The document describes the Specialist Hospital for Orthopaedics and General Surgery "Dr. NEMEC" located in Croatia. The hospital offers a variety of orthopaedic and general surgery services performed by experienced physicians. Key services include knee, hip, shoulder, foot, and elbow procedures for conditions such as ligament tears, cartilage defects, arthritis, and other sports injuries or trauma. The document provides details on specific surgical techniques and post-operative recovery timelines.

1. 1
CROATIAN MEDICAL TOURISM
Orthopaedics and general surgery
Orthopaedics and
general surgery
Specialist
Hospital for
orthopaedics
and general
surgery
“Dr NEMEC”
www.croatianmedicaltourism.com

2. CROATIAN MEDICAL TOURISM 2
Orthopaedics and general surgery
Specialist Hospital for orthopaedics
and general surgery “Dr NEMEC”
www.croatianmedicaltourism.com

3. 3
CROATIAN MEDICAL TOURISM
Orthopaedics and general surgery
CONTENT
About the hospital
Our physicians
Services of special hospital
Ailments & lesions
www.croatianmedicaltourism.com

4. CROATIAN MEDICAL TOURISM 4
Orthopaedics and general surgery
ABOUT THE HOSPITAL
The Specialist Hospital for orthopaedics and general surgery “Dr NEMEC” is located in Matulji, near the city of
Rijeka, at the address Dalmatinskih Brigada b.b. The hospital was built with the purpose of treating patients with
lesions and ailments of the locomotor apparatus and provides the most recent medical equipment. Its highly
skilled staff will be on hand to offer you professional medical care.
Modernly built and equipped operating facility, contains two operating theatres, a patient waking room, anaesthetist
room, washing and sterilization room, doctor’s room, and storerooms of medical and sterile material.
OUR PHYSICIANS
Prof. Boris Nemec, MD PhD
He was born in Varaždin, Croatia, where he finished elementary and high school. He graduated from the
Rijeka University Medical School and in 1972 started working at the Clinic for Orthopaedics
Rijek
in Lovran where he completed his internship and residency in orthopaedic surgery. He
Lo
passed the Orthopaedics specialization exam in 1976 at the Clinic for Orthopaedics in
pass
Zagreb and this was followed by a Masters degree in 1982 and a PhD in 1989.
Zagr
Since 1987 he was an assistant professor and lecturer on the matter of orthopaedics at the
Sinc
Rijeka University Medical School where he performed the duty of the School’s vice-dean
Rijek
for a period of 4 years (1991-1995). In 2005 he was elected professor in orthopaedics at
the R
Rijeka University Medical School.
In 19 he received an award from the town Opatija for his contribution to medical science
1991
and the development of knee surgery. He has been a member of the ESKA (European Association of Knee Surgery and Arthroscopy)
k
since 1988, a member of the Croatian Association of Orthopaedics since 1990 and a member of the AAOS (American Association
of Orthopaedic Surgeons) since 1998.
He has been a member of the FIFA Health Comity since 1999. He is the president of the Health Commission of the Croatian Football
Federation and a physician of the Croatian national football team, as a part of which he participated in the European Football
Championships in England and Portugal and in the World Football Championships in France and Japan and Korea.
He takes professional advancement seriously - on numerous occasions he spent a few months in various clinics over the world e.g.
Basel, Moscow, Newcastle, Leeds, New York, Boston, Bologna, Perugia, Milan, and Stockholm, improving his own techniques and
acquiring new ones.
In 1981, while working at the Clinic for Orthopaedics in Lovran, he performed an osteocartilage transplantation of the thighbone with a
part of knee, which was one of the first of its kind in Europe. Ten years later he began performing reconstructive surgery of the anterior
cruciate ligament using homotransplantes and in 2004 started with transplantations of knee-cartilage with in vitro bred cartilage
explants on a 3D hyaluronic acid matrix (Hyalograph C), the first surgeries of the kind performed in Croatia.
doc. dr. sc. Boris Lah, spec. ortoped
prim. mr. sc. Ernest Irha, spec. ortoped
dr. sc. Damir Štifanić, spec. anesteziolog
Anić Tomislav, dr. med.
www.croatianmedicaltourism.com

