Calcaneus fractures are still a delicate point regarding the indication for osteosynthesis. Knowi... more Calcaneus fractures are still a delicate point regarding the indication for osteosynthesis. Knowing the skin's poor vascularisation of the back foot, the purpose of this study is to present the benefits of proper surgical options between an open and invasive osteosynthesis with anatomical reduction and internal fixation or minimally invasive approach preserving the quality of the soft parts. 66 interventions that targeted reduction and internal fixation of calcaneus fractures were performed between 2009-2012, in the Orthopaedic and Traumatology Department of Bucharest Emergency University Hospital. 29 cases underwent open reduction and internal fixation with plates and screws or Kirschner wires, and 37 cases underwent a minimally invasive reduction and Essex Lopresti osteosynthesis technique. No patient who underwent a minimally invasive reduction had skin lesions, but showed pain due to osteoarthritis lesions that appeared in the subtalar joint. 4 of them, who underwent open reduction and internal fixation had postoperative wound infections and skin necrosis.
Poor oral hygiene leads to serious damages of theteeth’s surface enamel such as micro-abrasions a... more Poor oral hygiene leads to serious damages of theteeth’s surface enamel such as micro-abrasions and acid erosion. These alterations combined with bacterial plaque result in cavity appearance. Prophylactic measures include various techniques for enamel surface restoration. Fluorination is one of the most important treatments for this purpose. Therefore, in the present research, we investigated the classical fluorination treatment compared with laser photodynamic fluorination performed on human enamel samples with poor surface quality. Three sample groups were investigated: veneer (F), inlay (I), and crowns (C). The general morphologic aspect was investigated by scanning electron microscopy (SEM), and the specific details such as the fine microstructure and nanostructure were investigated by atomic force microscopy (AFM) of the surface roughness. The samples were also investigated by Fourier transformed infrared attenuated total reflectance (FTIR-ATR) to evidence the fluorination effe...
In this experimental study, the mechanical and adhesion properties of several hydraulic lime mort... more In this experimental study, the mechanical and adhesion properties of several hydraulic lime mortars incorporating graphene oxide (GO)-based nanomaterials were evaluated. Four different composite mortar samples were prepared by adding different percentages of GO-based powders (functionalized), i.e., 1 wt.% GO, 5 wt.% GO, 5wt.% GO-Ag-GO-Fly ash, and 5 wt.% GO-ZnO-GO-TiO2 into the reference mortar sample. The mortar specimens were analyzed through mechanical tests, FT-IR, and SEM. The behavior of selected mortars exposed to chemical attacks was also investigated. The results indicate that the addition of the functionalized GO-based powders leads to a significant improvement in the mortar’s adhesion to the brick substrate (up to 80%) compared to the reference sample, especially in the case of the hydraulic lime mortar incorporating the mixture of GO-Ag and GO-Fly ash, which also showed good resistance to chemical attacks.
Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer o... more Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. We present this retrospective study, in which we proposed local endometrial injury for the management of the uterine factors in the case of 30 couples with recurrent implantation failure. Our conclusion was that local endometrial injury improved the clinical pregnancy rate for these couples, especially when the study population met specific criteria.
Romanian Journal of Morphology and Embryology, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Osteosarcoma is the most common primary malignant bone tumor, with a higher prevalence among chil... more Osteosarcoma is the most common primary malignant bone tumor, with a higher prevalence among children and young adults. Its most frequent localization is in the distal femur, followed by the proximal humerus and the proximal femur. In this article, we will describe the case of a 25-year-old male patient who presented to our medical facility, accusing spontaneous pain and swelling, both originating from the left knee. The X-ray of the distal femur showed a heterogeneous mass around the left femoral metaphysis with massive periosteal reaction. The computerized tomography (CT) analysis revealed cortical destruction, with extra-compartmental localization. The patient has later undergone to an incisional biopsy. The histopathology report showed the presence of a chondroblastic osteosarcoma. According to the multidisciplinary diagnosis, the tumor was finallyclassified as type IIB on the Enneking classification. In such cases, the elective surgical procedure is reconstructive surgery, cons...
