Romanian Journal of Orthopaedic Surgery and Traumatology最新文献_第8页

Primary Total Knee Arthroplasty (TKA) with revision Total Stabilizer Prosthesis in a 66-year-old patient with secondary knee osteoarthritis and valgus deformity. Case Report 一期全膝关节置换术加改良全稳定假体治疗66岁继发膝骨关节炎和外翻畸形患者。病例报告

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-12-01 DOI: 10.2478/rojost-2018-0083

Mihai Gherman, A. Sere, Mihai-Daniel Angheluță, R. Coste

{"title":"Primary Total Knee Arthroplasty (TKA) with revision Total Stabilizer Prosthesis in a 66-year-old patient with secondary knee osteoarthritis and valgus deformity. Case Report","authors":"Mihai Gherman, A. Sere, Mihai-Daniel Angheluță, R. Coste","doi":"10.2478/rojost-2018-0083","DOIUrl":"https://doi.org/10.2478/rojost-2018-0083","url":null,"abstract":"Abstract Knee osteoarthritis (gonarthrosis) is the most prevalent knee pathology encountered nowadays in the third age population, leading to severe disability and reduced life quality. Secondary gonarthrosis may be caused by a traumatic event, which subjects the knee joint to a transitory highly increased mechanical stress, initiating a rapidly progressive degrading process of the articular cartilage and subjacent bone tissue. TKA is intended to replace all the intra-articular components with artificial parts, in order to relieve pain, compensate for ligament instability, correct deformities, and restore proper joint functionality. Semi-constrained, non-hinged implants are usually used for revision TKA, in knees that already had a primary TKA but sustained complications. Nevertheless, here we reported the case of a 66-year-old female patient diagnosed with posttraumatic gonarthrosis who underwent TKA with a revision total stabilizer implant as primary treatment due to severe joint instability and high grade valgus deviation. The outcome of the surgical procedure was positive, with significant pain relief and increased knee stability. The valgus angle was reduced from 37° to 4° and the KSS score increased from 3 to 87 points. Therefore, revision semi-constrained prosthesis may be used as a primary implant with promising result in severe cases.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128129372","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}

引用次数: 1

Guidance and Guideline-recommendations for the treatment of femoral neck fractures Romanian Society of Orthopaedics and Traumatology- SOROT 2018 罗马尼亚骨科和创伤学会- SOROT 2018股骨颈骨折治疗指南和指南建议

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-12-01 DOI: 10.2478/rojost-2018-0087

O. Lupescu, M. Roman, B. Deleanu, H. Benea, H. Haragus, R. Prejbeanu, D. Sandesc, O. Russu, T. Bataga, G. Popescu, C. Cirstoiu

{"title":"Guidance and Guideline-recommendations for the treatment of femoral neck fractures Romanian Society of Orthopaedics and Traumatology- SOROT 2018","authors":"O. Lupescu, M. Roman, B. Deleanu, H. Benea, H. Haragus, R. Prejbeanu, D. Sandesc, O. Russu, T. Bataga, G. Popescu, C. Cirstoiu","doi":"10.2478/rojost-2018-0087","DOIUrl":"https://doi.org/10.2478/rojost-2018-0087","url":null,"abstract":"Abstract Two types of femoral neck fractures are nowadays identified: those resulting from low energy trauma, usually by direct by falling on the hip, in patients with affected bone stock (the so-called “fragility fractures”) and those produced by high energy trauma, even in younger people, with normal bone stock. These recommendations are addressed to the first category. for which impaired mineral bone density (MBD), osteopenia, and osteoporosis represent major enabling factors. These recommendations refer to classification-based local and general treatment of femoral neck fractures (excluding the basilar neck ones). The presumptive and definitive diagnoses include the precise description of the fracture pattern, by complete imagistic evaluation. The treatment depends on the type of the patient (demanding or non-demanding), on the type of the fracture (stable or unstable), as well as on the facility of early treatment, in certain cases. The main therapeutic goal in femoral neck fractures is early social and professional reinsertion of the patient, by gaining a status as close as possible to the one before the trauma; stable stabilization allowing early mobilization has a key role in fulfilling this objective Therefore, complete evaluation and monitoring of the patient by a multidisciplinary team is mandatory in order to perform a proper evaluation of the anaesthetic and surgical risk ( as these patients usually have pre-existing health problems, sometimes severe) , a safe and adapted (form the point of view of invasivity) surgery and an appropriate post-operative local and general treatment. Therefore, these recommendations have numerous connections with those involving the intervention of physicians from other specialities with whom orthopaedic surgeons must cooperate in these cases","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126877001","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}

