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Volume 4 (2021): Issue 2 (December 2021)

Volume 4 (2021): Issue 1 (June 2021)

Volume 3 (2020): Issue 2 (December 2020)

Volume 3 (2020): Issue 1 (June 2020)

Volume 2 (2019): Issue 2 (December 2019)

Volume 2 (2019): Issue 1 (June 2019)

Volume 1 (2018): Issue Supplement (June 2018)
Special issue

Volume 1 (2018): Issue 2 (December 2018)

Volume 1 (2018): Issue 1 (June 2018)

Journal Details
Format
Journal
eISSN
2544-8978
First Published
30 May 2018
Publication timeframe
1 time per year
Languages
English

Search

Volume 4 (2021): Issue 2 (December 2021)

Journal Details
Format
Journal
eISSN
2544-8978
First Published
30 May 2018
Publication timeframe
1 time per year
Languages
English

Search

7 Articles
Open Access

Perioperative pain management in total hip and knee arthroplasty

Published Online: 14 May 2022
Page range: 53 - 53

Abstract

Open Access

Complex table saw hand injury-case report

Published Online: 14 May 2022
Page range: 54 - 58

Abstract

Abstract

Currently, Romania lacks a tradition of trade schools. This is due to the lack of awareness on the importance of this educational structure. Such multiple trades have been learned by simple observation from one individual to another. The importance of security measures has been taken for granted if not ignored. The number of traumas produced in wood processing has decreased rapidly due to the appearance of wood processing robots, the human factor being reduced only to their programming. The cases that arrive in the emergency departments are in a major percentage from the rural area, where the wood processing is done in the household without an adequate training and without going through a learning process. Hand injuries represent a great part of the Emergency Department presentations, and because of their fundamental functional use in daily life, repair of such lesions should be done with utmost care. Wounds of the hand typically have different degrees of severity depending on the mechanism of injury. Hand trauma probably represents the most frequent pathology of a plastic surgery ER and it should be handled with utmost care because of the fundamental function in the daily routine. The present article presents the therapeutic conduct of a complex case, multiple wounds with bone exposure, digital nerve sectioning and destruction of the flexor system of several fingers.

Keywords

  • table saw
  • hand injury
  • trauma
  • case report
Open Access

Medical rehabilitation of a patient with CRPS type I after tibial plateau fracture and sprain of the ankle: A case report and Literature review

Published Online: 14 May 2022
Page range: 59 - 66

Abstract

Abstract

Complex regional pain syndrome is a clinical syndrome characterized by chronic, severe, neuropathic pain, which is associated with sensory, trophic, and autonomic disorders and decreased range of motion of the affected joint. Symptoms begin at a variable interval, at least 6 weeks after a traumatic event or after surgery. The evolution of symptoms is unpredictable, as they can range from complete and self-limiting resolution to significant chronic pain with decreasing limb function and quality of life. Depending on the absence or presence of a well-identified neural lesion, types I and II of CRPS can be observed. Because it is a relatively rare condition, it can be overlooked due to the limited experience that doctors have with this one.

A 61-year-old male patient presented with severe pain 9/10 on the Visual Analogue Scale (VAS) and a significant decrease in mobility after suffering a traumatic fracture with a left tibial plateau fracture 4 months before, which required orthopedic treatment with a plate and screws, and a left ankle sprain. Previously, the patient presented to several emergency services where he received anti-inflammatory and analgesic treatment with gradual aggravation of pain and impaired mobility of the left lower limb, walking being possible only on two axillary crutches. The patient received treatment that combined drug therapy with medical rehabilitation exercises and physical therapy agents, with a favorable evolution. At the time of discharge, the pain was 5/10 on the VAS scale and the patient could move with a single Canadian crutch.

Keywords

  • CRPS
  • pain
  • trauma
  • fracture
  • quality of life
Open Access

Bone grafts versus synthetic bone substitutes in the treatment of benign bone tumors

Published Online: 14 May 2022
Page range: 67 - 70

Abstract

Abstract

Benign bone tumors represent an important chapter in the pathology of the musculoskeletal system, most commonly affecting young people under the age of 30. The most common benign bone tumors diagnosed in orthopedic surgery are: osteochondroma, osteoid osteoma, osteoblastoma, giant cell tumor, bone aneurysmal cyst, and fibrous dysplasia. An important feature is the lack of secondary determinations.

