Marko Bumbasirevic

University of Belgrade · School of Medicine

Artificial communication with the brain through peripheral nerve stimulation shows promising results in individuals with sensorimotor deficits. However, these efforts lack an intuitive and natural sensory experience. In this study, we design and test a biomimetic neurostimulation framework inspired by nature, capable of “writing” physiologically pl...

Artificial communication with the brain through peripheral nerve stimulation recently showed promising results in people with sensorimotor deficits. However, these efforts fall short in delivering close-to-natural rich sensory experience, resulting in the necessity to propose novel venues for converting sensory information into neural stimulation p...

Bioelectronic medicine is a promising venue for treatment of disabilities using implantable neural interfaces. Peripheral neurostimulation of residual nerves recently enabled multiple functional benefits in amputees. Despite the preliminary promising impact on patients' life, the overtime stability of implants and the related nerve reactions are un...

Background: In the last decade, regenerative therapies have become one of the leading disease modifying options for treatment of knee osteoarthritis (OA). Still, there is a lack of trials with a direct comparison of different biological treatments. Our aim was to directly compare clinical outcomes of knee injections of Bone Marrow Aspirate Concentr...

Purpose: The femoral condyle diameter may influence anterior tibial translation whose main stabilizer is the ACL. The aim of this study is to determine the influence of the size of the lateral and medial femoral condyles on ACL rupture. Methods: 41 matched pairs of subjects were included in the study who had suffered knee injury and were either pro...

Objective Although it may have been criticized and questioned by numerous authors, external fixation holds its place in modern orthopaedics and traumatology. The aim of this paper is to show the applicability of the unilateral 3D external fixation in everyday practice. Methods For external fixation of the bones, we used unilateral 3D external fixat...

A mangled extremity is the most devastating limb injury and presents a challenge for the orthopedic surgeon. There are two main treatment options, reconstruction or amputation, but sometimes indications for either are not clear. There are many pro and contra arguments for both options. To make the decision easier numerous score systems have been in...

Introduction: Fractures of the scaphoid account for 60-70% of all wrist bone fractures. The results of treatment in terms of bone healing vary depending on the type and location of the fracture, the time elapsed since the injury, the type of surgical treatment. Nonunion occurs in 5-15% of the cases on average. The purpose of this paper is to compa...

PurposeAfter the appearance of first COVID-19 cases in Serbia, state of emergency was declared on 15 March 2020 and lasted for 54 days. The aim of this report is to compare orthopaedic fracture frequencies in this period, when the walk was limited at the home mostly, with those during the same part in the previous year with regular state, thus to e...

Amputations have a devastating impact on patients’ health with consequent psychological distress, economic loss, difficult reintegration into society, and often low embodiment of standard prosthetic replacement. The main characteristic of bionic limbs is that they establish an interface between the biological residuum and an electronic device, prov...

Replantation of lower extremity is a very complex and difficult procedure. There are still a lot of controversies about indications, even numerous scoring systems are now available that can facilitate the surgeon's decision. We present the functional results of a replanted below-knee amputation in an elderly patient, 27 years after the injury and d...

Introduction: Management of severe penile trauma presents great challenges for reconstructive urologists since these injuries vary from abrasions to total emasculation. A review of our case experience with penile amputation is presented, emphasizing techniques used to salvage or reconstruct the most difficult of penile injury cases. Materials and...

Lower limb amputation (LLA) destroys the sensory communication between the brain and the external world during standing and walking. Current prostheses do not restore sensory feedback to amputees, who, relying on very limited haptic information from the stump-socket interaction, are forced to deal with serious issues: the risk of falls, decreased m...

Purpose: The aim of this paper was to evaluate the outcomes of propeller perforator flaps used all over the body, and to appreciate their advantages and/or disadvantages over the free perforator flaps. Method: Patients that required propeller perforator flaps used all over the body were eligible to participate in this study. A preoperative Doppl...

Hand loss is a catastrophic event that generates significant demands for orthopedics and prosthetics. In the course of history, prostheses evolved from passive esthetic replacements to sophisticated robotic hands. Yet, their actuation and particularly, their capacity to provide patients with sensations, remain an unsolved problem. Sensations associ...

Background: The aim of this paper was to evaluate the outcomes of a homogenous series of emergency with a toe-to-hand transfer reconstructions with a different timing: immediate (same surgical step with the debridement), primary (in the first 24 h), early (24-72 h after the debridement) or delayed (72 h-7 days). Materials and methods: Between 20...