引用次数: 0

Interdisciplinary perspective of training and updates 跨学科视角的培训和更新

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-12-01 DOI: 10.2478/rojost-2018-0080

C. Cirstoiu

引用次数: 0

Treading on tricky ground: reconstructive approaches to Charcot neuropathic arthropathy of the foot 在棘手的地面上行走:重建方法的沙科神经性关节病的脚

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-12-01 DOI: 10.2478/rojost-2018-0089

D. Ion

{"title":"Treading on tricky ground: reconstructive approaches to Charcot neuropathic arthropathy of the foot","authors":"D. Ion","doi":"10.2478/rojost-2018-0089","DOIUrl":"https://doi.org/10.2478/rojost-2018-0089","url":null,"abstract":"Abstract Introduction and purpose:Charcot neuroarthropathy defines a cluster of progressive lesions affecting the joints and bones, as well as the soft tissues of the foot in the context of diabetes, a pivotal role being attributed to peripheral neuropathy. Loss of sensation and proprioception, subsequent repeated trauma, muscle and autonomic nervous system impairment contribute to the alteration of the foot’s architecture and distribution of pressure, ultimately triggering ulceration and gangrene. The urge to avoid amputation has fueled the development of conservative and reconstructive techniques capable of delaying, if not preventing such negative outcomes. The purpose of this review was to present the most frequently used reconstruction procedures and the challenges arising in adapting them to particular foot morphologies and lesion stages. Methods:Literature search was conducted using PubMed, resulting in around 90 articles, multicenter studies and reviews, 26 of which were considered most relevant in providing the guidelines for orthopedic reconstruction and postoperative care in Charcot foot patients with diabetic neuropathy prevailing over arteriopathy. Results:The tarsometatarsal and metatarsophalangeal joints are most frequently affected. Closed reduction, arthrodesis, and tendon lengthening are key features of an efficient correction, alternatively accompanied by resections and tenotomies. Ulceration and callus debridement may also be necessary, while prolonged casting and immobilization remain obligatory. Conclusions:Most authors agree that stabilizing the deformities, optimizing the pressure on the soft tissues, and promoting the healing of potential lesions are the main purposes of the interventions. Prompt recognition and correction of Charcot foot deformities improve life quality and minimize the prospects of amputation.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114403025","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}

引用次数: 0

Post Traumatic Multi-Injured patients. To wait, to operate or to use Damage Control Orthopedic template? A case report 创伤后多重损伤患者。是等待，是操作，还是使用损伤控制骨科模板?病例报告

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-12-01 DOI: 10.2478/rojost-2018-0084

Osama Al-Odat, M. M. Odat, S. Luca, M. Fotea, Andrei Nicolae Avădanei, M. Zarzecki

{"title":"Post Traumatic Multi-Injured patients. To wait, to operate or to use Damage Control Orthopedic template? A case report","authors":"Osama Al-Odat, M. M. Odat, S. Luca, M. Fotea, Andrei Nicolae Avădanei, M. Zarzecki","doi":"10.2478/rojost-2018-0084","DOIUrl":"https://doi.org/10.2478/rojost-2018-0084","url":null,"abstract":"Abstract Purpose. Damage Control Orthopedics (DCO) is a surgical concept used in the recovery of seriously injured patients. Given that the leading cause of death among trauma patients remains uncontrolled hemorrhage, DCO emphasizes on preventing the \"lethal triad” of acidosis, coagulopathy and hypothermia, rather than correcting the anatomy immediately. Thereby, we are presenting the crucial importance of using this technique in severe trauma cases. Methods. A 23-year-old female was admitted in the Emergency Room as a multi-trauma patient. Following the Advanced Trauma Life Support protocol, fully exposure examination showed bilateral forearm and femur deformities, with bilateral open femur fracture, left ankle deformity and pelvic ecchymosis. X-rays confirmed fractures of the ribs, bilateral pulmonary contusion, fracture of the left ankle fracture, bilateral superior and inferior pubic ramus, and bilateral femur fractures with both bone midshaft fracture on the right leg. DCO was proceeded immediately, during which external fixators were placed on the fractures, while splinting both forearms. After 11 days in the Intensive Care Unit (ICU), the patient underwent the definitive surgeries. Results. Managing the patient with the DCO protocol first and not rushing with the definitive surgical procedures resulted in a proper stabilization. After two years follow up, the patient fully recovered and returned to a normal life style. Conclusion. Performing a definitive operation on severely injured patients results in deleterious effects that could lower life expectancy. Short-term physiological recovery should be prioritized over definitive management and DCO should be proceeded in order for the best outcomes to be achieved.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"332 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121680852","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}