Depending on the type and the location of the benign bone tumors, treatment can be non-surgical or surgical.

Patients included in the study were between 25 and 55 years old with an average age of 40.

In both cases, the radiological image remains the routine investigation in the periodic postoperative control.

The purpose of this study was to compare the surgical treatment (curettage-filling) with synthetic bone substitute, compared to autograft in patients with benign bone tumors.

Keywords

  • synthetic bone substitute
  • autograft
  • benign tumors
  • bone
  • treatment
Open Access

Surgical management of bone metastasis located in the proximal femur-review of literature

Published Online: 14 May 2022
Page range: 71 - 77

Abstract

Abstract

Neoplasms are the second leading cause of death worldwide. The increase in diagnostic possibilities and development of new treatments has led to an increase in life expectancy among cancer patients.

The proximal region of the femur is a favorite site for bone metastases, these lesions being accompanied by increased mortality and morbidity.

The methods of treatment for metastatic bone disease can be surgical or non-surgical.

Bone metastases and pathological bone fractures in the proximal femur are most commonly located in the intertrochanteric or subtrochanteric region. Patients with bone metastases at this level most often require osteosynthesis with a centromedullary nail, but also plates and screws or dynamic hip screw can be used.

Bone metastases located in the femoral neck or femoral head can be treated surgically by hemiarthroplasty (HA) or total hip arthroplasty (THA). Both HA and THA have been shown to be successful surgeries in patients with bone metastases.

In patients with multiple bone metastases located in the head or neck of the femur and trochanteric region, but with increased life expectancy, resection and reconstruction using endoprostheses is a viable solution.

Given the complexity of oncological pathologies, the therapeutic decision in the case of a patient with secondary bone determinations must be established by a multidisciplinary team comprising the oncologist, orthopedic surgeon, pathologist, anesthetist, and radiotherapist.

Surgical treatment of symptomatic bone metastases that cause pain and functional impotence with limited patient mobility increases survival and quality of life regardless of the type of surgery and the implant chosen.

Keywords

  • bone metastases
  • proximal femur
  • surgery
  • osteosynthesis
  • endoprostheses
  • arthroplasty
Open Access

Muscle-skeletal metastatic pattern in vulvar cancer

Published Online: 14 May 2022
Page range: 78 - 82

Abstract

Abstract

Vulvar cancer is a rare malignancy of the genital tract, the fourth most common type in this category. The most common form of the clinical appearance is long-lasting pruritus, a lump or mass on the vulva. Despite its histological type, in most cases, invasive vulvar cancer metastasizes primarily through the lymphatic system. Bone metastases related to gynecological cancers are rare, often underdiagnosed, and have a very poor prognosis. The most common site of metastasis in vulvar cancer is the lung, which is affected in about 45%, followed closely by the liver and brain. Bone metastases are present in about 10% to a quarter of cases. The most common places are the spine, pelvic bone, ribs, skull, limb bones and sternum. The only characteristic of the bone microenvironment is its high sensitivity to endocrine status, as vulvar cancer affects postmenopausal women. Thus, the theory of the protective role of estrogen on bone density and bone metastases remains an open door for future protection and treatment strategies.

Keywords

  • vulvar cancer
  • bone metastases
  • post-menopause
  • diagnosis
Open Access

COVID-19 Era - Adapting treatment and education in the Orthopedics and Traumatology Department - review

Published Online: 14 May 2022
Page range: 83 - 96

Abstract

Abstract

Coronavirus disease (COVID-19) is a pandemic-level health disaster with more than 220 million verified cases and more than 4.6 million confirmed fatalities globally as of September 2021. Since its initial detection in 2019, the virus has spread rapidly around the world. In many parts of the world, the present status of health systems has resulted in a decline in elective procedures.

Physician shortages have been clearly reported in nations that have previously been infected with the virus. Experienced and young physicians were similarly recruited to work on the front lines in medical wards and intensive care units outside of their specializations. As a result, hospitals have made significant modifications to their care systems, such as updating general wards to include ICU capabilities, postponing, and canceling elective procedures, and rethinking the duties of healthcare personnel.