Introduction: Talus fractures are rare, but because of its peculiar anatomy the complications rat... more Introduction: Talus fractures are rare, but because of its peculiar anatomy the complications rate is high. Its arterial vascularisation can be compromised by trauma in displaced fractures or by the surgical approaches. Material and methods: Between 2001 and 2005, 30 patients with talus fractures were surgically treated in the Department of Orthopedics and Traumatology of Bucharest University Hospital. Sex ratio was 3 men/27 men. 27 fractures were closed. The mean age was 37 years (extremes: 17 – 54 years). Fractures were classified according to Hawkins classification: type I – 9 cases, type II – 13 cases, type III – 8 cases. All patients underwent clinical and radiological examinations at 3, 6 and 12 months and every year after this interval. Results: Hawkins type I fractures were treated by cast immobilization without weight bearing for 6 to 8 weeks. Orthopedic reduction was performed in emergency in order to avoid vascular and cutaneous complications. Hawkins type II and III frac...
CATALIN CIRSTOIU1, RAZVAN ENE1*, ZSOMBOR PANTI1, PATRICIA ENE2, MONICA CIRSTOIU3 1Orthopaedics-Tr... more CATALIN CIRSTOIU1, RAZVAN ENE1*, ZSOMBOR PANTI1, PATRICIA ENE2, MONICA CIRSTOIU3 1Orthopaedics-Traumatology Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania 2 E.N.T. Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania 3 Obstetrics-Gynecology Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania
Pseudomonas aeruginosa is an ubiquitous environmental microorganism, which can cause various infe... more Pseudomonas aeruginosa is an ubiquitous environmental microorganism, which can cause various infections, including infections of the skin or soft tissues, of joints or bones. Infections may have a fulminant course; therefore the rapid diagnosis is very important. Microcalorimetry technique allows the identification of P. aeruginosa in a very short time compared to classical methods. We present the case of a 94-year-old woman, who addressed our clinic for a wound located on her left hip, with a discharge of a purulent fluid on its surface. A month earlier at that level she had had a fracture for which she had undergone a surgical intervention. P. aeruginosa was isolated by classical microbiological methods. Using the microcalorimetry technique, the microorganism was identified in 11 hours.
The acromioclavicular joint dislocation represents a common shoulder injury that frequently occur... more The acromioclavicular joint dislocation represents a common shoulder injury that frequently occurs to young and active individuals. Most of these AC lesions can be treated conservatively but high-grade dislocation need surgical treatment. There are numerous surgical techniques described in literature for treating this injury. The surgeons must choose between open reduction with internal fixation and arthroscopic fixation, which is the latest technique developed. The aim of this study is to evaluate the functional results and the level of pain after an arthroscopic fixation using a TightRope system to treat AC dislocation. It is a less invasive technique, allowing a stable fixation of the joint. In our study we analyzed 48 patients with acute acromioclavicular dislocation, all of them surgically treated using an arthroscopic method with a single TightRope device. An important reduction in pain perception was achieved at six months after the surgery, comparing with the preoperative mo...
Total hip arthroplasty is a surgical procedure that adresses to people with severe hip disorder. ... more Total hip arthroplasty is a surgical procedure that adresses to people with severe hip disorder. The number of total hip replacements is growing year by year due to the good functional results obtained after this procedure, which include pain relief, improvement of walking and quality of life. With improvements in the techniques, materials and prostheses, hip arthroplasties are performed in the younger age patients, which leads to the demand for revision procedures. This procedure almost always comes across with acetabular bone defect. The main challenge for the surgeon during the revision hip arthroplasty is to achieve good implant stability. The purpose of this study is to assess the early clinical and radiological results after revision acetabular components using trabecular metal shells and augments. It was performed on 26 patients classified as Paprosky IIC and IIIA. The functional evaluation was performed perioperatively, at three and at six months after the surgery using radi...
