Publications by authors named "I Popia"

5 Publications

  • Page 1 of 1

[Py-Desmanet pinning in distal radius fractures].

Authors:
O Alexa I Popia

Rev Med Chir Soc Med Nat Iasi 2009 Oct-Dec;113(4):1155-9

Facultatea de Medicină, Disciplina de Ortopedie-Traumatologie, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi.

Unlabelled: Internal fixation by pinning is one of the most used methods of surgical treatment in fractures of the distal extremity of the radius. As in stable fractures a styloid pinning is satisfactory, in unstable fractures however we must resort to different patterns of pin insertion, in order to effectively prevent the secondary displacement of the fractured fragments. The elastic pinning described by Py and Desmanet is one of the possibilities of inserting the pins. The principle of this method is to use the bending-induced tension in the pins to counteract the postero-lateral displacing forces. The authors have treated by this technique five patients with distal radius fractures (3 women and 2 men) about 56 years of average age, all with good-quality bone, all with Colles' fracture pattern (2-4 cm above the radio-carpal articulation, no articular involvement, posterior displacement of the distal fragment). The reduction of the fractures was achieved by closed manipulation and controlled intraoperatively with the C-arm. We preferred to reduce the fractures before inserting the pins, although this is not compulsory, according to the authors of the technique. The approach was minimally-invasive, through two 1-cm long incisions. The pins, previously blunted and curved along the last centimeters, were introduced using a "T"-shaped handle. The potential complications, consisting of injuries of the many elements which cross the region, were avoided by sufficiently long incisions and identification and retraction of these elements (tendons, nervous branches) in order not to penetrate them with the pins. The aftertreatment consisted of immediate mobilization of the wrist in one patient, 21-day splinting in other two and 30-day splinting in the last two, depending on the intraoperative assessment of the stability of the fixation. The pins were removed at 45 days postoperatively in all cases. There were no complications such as loss of reduction or pin migration. In all cases, there were good anatomic and functional results.

Conclusions: This method is relatively fast and simple, does not require special or expensive equipment and it gives good results in carefully selected cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2010

[Primary total hip arthroplasty in bilateral acetabular protrusion, case report].

Rev Med Chir Soc Med Nat Iasi 2008 Apr-Jun;112(2):427-31

Disciplina de Ortopedie Traumatologie, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi.

Acetabular protrusion is a clinical entity consisting of deepening of the acetabulum and consequent sinking of the femoral head within this cavity, uni- or bilaterally, such that the bottom of the acetabulum protrudes in the pelvic cavity. Etiologically, the disease may be primary or secondary. This article presents the case of a 66-year-old man with primary bilateral acetabular protrusion admitted to our clinic for symptoms involving the hips: pain exacerbated at big effort in erect position and a progressive diminution of the amplitude of movement in both hips. The plain radiograph of the pelvis revealed the deepening of the acetabulum on both sides, intrapelvic protrusion of the bottom of the acetabular cavities, sinking of the femoral heads (and to a certain extent, also the femoral necks) into the acetabula. The articular space was altered bilaterally by osteoarthritic modifications. The diagnosis was bilateral acetabular protrusion with secondary hip osteoarthritis. Subsequently, he underwent bilateral total hip arthroplasty with an additional reinforcement with a Burch-Schneider ring on the left acetabulum. The operations were performed at a 6-months interval, with a favorable postoperative course for both hips.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2009

[Percutaneous repair of achilles tendon rupture--a technical note].

Rev Med Chir Soc Med Nat Iasi 2008 Oct-Dec;112(4):993-8

Disciplina Ortopedie-Traumatologie, Facultatea de Medicină, Universitatea de Medicină Si Farmacie Gr.T. Popa" Iaşi.