5. 5
CROATIAN MEDICAL TOURISM
Orthopaedics and general surgery
SERVICES OF SPECIAL HOSPITAL
In the Special hospital DR. NEMEC under the guidance of Boris Nemec, PhD prof., specialist in orthopaedics, following procedures
are done quickly, efficaciously and professionally:
• Orthopaedic examinations
• Surgical operations;
And in the same way, the following are treated:
• Orthopaedic ailments
• Sports-based lesions
You can also consult our experts or look for a second opinion.
In two operating theatres, the most modern operations are performed on the shoulder, elbow, wrist, hip, knee and foot, as well as
operations of bone rupture. In the postoperative period, the patients are accomodated in modernly arranged appartments.
AILMENTS & LESIONS
KNEE AILMENTS AND LESIONS
Meniscus lesions
Meniscus lesions are caused by frequent traumas or greater rotary motions of the knee.
The lesion can also be caused by a longer squat, and by a high intensity knee bend.
Surgical treatment is carried out by arthroscopic techniques of either the partial removal
or the stitching of the damaged meniscus. Patients are released a few hours after the
operation.
Lesions of the anterior cruciate ligament
The most frequent lesions of the anterior cruciate ligament occur during sports e.g.
football, handball, basketball or skiing, activities characterised by abrupt changes of
direction and stopping. The treatment is carried out by using the most recent techniques of
arthroscopic ligamentoplastics and ligament reconstruction with an adequate transplant.
A day after the operation, the patient starts walking and gradually burdening the operated
knee.
Cartilage defect
A cartilage defect or a cartilage break of part of the bone most often results from sport
or from a direct blow to the knee. It usually occurs with ligament lesions. In case of
cartilage defects (3 cm2) a transplantation of the patient’s own laboratory bred cartilage
can also be performed.
Luxation (dislocation) of patella (kneecap)
As the knee bends the unstable patella (kneecap) moves outwards and partially or
completely dislocates. It moves back to its position while stretching out the leg. The
treatment is carried out using the newest arthroscopic methods of patella stabilization.
Surgical skin cuts and later scars are thus avoided.
www.croatianmedicaltourism.com

6. CROATIAN MEDICAL TOURISM 6
Orthopaedics and general surgery
Jumping knee (Patella tendinitis)
This injury occurs due to overstraining the patellar ligament and other knee extensors and is usually caused by sporting activities
which involve frequent jumping. In case the conservative therapy shows no improvement, the pain can be relieved by means of
arthroscopic surgery.
Arthrosis of the knee joint (Gonarthrosis)
Degenerative changes on the knee arise due to mechanical and biological factors. There are often changes in the knee axis (knock-
knees or o-knees) which additionally overstrain the damaged cartilage, causing osteophytes (a protuberance in and around the joint)
and narrowing of the joint fissure. Walking becomes more difficult and painful, as well as standing up from a sitting position. The scope
of knee movements is gradually reduced and every change of position of the knee causes pain.
The implantation of total knee endoprosthesises is done applying a minimally invasive method. The advantages of such surgeries are
shorter rehabilitation periods, quicker recovery and a smaller, aesthetically more acceptable skin section. A day after the operation
patients walk on two crutches, burdening the knee as much as the pain allows. After seven days, walking is supported with one crutch
or without crutches. In most cases, employed patients return to work after a period of one month.
HIP AILMENTS AND LESIONS
Implantation of the total endoprosthesis of the hip joint
With patients under the age of 75, a cement-free endoprosthesis is implanted. The surface of these is made so that it allows the
bone to grow in.
After the age of 75 or with patients suffering from osteoporosis, a so-called cement endoprosthesis of the hip joint is implanted. Bone
cement is used to fixate it to the bone.
We usually implant cement-free endoprosthesises with a large diameter metal head. Higher joint stability is achieved this way and
the patient is able to walk, burdening the operated leg the day after the operation. It also allows a greater scope of movement without
the danger of the endoprosthesis dislocating. Rehabilitation is accelerated and the patient can start walking with a pair of crutches,
three weeks later with the use of just one crutch (in the hand opposite to the operated leg) and a few weeks later as normal.With male
patients under the age of 65, female patients under the age of 60, as well as those suffering from aseptic necrosis of the head of the
thigh bone, a new model of the “resurfacing” endoprosthesis of the hip joint is implanted.
Hip arthrosis
The term hip arthrosis covers all of the degenerative hip ailments which cause the progressive deterioration of cartilage between the
head of the femor and its socket. With the cartilage degrading, the surrounding joint structures as the bone, the joint capsule and the
contiguous muscles also start to erode, creating new bones on the edges of the socket and the head of the thigh bone-osteophites.
Setting the diagnosis
A diagnosis for hip arthrosis is based on the anamnesis (medical history), the patient’s check-up and the radiographic findings.
Treatment
In case conservative treatment does not reduce discomforts a hip endoprosthesis implantation is recommended.
The decision on which endoprosthesis model to implant is based on the patient’s age, accompanying disease and the condition
(deformation) of the joint. An orthopaedist will explain his decision and what the patient is supposed to do before the surgery (see
preoperative preparation) after the check-up and based on the x-ray image and the above mentioned info. The postoperative course
(see recovery) will also be explained.
www.croatianmedicaltourism.com

