Ana Bosak Veršić

Background/Objectives: Supracondylar humerus fractures are among the most common pediatric fractures and may be associated with neurovascular complications. Brachial artery entrapment is a rare but limb-threatening condition requiring urgent recognition and management. Methods: We present two pediatric cases of brachial artery entrapment associated with displaced supracondylar humerus fractures. Clinical presentation, imaging findings, surgical management, and outcomes were analyzed. Results: Both patients presented with absent radial pulse following trauma. Initial fracture reduction and fixation did not restore vascular flow. CT angiography confirmed brachial artery compromise. Surgical exploration with arterial decompression resulted in restoration of perfusion. One patient achieved full recovery, while the other developed severe neuropathy with partial recovery after rehabilitation. Conclusions: Brachial artery entrapment should be suspected in cases of persistent vascular compromise after fracture reduction. Prompt surgical intervention and thorough perioperative neurovascular assessment are essential to prevent long-term morbidity.

Violence against children is a complex socio-medical phenomenon with potential lifetime consequences. Therefore, it is very important to recognize the first signs of violence, as medical staff are quite often the only witnesses of child maltreatment. The objective was to determine types of abuse and neglect in the pediatric population, which children are most susceptible to abuse and neglect, the kinds and severity of injuries, and the required management. A retrospective study was conducted on all patients admitted to two different hospitals due to suspicion of abuse and neglect, with the involvement of a social worker, over a 6-year period. This study included 473 patients; their average age was 8.03 ± 6.01 years; the majority of children were aged 0 to 3 years (35.0%), and 67.2% were boys. Of them, 82.4% were hospitalized because of injuries and other medical conditions caused by neglect. A total of 17.6% were hospitalized due to suspected abuse: peer violence was present in 59.3% of the cases, 22.1% of the children were abused by their parents, and the least number of patients were abused by unknown persons, 18.6%. Minor injuries were present in 55.39% of the cases. In total, 232 children underwent surgical treatment due to injuries from abuse or neglect. The majority of children were neglected, not abused, and among the abused children peer violence was predominant. The most susceptibile to neglect and abuse were the youngest members of the pediatric population.

Introduction: Clavicle fractures are among the most common in children, typically treated conservatively, with standard radiographs used to diagnose and monitor healing. Recently, infrared thermography (IRT) has been proposed as an alternative method for fracture detection, but no study has correlated the temperature changes during callus formation. Materials and Methods: Children aged 4–18 with X-ray-diagnosed clavicle fractures were included in the study. IRT measured temperatures above the fracture and contralateral healthy side on the 1st, 4th, 8th, 15th, and 22nd day after the injury. Along with IRT, an ultrasound was used to assess callus formation. Results: The study included 27 patients with an average age of 12.4 years, mostly boys. The left side was more often affected than the right side (33%). We found a correlation between callus formation and the ∆T. A maximum temperature difference of an average of 0.7 °C was noted during the proliferative phase of callus formation. After the formation of the fibrocartilaginous callus (4th to 8th day), the temperature above the fracture declined until it was equal (22nd day) to that of the healthy side. The average temperature difference between the broken and the healthy sides was statistically significant on the 4th and 8th days (during callus formation). Conclusions: The increased skin temperature above the fracture correlates with the inflammatory phase of bone healing. After the callus is visible on ultrasound, the temperature linearly drops with no statistical difference between the injured and the healthy sides. The standard protocol for clavicle fracture treatment typically involves using X-rays to assess callus formation during follow-up. IRT has shown potential in diagnosing callus formation in children with clavicle fractures, potentially reducing the need for traditional X-rays.

Primarni megaureter uzrok je hidronefroze u gotovo četvrtine pedijatrijskih pacijenata. Primarni opstruktivni megaureter zapravo je funkcionalni poremećaj uretera karakteriziran dilatacijom njegovog lumena. S afirmacijom prenatalnog ultrazvuka kao st...

The aim of the study was to investigate whether the COVID-19 pandemic caused an increased incidence of complicated appendicitis due to the late presentation when compared to the pre-COVID-19 period. Summary Background Data. Acute appendicitis is one of the most common surgical emergencies. During the coronavirus-19 (COVID-19) pandemic, there has been a reported delay in the presentation of some urgencies to the emergency hospital departments. Methods. A total of 427 patients who underwent surgical treatment due to suspected acute appendicitis from June 2019 to November 2020 were retrospectively included in this study. The patients were divided into two groups: the first (pre-COVID-19) group consisted of patients who had surgery before the onset of COVID-19 pandemic (n = 240), while the second (COVID-19) group consisted of those who were operated during the COVID-19 pandemic (n = 187). The primary outcome of the study was to compare the incidence of perforated appendicitis before and during the onset of COVID-19. Results. Overall, 84 patients (19.67%) were diagnosed with perforated appendicitis. We found a weak significance ( ) in the rate of perforated appendicitis between the pre-COVID-19 (17.08%) and the COVID-19 era (22.99%). Conclusions. We did not observe any significant difference in the complications of acute appendicitis before and during the COVID-19 pandemic in a university hospital in Rijeka. An emergent medical care should always be accessible.