Currently, hip fractures are a common health problem. This type of pathology affects mostly postm... more Currently, hip fractures are a common health problem. This type of pathology affects mostly postmenopausal women, but the risk existing in other categories of patients is not negligible. This type of fracture is treated mostly with surgical techniques because the functional results with the non-surgical ones are not satisfactory. Orthopedic method is chosen in patients who have complex disorder that can’t be operated. Infections occur rarely in this pathology because open fractures are uncommon. In this case, we present a patient of 74 years old, who suffered a traumatic injury after falling from her feet two years ago. The fracture was treated using a Gamma nail. After the operation, the patient’s recovery was favorable. Two months ago, the patient came in the emergency department presenting an active fistula on the hip that was surgically treated. This type of pathology develops after the microorganisms inoculated at various sites disseminated through blood. Following the treatmen...
Romanian Journal of Morphology and Embryology, 2021
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Romanian Journal of Morphology and Embryology, 2020
We are reporting a case of natural evolution and pathological data from a young person that was d... more We are reporting a case of natural evolution and pathological data from a young person that was diagnosed with coronavirus disease 2019 (COVID-19). All data has been collected from the autopsy of a 30-year-old female, which was performed by the
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Pigmented villonodular synovitis is a benign proliferative condition that causes the synovium of ... more Pigmented villonodular synovitis is a benign proliferative condition that causes the synovium of the joints and tendons to thicken and overgrow. The causes have not been completely discovered, with trauma and repetitive inflammation being the most incriminated. Genetic aberrations have been reported in most cases and could suggest a neoplastic origin of the disease. It appears in 2 forms: localized or diffuse. Although it can affect all joints, the most common location is the knee. The treatment options include anti-inflammatory medication, surgical removal (open or arthroscopic) and radiotherapy (mixed results). We present the case of a 31-year-old male who came to our Clinic with pain and tumefaction of the right popliteal fossa. From the patient’s medical history, it resulted that he had developed a tumoral growth in the popliteal fossa 20 months before, which was removed. After extensive investigations (X-ray, CT, and MRI), a biopsy was performed. The result was pigmented villon...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Objectives. Sacral tumors represent about 1-4,3% of all bone tumors. They typically present with ... more Objectives. Sacral tumors represent about 1-4,3% of all bone tumors. They typically present with an abundance of blood vessels. Due to their anatomical localization, they are hard to approach surgically. Thus, a presurgical neoadjuvant therapy is indicated. The preoperative angiography with the embolization of the nutritive arteries decreases the perioperative blood loss and the symptomatology, and even decreases the volume of the tumors that cannot be surgically approached. Materials and methods. The principle of embolization consists in the targeting of the nutritive tumoral artery and in obturating it with embolic agents (polyvinyl alcohol, embospheres, etc.) through selective catheterization under angiographic control. The biopsy of the tumor is essential for certain diagnosis. The histological type of the tumor and the degree of differentiation influence the tumor’s physiopathology and often influence the therapeutic decision regarding its degree or recurrence. In some cases in...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Introduction. The management of critical bone defects has experienced an unprecedented improvemen... more Introduction. The management of critical bone defects has experienced an unprecedented improvement in the last few decades. A good primary mechanical stability and versatility of the modular reconstruction systems allowed the conversion to universal setups and the expansion of indication. The progression and reliability of the reconstruction possibilities available nowadays are outlined using the experience of our department. Material and method. A retrospective review of critical bone defect cases and the reconstruction management using endoprosthetic systems is presented. Ten reconstruction surgeries performed in the last 18 months in our department were observed. The patients were 3 males and 7 females with a mean age of 45.3 (range 19 to 75). Modular systems were used for the reconstruction of bone defects subsequent to resections of benign or malignant musculoskeletal tumors (76%) and to non-neoplastic conditions (24%). Results. On the latest follow-up, all the patients were al...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