7. 7
CROATIAN MEDICAL TOURISM
Orthopaedics and general surgery
The patient and his findings will be reviewed by an anaesthesiologist and the orthopaedist a day before the operation and then
antithrombotic profilaxy (protection from thrombosis) is initiated. Elastic socks, also with the purpose of thrombosis protection, will be
given to the patient shortly prior to the operation.
The operation
In most cases, the operation is performed under regional (spinal) or general anaesthesia.
The type of surgical approach is decided by the orthopaedist and this determines the postoperative rehabilitation.
The hip endoprosthesis consists of the body of the prosthesis, the head and the socket. The whole thighbone head is extracted during
surgery and a cavity in the pelvis is made for the insertion of the socket. Another one is then drilled in the thighbone for the body of
the endoprosthesis, onto which a ceramic or metal head is then placed. The hip is reset and after the stability of the prosthesis and
the implanted components is tested, the wound is stitched up.
After the operation the patient is transferred into the intensive care unit and when they’re stable, a few hours later, they are moved
to the recovery room where all vital signs continue to be monitored (EKG, heart rate, blood pressure and oxygen saturation level).
Circulation and the swelling of the operated leg are under surveillance as well.
Analgesics and antibiotics are given intravenously so as to relieve pain and prevent infection.
SHOULDER AILMENTS AND LESIONS
Shoulder instability
There are various forms and directions of shoulder instability. The most common is anterior instability which results from injuries, often
in sports, caused by falling onto open hands or by a blow into the shoulder. These injuries mainly cause damaging of the cartilage
margin of the joint and the joint capsule. The blow can also cause a defect of the head of the upper arm bone (humerus). After such
injuries even normal movements of the shoulder cause instabilities. In order to retrieve stability and function of the shoulder, surgical
treatment is necessary. Since the surgery is arthroscopic, the patient can check out from hospital on the next day.
Impingement and rotator cuff lesion
Pain and damaging are a consequence of a collision of soft tissues, muscular membrane and the bony part of the shoulder. The
muscular lesion is intensified by the pressure of the humerus head onto the rotator cuff muscles against the shoulder-blade bone
margin. Based on the local findings and the existing difficulties, surgical treatment is performed, arthroscopical or by means of a
minimal section. The patient checks out from hospital a few hours after the operation.
FOOT AILMENTS AND LESIONS
Hallux valgus (bunion deformity)
The most frequent static deformity of the front part of the foot. The big toe is rotated and turned aside toward the neighbouring toe.
Problems arise in choosing footwear, the wearing of which causes pain.
Conservative treatment is of limited value and only an adequate surgical treatment results in retrieving painless burden transfer over
the foot. The patient checks out from hospital two hours after the operation.
www.croatianmedicaltourism.com

8. CROATIAN MEDICAL TOURISM 8
Orthopaedics and general surgery
Digiti flexi (bent fingers)
There are various forms and degrees of bent fingers, yet all are related to the formation of corns on the upper side of toes and
painful calluses on the lower side of toes.
It is impossible to find or make comfortable footwear, but this deformity needn’t be the reason to reduce one’s physical activity. By a
simple operation the fingers are straightened.
Achilles tendon rupture and similar lesions
These difficulties are always painful. They can be treated conservatively and surgically if necessary. After the operation of a recent
tendon rupture, the patient walks on two crutches for three weeks, whereby the lower leg and the foot are immobilised in a splint,
which is taken off every day to perform foot stretching exercises. Three weeks after the operation the patient starts walking without
crutches, burdening the operated foot.
Haglund’s bump
Haglund’s bump is a condition where a firm fibro-fatty swelling develops over the posterior (back) aspect of the heel at the area of the
insertion of the Achilles tendon. It causes difficulties in wearing footwear and frequent inflammations of the Achilles tendon. In some
cases, the sore part needs to be removed surgically.
Excessive foot bones (ossa accessoria pedis)
Bone nucleuses that have not grown together with the primary bone can cause pain in places of contact with footwear.
Posttraumatic conditions
These conditions appear along with contractures and ankle deformity (valgosity, varus and equinus). The ankle and/or bone position
mobility disorder can significantly reduce the degree of foot burdening. Such deformities can be corrected surgically, thus improving
ankle function.
Excavated foot (Pes excavatus)
Due to pain, surgical treatment is sometimes necessary.
ELBOW AILMENTS AND LESIONS
Epicondylitis humeri (tennis elbow)
It is a localized inflammation in the area of the stretching musculature of the forearm and the hand, often caused by overstraining in
sports and other activities. It is also known as the “tennis elbow”.
Consequences of traumatic damaging
These are cubitus valgus and cubitus varus (a deviation of the elbow axis toward the thumb bone or toward the elbow bone of the
forearm). In these cases, a surgical correction of the bone axis is necessary.
Loose joint bodies
This is a consequence of an injury or ailment which causes the cartilage bone fragment to detach from the elbow joint surface.
Loose joint formations are removed arthroscopically from the joint.
www.croatianmedicaltourism.com

9. 9
CROATIAN MEDICAL TOURISM
Orthopaedics and general surgery
CHILDREN’S ORTHOPAEDICS
Orthopaedic ailments of children (diagnostics and surgical treatment)
Ultrasound of a baby’s hips
Hand and leg deformities (inborn or acquired - posttraumatic conditions)
Sports injuries of children and youth
Cerebral palsy
We offer individual approach to each child, needed for the choice of the most effective therapy procedures. Depending on the
realized and the potential neuromotoric development, we decide on the necessary conservative or surgical orthopaedic treatment.
“Please, contact us to request more informa on about
Specialist Hospital for orthopaedics and general surgery
“Dr NEMEC”.”
www.croatianmedicaltourism.com