The treatment of severely injured extremities still presents a very difficult task for trauma orthopaedic surgeons. Despite improvements in technology and surgical/microsurgical techniques, sometimes a limb must be amputated, otherwise severe and potentially fatal complications may develop. There is a well-established belief that severe open fractu...

Aim: The aim of this paper is to demonstrate the advantages of using local resources in the coverage of such defects. Our approach in fingers' defects is the use of local perforator flaps, both as propeller flaps or bi-lobed pedicled flaps. Patients and methods: After performing an anatomical study on cadaver segments injected with latex followe...

Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to above-knee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical fatigue1–4. The lack of physiological feedback from the remaining extremity to the brain also contributes to the...

Introduction. We report a case of calcification of a cervical intervertebral disk in a child. This is a rare condition, and has been described in about 400 cases worldwide. Children affected by it present with the onset of pain, muscle spasm, and the presence of calcification of a intervertebral disk on radiography. Our objective was to present a c...

Microsurgery is a term used to describe the surgical techniques that require an operating microscope and the necessary specialized instrumentation, the three “Ms” of Microsurgery (microscope, microinstruments and microsutures). Over the years, the crucial factor that transformed the notion of microsurgery itself was the anastomosis of successively...

Objectives To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. DesignThis is a prospective study of 20 consecutive patients in one center. Patients and methodsThis study included 20 patients (19 males) with a mean SNU duration of...

As a result of its proximity to the humeral shaft, as well as its long and tortuous course, the radial nerve is the most frequently injured major nerve in the upper limb, with its close proximity to the bone making it vulnerable when fractures occur. Injury is most frequently sustained during humeral fracture and gunshot injuries, but iatrogenic in...

Introduction: Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred technique in injuries of the extension type. Objective: The aim of this study was to compare three common orthopaedic procedure...

It is well known that the peripheral nervous system has a good potential for regeneration. The aim of this study was to explore the effects of vitamin B therapy (with a complex of vitamins B1, B2, B3, B5, B6, and B12) on motor nerve recovery after femoral nerve injury. Our study was conducted on an experimental animal model of femoral nerve injury...

The femoral fractures remain the great challenge for orthopedic surgeons regarding time of fixation and appropriate fixation techniques. There is a bimodal distribution of fractures occurring most frequently in young males after high-energy trauma (motor vehicle accidents) and in elderly females after falls from standing. Young patients with femora...

Injuries of the Lisfranc’s joint are not so common, but in most of cases they are misdiagnosed. This have been changed by better diagnostic procedures, CT scan and MRI in some of the cases. The number of patients increases and this is of importance, due to the mentioned overlooked cases. The surgical treatment is preferable, either within few days...

Elbow joint stiffness is a common complication following supracondylar humerus fractures. In prospective study, dynamics of establishing a full range of motion in the elbow joint following the treatment of supracondylar humerus fractures were assessed, together with the effects of physical therapy on improvement in the range of motion. Two groups o...

This study evaluates the effects of three surgical procedures in the treatment of pronation deformities of the forearm in cerebral palsy patients; namely the transposition of pronator teres to extensor carpi radialis brevis muscle; and rerouting of the pronator teres muscle with or without pronator quadratus muscle myotomy. Sixty-one patients, 48 m...

The aim of this paper was to determine whether the change in the position of the patient's leg as well as the use of flexible reamers may help in obtaining a longer femoral tunnel with minimal risk of perforating the posterior cortex. One hundred and twenty-five patients who had undergone anatomic ACL reconstruction between 2010 and 2013 were inclu...

Giovanni Battista Monteggia was born in Laverne on the 8th of August 1762. Monteggia started his education in the School of Surgery at the Hospital Maggiore in Milano in 1779. This hospital was called “Big House” and it is one of the oldest medical institutions in Italy. He passed exam in surgery in 1781. Monteggia was promoted to assistant at surg...

Aim: The surgical management of injured digital nerves is a common part of hand trauma surgery. Despite improvements in the surgical techniques and suture material, the final outcomes of peripheral nerve repair can still be disappointing. This study investigates the outcomes following the surgical treatment of traumatic digital nerve lesions of th...

During the human history there were many attempts to treat fractures and injuries of extremities. Since Mathijsen and his plaster cast there was many attempts to make immobilization at the fracture site, to protect obtained reduction. Hugh Owen Thomas invent traction which greatly decrease mortality in the patients with femoral fractures during the...

