Romanian Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Posterior interosseous nerve entrapment by intramuscular lipoma arising from the supinator muscle - a case report","authors":"O. Refai, M. Elsherif, A. Khalifa","doi":"10.2478/rojost-2021-0005","DOIUrl":"https://doi.org/10.2478/rojost-2021-0005","url":null,"abstract":"Abstract Background: Lipomas are benign, slow-growing tumors frequently subcutaneous and asymptomatic, intramuscular lipoma constituting a rare subtype. However, a lipoma occurring nearby the proximal radius may cause posterior interosseous nerve (PIN) entrapment. Case presentation: We described an uncommon case of a 45-year-old-man with a history of progressive, painless proximal right (dominant) forearm swelling for 4 months associated with PIN entrapment syndrome, presenting as fingers extension weakness. Intramuscular lipoma was observed in the supinator muscle in the magnetic resonance imaging (MRI). Lipoma surgical excision and release of the PIN through proximal forearm direct anterior approach was performed. Results: The histopathological examination confirmed the diagnosis of benign intramuscular lipoma. The follow-up of the patient showed full recovery within three months postoperatively. Discussion: Intramuscular lipoma is rare; however, it could originate from supinator muscle in the forearm, presenting with vague pain and could lead to compression of nearby neurovascular structures such as the PIN. Clinical evaluation and imaging studies, especially MRI, are crucial for diagnosis. If neural compression is evident, surgical resection is mandatory. Conclusion: Intramuscular lipoma entrapping PIN is rare and requires early clinical diagnosis confirmed by imaging and neurophysiological studies, surgical excision being the method of choice for optimum functional outcomes.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122154864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of knee joint mucormycosis with pathological fracture after COVID-19 infection","authors":"Sergiu-Andrei Iordache, A. Cursaru, B. Șerban, M. Popa","doi":"10.2478/rojost-2021-0003","DOIUrl":"https://doi.org/10.2478/rojost-2021-0003","url":null,"abstract":"Abstract Mucormycosis is a fungal infection that generally occurs in patients with some degree of immunosuppression, such as patients with malignancies, diabetes, HIV infection, or patients who require the administration of immunosuppressive drugs. The final diagnosis is established by collecting some tissue from the infectious process and isolating the fungus using lab cultures. The treatment of mucormycosis is complex and consists of trying to reduce risk factors, rigorous surgical debridement, and specific antifungal treatment. We present the case of a 54-year-old male patient with a background of SARS-COV2 infection (moderate form), that started 3 months prior to presentation to our hospital, initially treated at home. The patient presented to the Orthopaedics Department of the University Emergency Hospital of Bucharest with pain and total functional impotence in his left knee as a result of a trauma that occurred about 2 months before the presentation to the hospital, at that moment with progressive worsening of the symptoms. Clinical and imaging examination established the diagnosis of pathological supra-intercondylar fracture of the left femur. The purpose of this case report is to present the risk of infection with an opportunistic agent as a result of immunosuppression induced by COVID-19 or its treatment with immunosuppressive agents necessary to combat the inflammatory process. The patient presented with a moderate form of COVID-19 treated at home with nonsteroidal anti-inflammatory drugs and antibiotics to prevent a bacterial superinfection. Mucormycosis remained a challenging situation for the physician, regardless of his medical specialty, both in terms of diagnosis and treatment. In this case, COVID-19 is one of the risk factors that contributed to the appearance of mucormycosis.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114308159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptures of mesentery- a silent posttraumatic injury (Case Report)","authors":"I. Eremia, L. Grecescu, S. Albu, A. Iancu, R. Nica, S. Nica","doi":"10.2478/rojost-2020-0013","DOIUrl":"https://doi.org/10.2478/rojost-2020-0013","url":null,"abstract":"Abstract The mechanism of mesenteric injury in blunt abdominal trauma involves compression and deceleration forces which result in a spectrum of injuries that range from contusions to tearing of the bowel wall, tearing of the mesentery, and loss of vascular supply. Hemoperitoneum is a major sign of severity in abdominal trauma, which, in most cases, requires emergency surgery. Our patient showed that the diagnosis of mesenteric injury should be considered even in patients who sustain only minor abdominal trauma. In this case the patient’s symptoms were suggestive only for the orthopedic lesion and not for the hemoperitoneum. Trans-scapho-lunate dislocation fracture is a rare lesion that may go unnoticed at initial assessment in a polytraumatized patient. A delay in the diagnosis and treatment of a scaphoid fracture may alter the prognosis after consolidation.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126458787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for an educational campaign in Romania to encourage people with chronic hip or knee pain to make informed decisions when having surgery during COVID-19 pandemic","authors":"C. Cirstoiu","doi":"10.2478/rojost-2020-0012","DOIUrl":"https://doi.org/10.2478/rojost-2020-0012","url":null,"abstract":"","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125280489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decline in hospitalization for all medical conditions during the COVID-19 pandemic","authors":"A. Cotiga, C. Ivan, S. Nica, M. Zivari","doi":"10.2478/rojost-2020-0016","DOIUrl":"https://doi.org/10.2478/rojost-2020-0016","url":null,"abstract":"Abstract Introduction: Hospital admissions fell dramatically in Romania during the COVID-19 pandemic partially due to urgent legislation for controlling the infection rates that influenced the selection criteria