One of the most common neoplasms in the world, ranking third, is the colorectal cancer. 96% of al... more One of the most common neoplasms in the world, ranking third, is the colorectal cancer. 96% of all cases of colorectal cancer are adenocarcinoma. The prognostic of this diagnostic is a bad one, with low 5-years survival rate. Although the most common locations for the metastases are the liver and the lungs, the bones can also be targeted (5.5%). We present the case of a 65-year-old male who came to the hospital with pain and tumefaction at the right fibular head. After extensive clinical and paraclinical examinations, a biopsy was performed, at which stage the entire tumor was removed. The result was that of moderate differentiated adenocarcinoma. The patient was then further examined and a tumor was discovered at the sigmoid colon. The primary tumor was removed and the patient underwent oncological treatment. 2 years later, the patient returned with a recurrence of the bone metastasis. After a PET-CT that infirmed other metastases coupled with a satisfactory evolution of the primar...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
In the last decades, immunohistochemistry (IHC) has shown an important role in tumor differential... more In the last decades, immunohistochemistry (IHC) has shown an important role in tumor differential diagnosis and has proven its prognostic role. Due to the various histological subtypes of primary malignant bone tumors, its role will be more important in the future. Based on recent studies, tumor growth, cell mobility, and metastases strongly correlate to the survival of these patients. An increased number of specific IHC markers have been used to determine the aggressiveness of the metastatic capacity of these tumors in enhancing early specific oncological therapies. This study presents 15 cases of primary malignant bone tumors, over a period of 4 years (2014-2018), from the Orthopedics and Traumatology Department of the University Emergency Hospital in Bucharest, where we evaluated the proliferation index using Ki67 IHC marker, tissue remodelation, the presence of necrosis in osteosarcoma cases in which chemotherapy was applied, and the aspect of the cytoskeleton with vimentin. Bes...
Calcaneus fractures are still a delicate point regarding the indication for osteosynthesis. Knowi... more Calcaneus fractures are still a delicate point regarding the indication for osteosynthesis. Knowing the skin's poor vascularisation of the back foot, the purpose of this study is to present the benefits of proper surgical options between an open and invasive osteosynthesis with anatomical reduction and internal fixation or minimally invasive approach preserving the quality of the soft parts. 66 interventions that targeted reduction and internal fixation of calcaneus fractures were performed between 2009-2012, in the Orthopaedic and Traumatology Department of Bucharest Emergency University Hospital. 29 cases underwent open reduction and internal fixation with plates and screws or Kirschner wires, and 37 cases underwent a minimally invasive reduction and Essex Lopresti osteosynthesis technique. No patient who underwent a minimally invasive reduction had skin lesions, but showed pain due to osteoarthritis lesions that appeared in the subtalar joint. 4 of them, who underwent open reduction and internal fixation had postoperative wound infections and skin necrosis.
Poor oral hygiene leads to serious damages of theteeth’s surface enamel such as micro-abrasions a... more Poor oral hygiene leads to serious damages of theteeth’s surface enamel such as micro-abrasions and acid erosion. These alterations combined with bacterial plaque result in cavity appearance. Prophylactic measures include various techniques for enamel surface restoration. Fluorination is one of the most important treatments for this purpose. Therefore, in the present research, we investigated the classical fluorination treatment compared with laser photodynamic fluorination performed on human enamel samples with poor surface quality. Three sample groups were investigated: veneer (F), inlay (I), and crowns (C). The general morphologic aspect was investigated by scanning electron microscopy (SEM), and the specific details such as the fine microstructure and nanostructure were investigated by atomic force microscopy (AFM) of the surface roughness. The samples were also investigated by Fourier transformed infrared attenuated total reflectance (FTIR-ATR) to evidence the fluorination effe...
