outcomes, including three early deaths and four limb amputations.

Discussion:
Necrotizing fasciitis necessitates rapid, effective, and multidisciplinary management due to its severity and rapid progression. Advanced age and comorbidities, especially diabetes, correlate with poorer outcomes. Timely surgery, within 12 hours of diagnosis, is crucial for optimal prognosis.

Conclusion:
Necrotizing fasciitis demands swift intervention and multidisciplinary care. Delay in diagnosis or treatment significantly impacts prognosis, highlighting the importance of early recognition and prompt surgical intervention.

Fokomelije predstavljaju interkalarni gubitak tkiva gornjeg ekstremiteta uz postojanje tri tipa. Predstavljaju 0,8 % svih kongenitalnih anomalija gornjeg ekstremiteta. U svim tipovima ove anomalije postoji skelet prstiju. Naziv koji se još koristi je interkalarna aplazija. Prvi tip je takav da je šaka vezana direktno za trup. Drugi tip predstavlja formu gde donekle postoji razvijena podlaktica i šaka, bez razvijenog humerusa. Treći tip- distalna fokomelija, gde postoji šaka koja je vezana za humerus. U našoj ustanovi je operativno lečenja ženska osoba, devetnaest godina starosti sa obostranom fokomelijom, rođena je kao treće dete, bez prethodnog postojanja anomalija u porodici. Operacija je izvršena u totalnoj intravenskoj anesteziji, u smislu amputacije zaostalih prtsiju šake sa leve strane. Cilj lečenja je obezbeđivalje adekvatnog patrljka i dalji nastavak lečenja u centru za rehabilitaciju u smislu protetisanja, kako bi se pacijetkinji obezbedili uslovi za poboljšanje kvaliteta života u smuslu upisivanja na viši stepen obrazovanja kao i polaganje vozačkog ispita.

Introduction: Fractures of the posterior process of the talus are rare and pose a challenge for orthopaedic surgeons due to limited exposure and fixation options. We present a case of a middle-aged man who sustained such a fracture following a fall from a ladder.
Case presentation: A 60-year-old man presented to our Emergency department with pain in the right ankle following a fall from a ladder. He reported pain in his right ankle and an inability to bear full weight. Initial inspection revealed tenderness of the posteromedial aspect of the talocalcaneal joint as well as haematoma over the medial aspect of the foot. Plain radiographs and computerised tomography confirmed the diagnoses.
Management and outcome: A short-leg plaster slab was placed initially to prevent further fracture dislocation. Surgical intervention was performed using a posteromedial incision,
which allowed adequate exposure for fracture reduction and fixation. Initial fixation was achieved using a K-wire, followed by definitive fixation with a cortical screw. Short-leg plaster slab was placed postoperatively and a strict rehabilitation protocol was followed. After nine weeks the patient had satisfactory healing of the fracture without any irregularity of the articular surface and ambulant pain free with satisfactory range of ankle movements.
Conclusion: The ideal treatment of talar fractures should be customized as per fracture morphology. This case highlights the effectiveness of a posteromedial approach for posterior processus of the talus fractures. Early recognition, appropriate surgical intervention and meticulous postoperative care are crucial for achieving favourable outcomes in such challenging injuries.

The extensor pollicis longus (EPL) is a muscle that follows a complex anatomical course in the hand to allow for thumb extension. Almost all manual activities require the use of the EPL; therefore, when ruptured it can be very disabling for patients.
The etiologies behind traumatic EPL rupture were mostly attributed to distal radius fracture in the literature. However, EPL rupture remains uncommon, and other traumatic etiologies exist. Distal radius fractures remain the most common cause of EPL rupture; however, other causes, such as lacerations, blunt trauma, and direct cuts to the EPL tendon, should be considered. Transposition of the extensor indicis seems to be the most common procedure for reconstruction of the ruptured or severed extensor pollicis longus (EPL) tendon. Either an extensor indicis transposition (EIT) or an intercalated free tendon graft (FTG) can be used for secondary reconstruction of the extensor pollicis longus (EPL) tendon. For isolated
secondary reconstruction of the EPL tendon, both the extensor indicis transposition and a free autologous tendon graft successfully restore thumb function. Therefore, both surgical techniques can be considered equal alternatives.