for hospitalization and also due to fear of infection with SARS-CoV-2 which resulted in avoiding medical services. Aim: This study aimed to assess the impact of COVID-19 pandemic on the population availability to access medical services by comparing the admission rates for all departments of the University Emergency Hospital, Bucharest, from March to August 2019 and March to August 2020. Methods: A cohort of 38.730 patients was analyzed according to hospitalization rate from March to August 2019 and March to August 2020. Results: From March to August 2020 patients were hospitalized as a result of a medical emergency rather than an appointment, as outpatient and hospitalization rates changed dramatically. Thus, 67.4% accessed hospitalization from March to August 2019 and 32.6% accessed hospitalization from March to August 2020. The proportion of the patients admitted from the Ambulatory Care Unit decreased significantly from 44.2% in 2019 to 32.7% in 2020. Also, the structure of the patients’ profile has been affected. Discussion: The COVID-19 pandemic period in 2020 (March-September) affected the hospitalization rate and the structure of the patients’ profile that came to the University Emergency Hospital in Bucharest, Romania. Conclusion: The patients who would have accessed the medical health services that might have resulted in hospitalization could have resulted in out-of-hospital deaths and this should also be the focus of the public health authorities.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129124657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of blunt liver trauma in times of COVID-19 pandemic","authors":"V. Braga, I. Slavu, A. Tulin, B. Socea, L. Alecu","doi":"10.2478/rojost-2020-0014","DOIUrl":"https://doi.org/10.2478/rojost-2020-0014","url":null,"abstract":"Abstract The liver is one of the most affected organs in abdominal trauma mostly because of its considerable dimensions, the fragility of the liver parenchyma. We present the case of a 29-year-old patient who sustained an abdominal trauma after an accidental fall from a 3 m height. The patient tested positive at RT-PCR for SARS-CoV-2 at admission, without any symptoms of viral infection. The emergency CT scan revealed a blunt liver trauma with an expanding hematoma (grade III). The patient was initially hemodynamically stable but shortly after admission became unstable and required surgical treatment that initially consisted of damage control and liver packing. Reintervention was decided 36 hours later, after reevaluation unpacking and hepatorrhaphy were done. The postoperative evolution was uneventful. The case indicated the importance of continuous monitoring of the traumatic patient. In liver trauma, hemodynamic instability guarantees an emergency laparotomy. The time of operations in trauma patients with SARS-CoV-2 must be reduced to the maximum both as an objective of damage control and also to minimize the risk of contagion.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127475884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopedic surgery related infections; study of the importance of associated comorbidities in relationship with septic evolution","authors":"M. Popa, B. Șerban, Sergiu-Andrei Iordache, A. Lupu, G. Iacobescu, A. Cursaru","doi":"10.2478/rojost-2020-0015","DOIUrl":"https://doi.org/10.2478/rojost-2020-0015","url":null,"abstract":"Abstract The current socio-economic development has improved the standard of living of the general population. Technological evolution has led to the use of an increasing number of motor vehicles. Associated with the growing violence observed globally, orthopedic surgery involves frequent use of osteosynthesis materials and prostheses. Therefore, an increasing number of patients live with these implants, having a higher risk, compared to the general population, to develop complications. Although technological developments have increased the quality of life, it must not be forgotten that these foreign materials come with certain risks, the most feared being the associated infections. We conducted an epidemiological study on infections identified in patients treated in the Orthopedics and Traumatology Department of Bucharest Emergency University Hospital, from 01.01.2016 to 01.06.2019. We were able to extract data about patients without neglecting their confidentiality. The information sought, primarily involved the pathogen causing the infection, but at the same time we tried to build a more accurate history of each patient in order to determine the cause of infection and the risks posed by various associated pathologies. During these 4 years we were able to identify 139 patients who suffered an infection in the musculoskeletal system. In most cases we identified mono-microbial infections, but there were 7 cases in which two pathogens were identified.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123728729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electric scooter vs. motorcycle injuries – little toys with an underestimated impact","authors":"S. Nica, I. Eremia, Maria-Adriana Albu, A. Cursaru, S. Albu","doi":"10.2478/rojost-2020-0017","DOIUrl":"https://doi.org/10.2478/rojost-2020-0017","url":null,"abstract":"Abstract Introduction: The study weighs the impact of accidents involving electric scooters and motorcycles, its main purpose being that of showing the injuries produced by the use of electric scooters. Materials and method: The retrospective study was conducted in the Emergency Unit of the University Emergency Hospital Bucharest, Romania, between 01.06.2020 and 30.09.2020, by analyzing the data from the presentation sheets and the hospital database. It followed and compared a total of 55 cases, out of which 29 patients were involved in motorcycle accidents, and 26 patients were involved in electric scooter accidents, by number, age, sex, imaging investigations, severity of injuries, hospitalization days, and the treatment of discharged patients. General data about the number of analyzed presentations was extracted and compared to similar data from the same period of the year 2019. Results: The study showed an increase in presentations due to electric scooter accidents. Also, most of the injuries in both types of accidents are musculoskeletal (96.5% in motorcycle accidents and 84.61% in electric scooter accidents), and the percentage of discharged patients who needed immobilization by various orthopedic devices was higher in electric scooter accidents (34.8%) than in motorcycle accidents (26%). Discussions: The study was conducted in the middle of the COVID-19 pandemic, in an atypical situation, due to regulations imposed by the authorities. Conclusion: There was an increase in the use of electric scooters in the summer of 2020, which resulted in an increased number of mainly orthopedic injuries, and implicitly of immobilization for discharged patients, underestimated by the population, as protective equipment is not mandatory for people aged over 16 years.