In this experimental study, the mechanical and adhesion properties of several hydraulic lime mort... more In this experimental study, the mechanical and adhesion properties of several hydraulic lime mortars incorporating graphene oxide (GO)-based nanomaterials were evaluated. Four different composite mortar samples were prepared by adding different percentages of GO-based powders (functionalized), i.e., 1 wt.% GO, 5 wt.% GO, 5wt.% GO-Ag-GO-Fly ash, and 5 wt.% GO-ZnO-GO-TiO2 into the reference mortar sample. The mortar specimens were analyzed through mechanical tests, FT-IR, and SEM. The behavior of selected mortars exposed to chemical attacks was also investigated. The results indicate that the addition of the functionalized GO-based powders leads to a significant improvement in the mortar’s adhesion to the brick substrate (up to 80%) compared to the reference sample, especially in the case of the hydraulic lime mortar incorporating the mixture of GO-Ag and GO-Fly ash, which also showed good resistance to chemical attacks.
Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer o... more Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. We present this retrospective study, in which we proposed local endometrial injury for the management of the uterine factors in the case of 30 couples with recurrent implantation failure. Our conclusion was that local endometrial injury improved the clinical pregnancy rate for these couples, especially when the study population met specific criteria.
Romanian Journal of Morphology and Embryology, 2022
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Osteosarcoma is the most common primary malignant bone tumor, with a higher prevalence among chil... more Osteosarcoma is the most common primary malignant bone tumor, with a higher prevalence among children and young adults. Its most frequent localization is in the distal femur, followed by the proximal humerus and the proximal femur. In this article, we will describe the case of a 25-year-old male patient who presented to our medical facility, accusing spontaneous pain and swelling, both originating from the left knee. The X-ray of the distal femur showed a heterogeneous mass around the left femoral metaphysis with massive periosteal reaction. The computerized tomography (CT) analysis revealed cortical destruction, with extra-compartmental localization. The patient has later undergone to an incisional biopsy. The histopathology report showed the presence of a chondroblastic osteosarcoma. According to the multidisciplinary diagnosis, the tumor was finallyclassified as type IIB on the Enneking classification. In such cases, the elective surgical procedure is reconstructive surgery, cons...
Introduction: Talus fractures are rare, but because of its peculiar anatomy the complications rat... more Introduction: Talus fractures are rare, but because of its peculiar anatomy the complications rate is high. Its arterial vascularisation can be compromised by trauma in displaced fractures or by the surgical approaches. Material and methods: Between 2001 and 2005, 30 patients with talus fractures were surgically treated in the Department of Orthopedics and Traumatology of Bucharest University Hospital. Sex ratio was 3 men/27 men. 27 fractures were closed. The mean age was 37 years (extremes: 17 – 54 years). Fractures were classified according to Hawkins classification: type I – 9 cases, type II – 13 cases, type III – 8 cases. All patients underwent clinical and radiological examinations at 3, 6 and 12 months and every year after this interval. Results: Hawkins type I fractures were treated by cast immobilization without weight bearing for 6 to 8 weeks. Orthopedic reduction was performed in emergency in order to avoid vascular and cutaneous complications. Hawkins type II and III frac...
CATALIN CIRSTOIU1, RAZVAN ENE1*, ZSOMBOR PANTI1, PATRICIA ENE2, MONICA CIRSTOIU3 1Orthopaedics-Tr... more CATALIN CIRSTOIU1, RAZVAN ENE1*, ZSOMBOR PANTI1, PATRICIA ENE2, MONICA CIRSTOIU3 1Orthopaedics-Traumatology Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania 2 E.N.T. Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania 3 Obstetrics-Gynecology Department of Bucharest Emergency University Hospital, 169 Splaiul Independentei, 050098, Bucharest, Romania
Pseudomonas aeruginosa is an ubiquitous environmental microorganism, which can cause various infe... more Pseudomonas aeruginosa is an ubiquitous environmental microorganism, which can cause various infections, including infections of the skin or soft tissues, of joints or bones. Infections may have a fulminant course; therefore the rapid diagnosis is very important. Microcalorimetry technique allows the identification of P. aeruginosa in a very short time compared to classical methods. We present the case of a 94-year-old woman, who addressed our clinic for a wound located on her left hip, with a discharge of a purulent fluid on its surface. A month earlier at that level she had had a fracture for which she had undergone a surgical intervention. P. aeruginosa was isolated by classical microbiological methods. Using the microcalorimetry technique, the microorganism was identified in 11 hours.