Humeral shaft fractures may occur as a result of arm wrestling. The aim of this study was to present our treatment of humerus fracture sustained during arm wrestling. A total of six patients, aged 22 to 48, were treated at our department form January 2008 to January 2010 with open reduction and internal fixation and with hanging arm casts. A review...

The free microvascular fibula and soft tissue transfer has become a widely used method for reconstruction of different regions. Donor site morbidity for free fibula microvascular flaps has generally been reported to be low, or at least acceptable. We describe the case of a patient who underwent vascularized free fibula graft harvest for mandibular...

Purpose: The anterolateral ligament, a structure that has been known for 130 years, has again attracted the attention both of orthopaedic doctors and anatomists. Since its initial description until now, this structure has had different names. Whether labelled as the mid-third lateral capsular ligament, the anterior oblique band of the fibular coll...

Purpose The purpose of this study is to determine the difference in the concentrations of testosterone, 17-β estradiol and progesterone between male patients with and without ACL rupture, as well as the possible effect of these hormones on generalized joint laxity. Methods Male subjects with non-contact knee joint injury were included in this study...

Background: Depression is the most common mood disorder in elderly people and one of the most prevalent comorbidities in older people with hip fracture. While several authors have confirmed that depressive symptoms assessed at a later stage after hip fracture impact functional outcome and mortality, the role of depressive symptoms identified at an...

Purpose: The purpose of this study was to determine the difference in the concentrations of testosterone, 17-β estradiol and progesterone between female patients with and without ACL rupture and the possible effect of these hormones on generalised joint laxity. Methods: Female subjects with non-contact knee joint injury were included in this stu...

Gonarthrosis is a progressive chronic arthropatic disease of the knee which includes de-generative changes of the knee cartilage and hypertrophic changes of the bone tissue around of the articulare surface. The onset of the disease is insidious and vague. As the condition progresses, clinical signs became more significant like weakness of musculus...

The objective of this study was to test clinically one new portable, motorised, remote controlled fracture reduction device. In vivo fluoroscopic analysis of the function of the device. Radiation exposure of the surgical team during fluoroscopy is one potential danger for the health. Minimal invasive surgery searching for reduction device which wil...

Modified, reversal technique of fixation in digital replantation using K-wires was analyzed. The results obtained from the standard technique and reversal technique of fixation using K-wires were compared. The aim was to compare the results of osteofixation using K-wires in digital replantation when either standard or reversal, modified technique w...

The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was todeter mine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. The study included 33 matched pairs of patients divided into two...

Bony defects caused by trauma, tumors, infection or congenital anomalies can present a significant surgical challenge. Free vascularised fibular bone grafts (FVFGs) have proven to be extremely effective in managing larger defects (longer than 6 cm) where other conventional grafts have failed. FVFGs also have a role in the treatment of avascular nec...

Background There is growing evidence that devastating consequences of hip fracture can possibly be counteracted with multidisciplinary inpatient rehabilitation3. Recognition of variables that influence mortality at an early stage is needed in order to set realistic rehabilitation goals, adequately allocate rehabilitation resources, and optimize rec...

Free vascularized fibular graft is of the greatest importance in the orthopaedics and trauma. Bone, skeletal defects due to the trauma, infections and congenital anomalies could be successfully solved by the free vascularized fibular grafts. In this article the main anatomical data of fibular graft, surgical techniques, indications for the FVFG in...

Replantation is defined as reattachment of the part that has been completely amputated and there is no connection between the severed part and the patient. In Boston in 1962 Malt successfully replanted a completely amputated arm of a 12-year-old boy. Komatsu and Tamai reported the first successful replantation of an amputated digit by microvascular...

Distal radius fractures are an increasingly prevalent upper extremity injury, especially among elderly patients. They represent approximately 3% of all upper extremity injures. Severity of these fractures is directly related to bone mineral density of the patient, and clinical results are dependent on this parameter as well. There is a bimodal dist...

The aim of this study is to describe the nature of war wounds with fracture caused by cluster bombs and to suggest treatment options for such injuries. The nature of wounds caused by cluster bombs differs from those caused by conventional arms (they are more severe). The sides of the wounds are represented by conquasated soft tissues (such as fat a...

Although hand fractures are most common fractures treated in orthopedic practice, many practicians treat them as trivial injuries. Improperly managed they can cause consequences and impair hand function. Metacarpal and phalangeal fractures are classified based on geometry, anatomic localization and wound presence and treatment depend on mechanism o...