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"310 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122779026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amputation, psychological consequences, and quality of life among Romanian patients","authors":"A. Cotiga, M. Zivari, A. Cursaru, Cătălin Aliuș, C. Ivan","doi":"10.2478/rojost-2020-0006","DOIUrl":"https://doi.org/10.2478/rojost-2020-0006","url":null,"abstract":"Abstract Amputation of the limb is a major psychological health issue that was not fully studied. Patients and their families struggle with symptoms of depression, posttraumatic stress disorder, anxiety, phantom limb phenomena, etc. There is also a tremendous impact on the person’s quality of life. Aim: This study aimed to assess the psychological symptoms of depression, anxiety, and the quality of life among persons suffering from amputation of the limb. Methods: 31 respondents agreed to participate in the study. They were recruited from the Department of Orthopaedics and Traumatology, University Emergency Hospital, Bucharest, Romania. The medical conditions and the socio-demographic data (i.e., gender, marital status, income, etc.) along with the assessment of the psychological conditions and quality of life were contributions to the statistical analysis of the study. Results: This study showed that levels of depression are moderate to severe for a significant percent of the population (i.e., a “moderate to severe” or “severe” level of depression was presented by 29% of the patients according to the PHQ-9 test, and 16.1% of the patients according to Beck’s Depression Inventory). Moreover, the levels of anxiety were relatively higher than those of the general population (i.e., severe anxiety was confirmed by the GAD-7 test in the case of 38.7% of the patients) and for most of them the quality of life was impaired. Discussion: Amputation occurs mainly in adults/elderly aged over 50 years, married, living in urban areas, with different levels of depression and anxiety. At least half of them had a self-perceived health condition that was deteriorated, their physical and role functioning being primarily affected. Conclusion: There is a need for psychological support of the patients suffering from limb amputation as most of the studies showed high prevalence of depression and anxiety. Socio-demographic factors also represent important elements in defining the quality of life of those patients.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125520599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlations between intra and extraarticular factors measured by computed tomography in patients with recurrent patellar dislocation","authors":"G. Iacobescu, A. Cursaru, D. Anghelescu, M. Popa, D. Popescu","doi":"10.2478/rojost-2020-0005","DOIUrl":"https://doi.org/10.2478/rojost-2020-0005","url":null,"abstract":"Abstract Introduction: Lateral patellar dislocation (LPD) is a common injury of the knee, most frequent in young patients. It has a multifactorial etiology with several underlying risk factors. In most cases, patellar dislocation occurs on the lateral side, with the rupture of the medial patellofemoral ligament (MPFL), appearing in more than 80% of the cases. The tibial tuberosity-trochlear groove (TT-TG) distance of 20 mm or more in patients with lateral patellar dislocation is a gold standard for the surgical indication of tibial tubercle osteotomy (TTO). Hypothesis: Our investigation aimed to establish whether there is a correlation between the TT-TG distance and other bony landmarks, like trochlear groove medialization, tibial tuberosity lateralization, and knee rotation angle, in the surgical algorithm for the patient with patellar dislocation. Methods: We conducted a prospective study, analyzing and comparing data from two groups, 33 patients with a diagnosis of patellar dislocation, and a control group of 30 patients, with meniscal injury, but healthy contralateral limb. Using computed tomography, we measured the TT-TG distance, femoral anteversion, tibial torsion, knee rotation angle, tuberosity lateralization, and trochlear groove medialization of all the patients in our study. The measurements were conducted by two independent orthopedic surgeons in a randomized manner. Using an unpaired t test, we compared and analyzed each parameters value from the study and the control group. Results: Comparing the two groups, we observed a significant difference for TT-TG distance, knee rotation angle and tibial tuberosity lateralization with higher values in the study group compared to the control group (CI 95% 6.44-9.72, CI 95% 8.64-10.39, CI 95% 3.77-5.46, respectively), with a p value < 0.0001 in all cases. Also, the TT-TG distance positively correlated with knee rotation angle (r=.97, p=0.01) and tibial tuberosity lateralization (r=.86, p=0.0001) in the study group. Conclusions: The TT-TG distance measurement usually defines the lateralization of the tibial tuberosity; yet, in some cases, it can be caused by the trochlear groove medialization, or high rotation between the femur and tibia. Our study revealed that knee rotation and tuberosity lateralization were factors implicated in patellar dislocation and they should be taken into account when making the decision of tibial tubercle osteotomy.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114575539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}