The acromioclavicular joint dislocation represents a common shoulder injury that frequently occur... more The acromioclavicular joint dislocation represents a common shoulder injury that frequently occurs to young and active individuals. Most of these AC lesions can be treated conservatively but high-grade dislocation need surgical treatment. There are numerous surgical techniques described in literature for treating this injury. The surgeons must choose between open reduction with internal fixation and arthroscopic fixation, which is the latest technique developed. The aim of this study is to evaluate the functional results and the level of pain after an arthroscopic fixation using a TightRope system to treat AC dislocation. It is a less invasive technique, allowing a stable fixation of the joint. In our study we analyzed 48 patients with acute acromioclavicular dislocation, all of them surgically treated using an arthroscopic method with a single TightRope device. An important reduction in pain perception was achieved at six months after the surgery, comparing with the preoperative mo...
Total hip arthroplasty is a surgical procedure that adresses to people with severe hip disorder. ... more Total hip arthroplasty is a surgical procedure that adresses to people with severe hip disorder. The number of total hip replacements is growing year by year due to the good functional results obtained after this procedure, which include pain relief, improvement of walking and quality of life. With improvements in the techniques, materials and prostheses, hip arthroplasties are performed in the younger age patients, which leads to the demand for revision procedures. This procedure almost always comes across with acetabular bone defect. The main challenge for the surgeon during the revision hip arthroplasty is to achieve good implant stability. The purpose of this study is to assess the early clinical and radiological results after revision acetabular components using trabecular metal shells and augments. It was performed on 26 patients classified as Paprosky IIC and IIIA. The functional evaluation was performed perioperatively, at three and at six months after the surgery using radi...
Currently, hip fractures are a common health problem. This type of pathology affects mostly postm... more Currently, hip fractures are a common health problem. This type of pathology affects mostly postmenopausal women, but the risk existing in other categories of patients is not negligible. This type of fracture is treated mostly with surgical techniques because the functional results with the non-surgical ones are not satisfactory. Orthopedic method is chosen in patients who have complex disorder that can’t be operated. Infections occur rarely in this pathology because open fractures are uncommon. In this case, we present a patient of 74 years old, who suffered a traumatic injury after falling from her feet two years ago. The fracture was treated using a Gamma nail. After the operation, the patient’s recovery was favorable. Two months ago, the patient came in the emergency department presenting an active fistula on the hip that was surgically treated. This type of pathology develops after the microorganisms inoculated at various sites disseminated through blood. Following the treatmen...
Romanian Journal of Morphology and Embryology, 2021
This is an open-access article distributed under the terms of a Creative Commons Attribution-NonC... more This is an open-access article distributed under the terms of a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License, which permits unrestricted use, adaptation, distribution and reproduction in any medium, non-commercially, provided the new creations are licensed under identical terms as the original work and the original work is properly cited.