Residents and fellows in training in orthopedic surgery have not been immune to these developments. As a result of many hospitals discontinuing elective procedures, orthopedic case volume has decreased significantly. Numerous educational activities must be implemented to provide workers with the knowledge and skills essential to protect themselves and their families from infection and to care for COVID-19 patients.

Keywords

  • Covid-19
  • shortages
  • infrastructure
  • education
7 Articles
Open Access

Perioperative pain management in total hip and knee arthroplasty

Published Online: 14 May 2022
Page range: 53 - 53

Abstract

Open Access

Complex table saw hand injury-case report

Published Online: 14 May 2022
Page range: 54 - 58

Abstract

Abstract

Currently, Romania lacks a tradition of trade schools. This is due to the lack of awareness on the importance of this educational structure. Such multiple trades have been learned by simple observation from one individual to another. The importance of security measures has been taken for granted if not ignored. The number of traumas produced in wood processing has decreased rapidly due to the appearance of wood processing robots, the human factor being reduced only to their programming. The cases that arrive in the emergency departments are in a major percentage from the rural area, where the wood processing is done in the household without an adequate training and without going through a learning process. Hand injuries represent a great part of the Emergency Department presentations, and because of their fundamental functional use in daily life, repair of such lesions should be done with utmost care. Wounds of the hand typically have different degrees of severity depending on the mechanism of injury. Hand trauma probably represents the most frequent pathology of a plastic surgery ER and it should be handled with utmost care because of the fundamental function in the daily routine. The present article presents the therapeutic conduct of a complex case, multiple wounds with bone exposure, digital nerve sectioning and destruction of the flexor system of several fingers.

Keywords

  • table saw
  • hand injury
  • trauma
  • case report
Open Access

Medical rehabilitation of a patient with CRPS type I after tibial plateau fracture and sprain of the ankle: A case report and Literature review

Published Online: 14 May 2022
Page range: 59 - 66

Abstract

Abstract

Complex regional pain syndrome is a clinical syndrome characterized by chronic, severe, neuropathic pain, which is associated with sensory, trophic, and autonomic disorders and decreased range of motion of the affected joint. Symptoms begin at a variable interval, at least 6 weeks after a traumatic event or after surgery. The evolution of symptoms is unpredictable, as they can range from complete and self-limiting resolution to significant chronic pain with decreasing limb function and quality of life. Depending on the absence or presence of a well-identified neural lesion, types I and II of CRPS can be observed. Because it is a relatively rare condition, it can be overlooked due to the limited experience that doctors have with this one.

A 61-year-old male patient presented with severe pain 9/10 on the Visual Analogue Scale (VAS) and a significant decrease in mobility after suffering a traumatic fracture with a left tibial plateau fracture 4 months before, which required orthopedic treatment with a plate and screws, and a left ankle sprain. Previously, the patient presented to several emergency services where he received anti-inflammatory and analgesic treatment with gradual aggravation of pain and impaired mobility of the left lower limb, walking being possible only on two axillary crutches. The patient received treatment that combined drug therapy with medical rehabilitation exercises and physical therapy agents, with a favorable evolution. At the time of discharge, the pain was 5/10 on the VAS scale and the patient could move with a single Canadian crutch.

Keywords

  • CRPS
  • pain
  • trauma
  • fracture
  • quality of life
Open Access

Bone grafts versus synthetic bone substitutes in the treatment of benign bone tumors

Published Online: 14 May 2022
Page range: 67 - 70

Abstract

Abstract

Benign bone tumors represent an important chapter in the pathology of the musculoskeletal system, most commonly affecting young people under the age of 30. The most common benign bone tumors diagnosed in orthopedic surgery are: osteochondroma, osteoid osteoma, osteoblastoma, giant cell tumor, bone aneurysmal cyst, and fibrous dysplasia. An important feature is the lack of secondary determinations.

Depending on the type and the location of the benign bone tumors, treatment can be non-surgical or surgical.

Patients included in the study were between 25 and 55 years old with an average age of 40.

In both cases, the radiological image remains the routine investigation in the periodic postoperative control.