The scaphoid is vitally important for the proper mechanics of wrist function. Fracture of the scaphoid bone is the most common carpal fracture. Among all wrist injuries the incidence of scaphoid fracture is second only to fractures of the distal radius. Scaphoid fractures are significant because a delay in diagnosis can lead to a variety of adverse...

The main goal of this paper is to present clinical results of surgical correction of angular (varus and valgus) deformities of knee area. Goal is also to present new external fixation device for surgical treatment of varus deformity of proximal tibia. As material it has been used series of 70 patients treated during the period of 6.5 years in Unive...

To review our experience with severe penile trauma, mechanism of injury, and their treatment modalities in 16 children younger than 18 years. Management of penile trauma poses diverse challenges to the reconstructive urologist, as injuries vary from abrasions to total emasculation. Analysis of 16 patients with severe penile injuries referred to us...

The objective of this study is to describe severe road traffic injuries (RTIs) in the population under 18 years in Belgrade, the capital of Serbia. We analysed both severe non-fatal and fatal RTIs in children and adolescents under 18 years old in the Belgrade area, during the period 2008-2011. Data sources were the official statistics of the Public...

Background Hip fractures in the elderly are followed by considerable risk of functional decline and mortality. Questions/purposes The purposes of this study were to (1) explore predictive factors of functional level at discharge, (2) evaluate 1-year mortality after hip fracture compared with that of the general population, and (3) evaluate the affe...

Osteomyelitis of the radius resulting in the radial clubhand is a very rare condition and few studies have been published about its prognosis and treatment. This is a case report of hematogenous osteomyelitis of the radius with a complete loss of the radius leaving only the distal radial metaphysis to carry the carpus. In order to achieve best func...

Unlabelled: Hip fracture incidence in the capital city of Serbia was assessed over a period of 10 years (2000-2009). Crude annual incidence rates increased significantly for all ages and both sexes (p = 0.002). Age-adjusted rates also showed a steady increase. The mean rate of annual change for age-adjusted rates was 8.6 % (95 %CI 7.5-9.7) in male...

Symptomatic acquired flatfoot is an important orthopaedic problem, due to progressive loss of whole foot function and the increasing problem of patient disability. It is a complex entity, involving the tibialis posterior tendon, ankle joint, hindfoot and midfoot. In most cases the posterior tibial tendon (PTT) is the root cause of acquired flat foo...

Hip fractures are the most serious consequence of falling in older people with osteoporosis. Early ambulation is one of the main goals of inpatient rehabilitation aimed at reducing negative effects of immobilization, and promoting functional recovery. Recognizing the role of different factors that are associated with time to ambulation time after h...

Theodor Emil Kocher (1841-1917), born in Bern, educated in many universities in Europe. Kocher as many surgeons of that time performed orthopedic surgery, general surgery, neurosurgery and endocrine surgery, but he become famous in orthopaedic surgery and endocrine surgery. He is remember as a surgeon who described the approach to the hip joint, el...

Free vascularized fibular graft is of the greatest importance in the orthopaedics and trauma. Bone, skeletal defects due to the trauma, infections and congenital anomalies could be successfully solved by the free vascularized fibular grafts. In this article the main anatomical data of fibular graft, surgical techniques, indications for the FVFG in...

The information on the inhibitory effect of propafenone in vascular smooth muscle is sparse. Propafenone acts through blockage of voltage-dependent cardiac Na+ channels, L-type Ca2+ channels, voltage-sensitive K+(Kv) channels, as well as p-adrenergic receptors in the heart. The introduction of different chemical groups in the benzyl moiety of propa...

Nowadays complications of diabetes mellitus are very often the main cause of the most serious diseases and disabilities. Changes caused by diabetes are the most common cause of lower limb amputations in adults. Surgical treatment of complications is usually a radical treatment chosen in complicated situations when there is no other possibility. Tak...

Hip fractures remain one of the most devastating injuries in the elderly. Early prediction of outcome following hip fracture potentially results in more efficient health care. The aims of this study were to explore predictors of ambulation status at hospital discharge in patients ≥65 years of age operated on for fracture of the hip, and to investig...

Purpose: A controversial relationship between osteoarthritis (OA) and bone fragility has been attracting considerable attention. However, despite interest in the effects of OA on femoral neck fracture risk and numerous studies analysing the changes in the arthritic femoral head, there is insufficient data about femoral neck 3D bone micro-architect...