Romanian Journal of Morphology and Embryology, 2020
We are reporting a case of natural evolution and pathological data from a young person that was d... more We are reporting a case of natural evolution and pathological data from a young person that was diagnosed with coronavirus disease 2019 (COVID-19). All data has been collected from the autopsy of a 30-year-old female, which was performed by the
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Pigmented villonodular synovitis is a benign proliferative condition that causes the synovium of ... more Pigmented villonodular synovitis is a benign proliferative condition that causes the synovium of the joints and tendons to thicken and overgrow. The causes have not been completely discovered, with trauma and repetitive inflammation being the most incriminated. Genetic aberrations have been reported in most cases and could suggest a neoplastic origin of the disease. It appears in 2 forms: localized or diffuse. Although it can affect all joints, the most common location is the knee. The treatment options include anti-inflammatory medication, surgical removal (open or arthroscopic) and radiotherapy (mixed results). We present the case of a 31-year-old male who came to our Clinic with pain and tumefaction of the right popliteal fossa. From the patient’s medical history, it resulted that he had developed a tumoral growth in the popliteal fossa 20 months before, which was removed. After extensive investigations (X-ray, CT, and MRI), a biopsy was performed. The result was pigmented villon...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Objectives. Sacral tumors represent about 1-4,3% of all bone tumors. They typically present with ... more Objectives. Sacral tumors represent about 1-4,3% of all bone tumors. They typically present with an abundance of blood vessels. Due to their anatomical localization, they are hard to approach surgically. Thus, a presurgical neoadjuvant therapy is indicated. The preoperative angiography with the embolization of the nutritive arteries decreases the perioperative blood loss and the symptomatology, and even decreases the volume of the tumors that cannot be surgically approached. Materials and methods. The principle of embolization consists in the targeting of the nutritive tumoral artery and in obturating it with embolic agents (polyvinyl alcohol, embospheres, etc.) through selective catheterization under angiographic control. The biopsy of the tumor is essential for certain diagnosis. The histological type of the tumor and the degree of differentiation influence the tumor’s physiopathology and often influence the therapeutic decision regarding its degree or recurrence. In some cases in...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
Introduction. The management of critical bone defects has experienced an unprecedented improvemen... more Introduction. The management of critical bone defects has experienced an unprecedented improvement in the last few decades. A good primary mechanical stability and versatility of the modular reconstruction systems allowed the conversion to universal setups and the expansion of indication. The progression and reliability of the reconstruction possibilities available nowadays are outlined using the experience of our department. Material and method. A retrospective review of critical bone defect cases and the reconstruction management using endoprosthetic systems is presented. Ten reconstruction surgeries performed in the last 18 months in our department were observed. The patients were 3 males and 7 females with a mean age of 45.3 (range 19 to 75). Modular systems were used for the reconstruction of bone defects subsequent to resections of benign or malignant musculoskeletal tumors (76%) and to non-neoplastic conditions (24%). Results. On the latest follow-up, all the patients were al...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
One of the most common neoplasms in the world, ranking third, is the colorectal cancer. 96% of al... more One of the most common neoplasms in the world, ranking third, is the colorectal cancer. 96% of all cases of colorectal cancer are adenocarcinoma. The prognostic of this diagnostic is a bad one, with low 5-years survival rate. Although the most common locations for the metastases are the liver and the lungs, the bones can also be targeted (5.5%). We present the case of a 65-year-old male who came to the hospital with pain and tumefaction at the right fibular head. After extensive clinical and paraclinical examinations, a biopsy was performed, at which stage the entire tumor was removed. The result was that of moderate differentiated adenocarcinoma. The patient was then further examined and a tumor was discovered at the sigmoid colon. The primary tumor was removed and the patient underwent oncological treatment. 2 years later, the patient returned with a recurrence of the bone metastasis. After a PET-CT that infirmed other metastases coupled with a satisfactory evolution of the primar...
Romanian Journal of Orthopaedic Surgery and Traumatology, 2018
In the last decades, immunohistochemistry (IHC) has shown an important role in tumor differential... more In the last decades, immunohistochemistry (IHC) has shown an important role in tumor differential diagnosis and has proven its prognostic role. Due to the various histological subtypes of primary malignant bone tumors, its role will be more important in the future. Based on recent studies, tumor growth, cell mobility, and metastases strongly correlate to the survival of these patients. An increased number of specific IHC markers have been used to determine the aggressiveness of the metastatic capacity of these tumors in enhancing early specific oncological therapies. This study presents 15 cases of primary malignant bone tumors, over a period of 4 years (2014-2018), from the Orthopedics and Traumatology Department of the University Emergency Hospital in Bucharest, where we evaluated the proliferation index using Ki67 IHC marker, tissue remodelation, the presence of necrosis in osteosarcoma cases in which chemotherapy was applied, and the aspect of the cytoskeleton with vimentin. Bes...
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