引用次数: 0

Pelvic Chondrosarcoma - The Role of the Biopsy and the Correlation Between the Histopathological Bioptic Diagnosis and the Excisional One 盆腔软骨肉瘤-活检的作用和组织病理活检诊断与切除之间的关系

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0079

R. Popescu, S. Cuculici, Ș. Cristea

{"title":"Pelvic Chondrosarcoma - The Role of the Biopsy and the Correlation Between the Histopathological Bioptic Diagnosis and the Excisional One","authors":"R. Popescu, S. Cuculici, Ș. Cristea","doi":"10.2478/rojost-2018-0079","DOIUrl":"https://doi.org/10.2478/rojost-2018-0079","url":null,"abstract":"Abstract Chondrosarcoma is one of the most frequent malignant bone tumors. We included in the initial study population 110 patients with pelvis biopsies and the histopathological result of chondrosarcoma. We excluded the cases with incomplete data. Thirty-five in block resections were included in the final study population. In the rest of the cases, the surgery was not made because of many considerations (multiple metastases, patient’s refusal, and surgical contraindications). In three cases, discrepancies were noted between the grade of malignancy found after biopsy and the one confirmed through the surgical excision. This corresponds to a precision rate of 91,42 % (32/ 35) in the confirmation of chondrosarcoma. The accuracy of the histopathological diagnosis between low grade chondrosarcoma and high grade chondrosarcoma was of 94,27 % (33/ 35). We concluded that the image-guided biopsy is useful in determining the grade of malignancy of the chondrosarcoma and in the planning of the subsequent treatment. A multidisciplinary team (orthopaedic surgeon, radiologist, and pathologist) is needed to improve the diagnosis of the pelvic chondrosarcoma.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121335311","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}

引用次数: 0

Statistically Based Survival Rate Estimation in Patients with Soft Tissue Tumors 基于统计的软组织肿瘤患者存活率估计

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0018

B. Șerban, Z. Pánti, M. Nica, M. Pleniceanu, M. Popa, R. Ene, C. Cirstoiu

{"title":"Statistically Based Survival Rate Estimation in Patients with Soft Tissue Tumors","authors":"B. Șerban, Z. Pánti, M. Nica, M. Pleniceanu, M. Popa, R. Ene, C. Cirstoiu","doi":"10.2478/rojost-2018-0018","DOIUrl":"https://doi.org/10.2478/rojost-2018-0018","url":null,"abstract":"Abstract Introduction. Although most soft tissue tumors are benign, with a high healing rate after surgical excision, there is a variety of malignant tumors with differences in progression and prognosis. The study aims to assess the survival rate in patients diagnosed with this pathology, based on the patient’s characteristics (age, gender, race), as well as the tumor’s (histological type, differentiation degree, location and size). Materials and methods. The retrospective study included a group of 103 patients diagnosed in our department during 2010 and 2017. Considering the high healing rate of benign tumors, only the group of neoplastic patients (45 cases) was involved in the survival rate estimation, assessing tumor characteristics and individual comorbidities. Within this lot, we emphasized a predominance of neoplasm in patients aged over 50 years (32 cases), men (29 cases), and localization of the neoplasm in the thigh (23 cases). The predominant histopathological type, liposarcoma, was diagnosed in 67% of the cases, with dimensions over 6 cm and with local extension. Results. There have been significant variations in mortality between the different histological subtypes (liposarcoma vs. synovial sarcoma). Local recurrences were shown in 18 cases of liposarcoma in the first 2 years after the surgical excision, with an increased aggressiveness of this neoplasm in men over 50 years. 12 cases developed distant metastasis, and, until the end of the study, 7 deaths were reported in 3 cases involving associated comorbidities. Conclusions. The five-year survival is inversely proportional to the extent of the tumor and the local invasion, as well as to the age of the patient. It is difficult to appreciate an overall survival rate in the context of a heterogeneous group of tumors so it must be evaluated for every histological subtype taking into account the patient’s particularities.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124364281","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}