The treatment of the acute ruptures of the achillean tendon remains controversial. For the time being, there is no consent regarding the ideal therapeutic approach. The therapeutical procedure for the recent achilean tendon tears varies between two possible solutions, one conservative and the other surgical. The choice between these is made based on the type of rupture and the experience of the surgeon. The conservative techniques can have good results in selected cases, but they produce a degree of elongation of the tendon, which may lead to improper functional results. The classical surgical treatment (the open technique) has the handicap of a relatively large, longitudinal incision, which is made in an area with relatively poor skin vascular supply. Also, the vascular supply of the tendon itself is based mainly on perforant, subfascial vessels, which are intercepted during the approach. Taking these facts into consideration, some new, minimally invasive (percutaneous) techniques, were imagined. The principles of the standard percutaneous technique consist of: 1) union of the ruptured ends without using a large surgical approach, thus also avoiding the drainage of the local hematoma and rushing the repair; 2) avoiding damaging of the tendon's vascular supply. This techique leads to a rapid transformation of the collagen fibers into elastic fibers, which are mechanically effective. We present in this paper the method which uses the TENOLIG kit. This kit consists of two wires with anchors at one end and needles at the other end; two washers and two poliethylene disks for securing the distal end of the wire. We obtained good morphological (proven by MRI scan) and functional results with this technique. The postoperative protocol includes immobilization with the foot initially in equinous, then in normal position, with isometric muscle contractions and non-weight-bearing, then removal of the cast and wires at 45 days postoperatively and continuing the recovery by kinetotherapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2010

[Percutaneous pinning for proximal humerus fractures].

Rev Med Chir Soc Med Nat Iasi 2007 Jan-Mar;111(1):184-9

Disciplina de Ortopedie Traumatologie, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr. T. Popa", Iaşi.

Proximal humerus fractures are relatively frequent. The are several possibilities for fixation of proximal humerus fractures: close reduction and fixation with percutaneous pinning or intramedullary rod, open reduction and fixation with tension band or a plate. Close reduction and percutaneous pinning have the advantage to be an easy technique, with good results and it is considered to be ideal in young patients with two-part fractures. The number and the directions of the pins depend upon the number of fragments displaced, reducibility, bone quality, patient age, other pathology associated. Some authors consider being enough the placement of 2 or 3 ascending pins, while others recommend at least 4 pins, ascending and descending. Usually we prefer the techniques in witch are used 3 ascending pins. The operative technique is presented. The most common intra-operative complication in percutaneous pinning is the possibility of damaging the adjacent neuro-vascular structures or tendons. Post-operative complications which may occur are: loosing reduction, pins migrations, aseptic necrosis of humeral head, pins infection. In conclusion percutaneous pinning for proximal humerus fractures it is an easy technique with good results. In this manner are avoided large incisions to the shoulder with can lead to aseptic necrosis of the humeral head. This technique can be used in young patients, with good bone quality, but also in elderly patients, with osteoporosis and other pathology associated. In some three or four-part fractures some reduction problems can occur, but this are rare in two-part fractures.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2007

[Stress fracture of the internal sesamoid bone of the first metatarsophalangeal joint. Case report].

Authors:
O Alexa I Popia

Rev Med Chir Soc Med Nat Iasi 2005 Oct-Dec;109(4):822-4

Disciplina de Ortopedie-Traumatologie, Facultatea de Medicină, Universitatea de Medicină Si Farmacie, Iaşi.

We present the case of a fourty-two year old truck driver without a major trauma history who was diagnosed in our unit as having a stress fracture of the first metatarsophalangeal joint medial sesamoid bone. Conservative treatment consisting of 30 day immobilisation was our treatment choice. The result was very good and at six month follow-up the patient had no complains. We have searched for other opinions but there is a paucity of published literature on the injuries of the lesser toe sesamoids of the foot. The literature review revealed different types of treatment such as: conservative treatment, internal fixation of the sesamoid fracture (screw fixation), reduction of weight-bearing pressure on the affected sesamoid, ice massage or sesamoidectomy. Due to the fact that the different conclusions are based on very few cases, it is no possible to conclude about optimal treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2006
-->