Medicinski pregled
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Dislocation of the proximal tibiofibular joint is a rare injury. It occurs during a sports activity that includes rough twisting movements of the bent knee. The role of the proximal tibiofibular joint is to reduce torsional loads to the ankle, to distribute the bending moment of the outer side of tibia, and transfer the vertical load while standing. In the literature there is no larger series; only several cases of the proximal tibiofibular joint dislocation treated by different methods have been published so far. ⋯ The proximal tibiofibular joint dislocation may be the cause of the chronic pain of the knee so it has to be taken into account when making differential diagnosis in case of the pain at the lateral side of the knee. The key for making the accurate diagnosis is the technically correct X-ray of the injured knee compared with the opposite one, showing the displacement of fibular head. If manual reposition fails, open reduction internal fixation and screw transfixation of the proximal tibiofibular joint allow good results and fast return to sport activities.
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Venous thromboembolism is one of the leading cause of maternal mortality worldwide. The incidence of venous thromboembolism is estimated at 0.76 to 1.72 per 100.000 pregnancies which is four times as great as the risk in nonpregnant women. The purpose of this article is to raise awareness of this frequent problem in pregnancy and provide a practical approach for the diagnosis, management, and prevention of venous thromboembolism during pregnancy and delivery. ⋯ Unfractionated heparin or low-molecular-weight heparin has a central place in the prevention and treatment of venous thromboembolism in pregnancy because they do not pass through the placenta, thus avoiding the risks likely to be induced by warfarin. The prevention of venous thromboembolism must focus on the patients known to be at high risk bearing in mind that the recommendations for prophylaxis, even in high-risk patients, are based on the limited data.