The purpose of this study was to compare the surgical treatment (curettage-filling) with synthetic bone substitute, compared to autograft in patients with benign bone tumors.

Keywords

  • synthetic bone substitute
  • autograft
  • benign tumors
  • bone
  • treatment
Open Access

Surgical management of bone metastasis located in the proximal femur-review of literature

Published Online: 14 May 2022
Page range: 71 - 77

Abstract

Abstract

Neoplasms are the second leading cause of death worldwide. The increase in diagnostic possibilities and development of new treatments has led to an increase in life expectancy among cancer patients.

The proximal region of the femur is a favorite site for bone metastases, these lesions being accompanied by increased mortality and morbidity.

The methods of treatment for metastatic bone disease can be surgical or non-surgical.

Bone metastases and pathological bone fractures in the proximal femur are most commonly located in the intertrochanteric or subtrochanteric region. Patients with bone metastases at this level most often require osteosynthesis with a centromedullary nail, but also plates and screws or dynamic hip screw can be used.

Bone metastases located in the femoral neck or femoral head can be treated surgically by hemiarthroplasty (HA) or total hip arthroplasty (THA). Both HA and THA have been shown to be successful surgeries in patients with bone metastases.

In patients with multiple bone metastases located in the head or neck of the femur and trochanteric region, but with increased life expectancy, resection and reconstruction using endoprostheses is a viable solution.

Given the complexity of oncological pathologies, the therapeutic decision in the case of a patient with secondary bone determinations must be established by a multidisciplinary team comprising the oncologist, orthopedic surgeon, pathologist, anesthetist, and radiotherapist.

Surgical treatment of symptomatic bone metastases that cause pain and functional impotence with limited patient mobility increases survival and quality of life regardless of the type of surgery and the implant chosen.

Keywords

  • bone metastases
  • proximal femur
  • surgery
  • osteosynthesis
  • endoprostheses
  • arthroplasty
Open Access

Muscle-skeletal metastatic pattern in vulvar cancer

Published Online: 14 May 2022
Page range: 78 - 82

Abstract

Abstract

Vulvar cancer is a rare malignancy of the genital tract, the fourth most common type in this category. The most common form of the clinical appearance is long-lasting pruritus, a lump or mass on the vulva. Despite its histological type, in most cases, invasive vulvar cancer metastasizes primarily through the lymphatic system. Bone metastases related to gynecological cancers are rare, often underdiagnosed, and have a very poor prognosis. The most common site of metastasis in vulvar cancer is the lung, which is affected in about 45%, followed closely by the liver and brain. Bone metastases are present in about 10% to a quarter of cases. The most common places are the spine, pelvic bone, ribs, skull, limb bones and sternum. The only characteristic of the bone microenvironment is its high sensitivity to endocrine status, as vulvar cancer affects postmenopausal women. Thus, the theory of the protective role of estrogen on bone density and bone metastases remains an open door for future protection and treatment strategies.

Keywords

  • vulvar cancer
  • bone metastases
  • post-menopause
  • diagnosis
Open Access

COVID-19 Era - Adapting treatment and education in the Orthopedics and Traumatology Department - review

Published Online: 14 May 2022
Page range: 83 - 96

Abstract

Abstract

Coronavirus disease (COVID-19) is a pandemic-level health disaster with more than 220 million verified cases and more than 4.6 million confirmed fatalities globally as of September 2021. Since its initial detection in 2019, the virus has spread rapidly around the world. In many parts of the world, the present status of health systems has resulted in a decline in elective procedures.

Physician shortages have been clearly reported in nations that have previously been infected with the virus. Experienced and young physicians were similarly recruited to work on the front lines in medical wards and intensive care units outside of their specializations. As a result, hospitals have made significant modifications to their care systems, such as updating general wards to include ICU capabilities, postponing, and canceling elective procedures, and rethinking the duties of healthcare personnel.

Residents and fellows in training in orthopedic surgery have not been immune to these developments. As a result of many hospitals discontinuing elective procedures, orthopedic case volume has decreased significantly. Numerous educational activities must be implemented to provide workers with the knowledge and skills essential to protect themselves and their families from infection and to care for COVID-19 patients.

Keywords

  • Covid-19
  • shortages
  • infrastructure
  • education

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