引用次数: 1

Interdisciplinary Approach in Cervical Neoplasm with Secondary Determinations – A Case Report 宫颈肿瘤继发性诊断的跨学科方法- 1例报告

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/ROJOST-2018-0068

D. Voicu, O. Bodean, F. Păuleț, O. Munteanu, L. Arsene, M. Cirstoiu

{"title":"Interdisciplinary Approach in Cervical Neoplasm with Secondary Determinations – A Case Report","authors":"D. Voicu, O. Bodean, F. Păuleț, O. Munteanu, L. Arsene, M. Cirstoiu","doi":"10.2478/ROJOST-2018-0068","DOIUrl":"https://doi.org/10.2478/ROJOST-2018-0068","url":null,"abstract":"Abstract Introduction. Cervical cancer is the third most common malignancy in women with gynecological pathology. Most of the times, patients are admitted to hospital in advanced stages, with multiple secondary metastases. Case report. We report the case of a 70-year-old patient initially admitted in the Orthopedic Department of University Emergency Hospital in Bucharest with suspicion of pubis fracture. After clinical, imagistic and paraclinical evaluation, cervical cancer was suspected and the patient was transferred to the Obstetrics and Gynecology Department of University Emergency Hospital in Bucharest in order to identify etiology of the multiple secondary metastases. CT examination revealed liver determinations as well as pelvic lymphadenopathy, accompanied by suggestive neoplastic transformation of the cervix and invasion of the uterine body, parameters, and bladder; inferior branch of the pubis, and bilateral pubis, with a suggestive side-by-side aspect, were also distinguished from osteolysis. Histopathological examination following a cervical biopsy revealed non-keratinized squamous carcinoma with secondary imagistic findings, placing this case in FIGO IVB stage. Conclusions. Due to the insidious evolution, cervical cancer can reach advanced stages. The prognosis of patients with advanced stage cervical cancer and bone secondary determinations is reserved.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122276327","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}

引用次数: 0

Postoperative TKA alignment in sagittal and axial plane, a systematic review 术后矢状面和轴向面TKA对齐，系统回顾

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0011

B. Crețu, C. Dragosloveanu, D. Cotor, Ș. Dragosloveanu, C. Stoica

引用次数: 0

Congenital Fibrosarcoma – Case Presentation 先天性纤维肉瘤- 1例报告

Romanian Journal of Orthopaedic Surgery and Traumatology Pub Date : 2018-06-01 DOI: 10.2478/rojost-2018-0026

L. Dobre, C. Vreme, A. Chirițoiu, G. Dorobantu, N. Ionescu, C. Vlad

{"title":"Congenital Fibrosarcoma – Case Presentation","authors":"L. Dobre, C. Vreme, A. Chirițoiu, G. Dorobantu, N. Ionescu, C. Vlad","doi":"10.2478/rojost-2018-0026","DOIUrl":"https://doi.org/10.2478/rojost-2018-0026","url":null,"abstract":"Abstract Introduction. Congenital fibrosarcoma is a rare soft tissue neoplasm, distal extremities being more commonly involved. This tumor has a rapid growth and extensive local invasion, but metastasis is rare. It is usually observed in children younger than two years old and is present at birth in up to 30% of the cases. Purpose. Evaluation of the methods of diagnosis and treatment in a case of a newborn known from intrauterine life, with a large tumor of the right arm. Materials and methods. We present the case of a 1-day-old patient, who was transferred from maternity in our clinics with the following diagnostics: large tumor of the right thoracic member, cardiac insufficiency, prematurity, severe respiratory distress. The tumor was visible at ultrasonography from intrauterine life, and the evolution was the increase in volume with necrosis areas and hair presence on its surface. After imagistic investigation, taking into account the tumoral extension with neurovascular involvement, without the possibility of a tumoral resection, but also the imminent danger of spontaneous rupture, we decided to perform a shoulder disarticulation without a biopsy in advance. Results. Postoperative evolution and the treatment of the cardiac insufficiency were good under antibiotics. The histopathological results advocate for the diagnosis of congenital fibrosarcoma, also confirmed by immunohistochemical tests. Conclusions. Soft tissue tumors are very rare and they need a multidisciplinary evaluation for the establishment of the right treatment. Imagistic and laboratory investigations can guide the diagnosis and the therapeutical conduct. The certainty diagnosis is established only after the histopathological results.","PeriodicalId":122325,"journal":{"name":"Romanian Journal of Orthopaedic Surgery and Traumatology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130235124","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}

引用次数: 0