Friedrich von Esmarch was born in 1823 in Germany and he is one of the greatest surgeons of the Germany of that time. Fridrich von Esmarch introduced the Esmarch tourniquet, which enables operative field bloodless. This revolutionary innovation is still present in the orthopaedic surgery all around world, as well as for the first line hemostasis. B...

Injuries of the talus represents an important part of the foot and ankle trauma. Since talar bone connect the lower limb and foot, the sequelas of its trauma could have significant influence on the function of the whole lower limb and gait. The specific vascularization of the talus results in delayed union and even in the avascular necrosis. The di...

In terms of access to treatment of acromioclavicular joint injuries, there are many controversies, especially after the appearance of works that promote "neglecting of injury". The aim of this paper is to give a comparative analysis of the results of rehabilitation of patients after acute injury of the acromioclavicular joint of the third degree, t...

involuntary, idiopathic, recurrent posterior shoulder subluxation is a rare entity. Subluxation of the shoulder joint occurs with every elevation movement of the hand with a certain level of pain. Active abduction and anteflexion are possible only to 90 degrees. Only surgical treatment produces results. The goal is to show that timely commenced, co...

Mangled describes an injury caused by cutting, tearing, or crushing, which leads to the limb becoming unrecognizable; in essence, there are two treatment options for mangled upper extremities, amputation and salvage reconstruction. With advances in our understanding of human physiology and basic science, and with the development of new fixation dev...

Osteoporotic fractures are a major cause of morbidity in the population. Therefore, fracture prevention strategies should be a major concern, and one of the priorities in the primary health care system. The aim of the study was to assess fracture and fall risk factors, and fracture risk level in patients with acute hip fracture, and to evaluate if...

The aim of the study was to determine to what extent severe cognitive impairment impacts short-term rehabilitation outcomes of elderly patients with proximal hip fracture. A total of 337 community-dwelling elderly patients with acute hip fracture were observed during a 12-month period at a major teaching hospital in Serbia. Cognitive status was ass...

Venous thromboembolism (VTE) is a common complication of orthopaedic surgery in the industrialised world; though there may be variability between population groups. This study aims to define the incidence and risk factors for symptomatic VTE following primary elective total hip and knee arthoplasty surgery in a single centre in Eastern Europe. This...

Apstrakt Uvod/cilj. Prevencija posledica osteoporoze postaje sve znaajnija. Cilj rada bio je da se odredi prisustvo relevantnih faktora rizika od nastanka pada i preloma, stepen rizika od nastanka preloma, kao i adekvatnost leenja osteoporoze pre povrede kod bolesnika hospitalizovanih zbog preloma kuka. Metode. Ispitivanjem su bila obuhvaena 342 bo...

Since the ancient times, man was faced with the problem of fracture treatment, which is first described in the records from ancient Egypt. Ever since, many treatment methods have been developed, but the real revolution in the fracture treatment was achieved by internal fixation. Since it was described for the first time, at the end of the 18th cent...

Calcaneal fractures, since their description in 1843 by Malgaigne, still remain a challenge in orthopaedic surgery. They are significant from an epidemiological point of view - they represent 60% of all tarsal fractures, and of an increasing number of fractures due to traffic accidents and their outcome is unpredictable. In contrast to the disappoi...

In the city of Belgrade pedestrians are under the high risk to sustain injuries in the road traffic accidents, they are often with multiple injuries, with long-term treatment and significant consequences. Most of them are in the )senior or in the school age group. We present the results of the epidemiological analysis of the mechanism of injury and...

The beginning of 21 century was marked by an enormous increase in the number of traffic accidents, which led to an increasing number of multiple injured patients with associated injuries, especially injuries of cervical spine, because of its anatomical features. Even in the era of modern diagnostic procedures, cervical spine injuries are still ofte...

Hip fracture is a pathological condition, more common in older age, i.e. in people over 65 years. The prevalence of this disorder is continuously increasing, simultaneously with higher age limit. In evaluation of risk for operation and anesthesia, older age itself represents higher risk and calls for special attention. In selection of anesthesiolog...

Evaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. A retrospective review of 18 consecutive patients in one centre. 18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpba...

In his work the orthopaedic surgeon deals with a large number of peripheral nerve injuries, especially of the upper extremity. Most of these injuries involve the hand (30%). The aim of the study was to analyze the influence of some factors (age, aetiology, level of injury, associated injuries) on surgical treatment outcome of digital nerve injury o...