At the Bihor County Hospital, the first operation

Medical premiere at the Bihor County Hospital. A patient with a humerus fracture following a road accident was operated on at the Bihor County Hospital using a surgical technique that involves fixing the bone with a titanium rod.

“A 16-year-old patient presented to the Bihor County Emergency Clinical Hospital with a displaced humeral diaphysis fracture, following a road accident. The long bone of the arm (humerus) was fractured, and the two segments were displaced from their place. The teenager had to be operated on to replace the fractured bone fragments, the classic solutions for the orthopedic treatment of pediatric fractures involving either mounting a plate with screws or using elastic rods. In this case, however, due to the age of over 15 years, the patient had closed growth cartilage, which represents a factor of incompatibility with the mentioned surgical options”, the representatives of the Bihor County Hospital sent, on Tuesday, in a press release .

The operating team decided to perform, for the first time in the county, the closed orthopedic reduction with osteosynthesis through a bolted titanium rod for a pediatric patient.

Closed orthopedic reduction of the fractured bone was performed under radiological control, and then a titanium rod was inserted to fix the bone fragments.

“The first step involved putting the two fragments of the fractured bone back together. With the help of special kits and radiological guidance, the surgeons inserted the rod to ensure the position of the fractured bone. This approach involved taking repeated x-rays during the procedure to see where the rod is and how close it is to the fracture site. After positioning it on the bone, the next step was the installation of 3 screws to anchor the rod in the humerus. The titanium rod is the caliber of the medullary canal, having dimensions of 28 cm long 8 phi in diameter. The intervention was highly complex, the humerus being a very difficult bone to reduce. The operation took place on 20.04.2024, it lasted an hour and a half and it went well”, the statement also states.

The condition of the teenager is very good. He has already been discharged.

“Thanks to the operative technique, it was no longer necessary for the arm to be immobilized with plaster, and the patient’s evolution is favorable. He was already able to resume his usual daily activities, including going to school. In six months, the patient will have to return for the removal of the rod”, the medical personnel also transmitted.

According to them, compared to other options of surgical treatment, this operative technique implies a series of advantages for the patient, such as: reduced operative time, minimization of intraoperative and postoperative complications and faster recovery of the patient, without the need to cast the arm. The approach is minimally invasive, with all three incisions having a maximum size of 3 centimeters.

“In addition to the fact that it is a first-of-its-kind intervention at the level of Bihor County, due to the high level of complexity, this is only done in the large medical centers in the country (Cluj-Napoca, Bucharest, Timisoara, Iaşi, Pitesti). At the Bihor County Emergency Clinical Hospital, this operative technique was introduced by Dr. Alexandru Pîrvan, pediatric orthopedics specialist. Mr. Dr. Pîrvan learned this technique at the Center Hospitalier de Luxembourg (CHL), where he carried out part of his residency training,” the cited document also states.

The operative team was composed of Dr. Alexandru Pîrvan, pediatric orthopedics specialist and two orthopedic-traumatology resident doctors: Dr. Barna Markus and Dr. Ţapoş Cătălin. The intervention took place with the oro-tracheal intubated patient, the general anesthesia being performed by Dr. Nedelcu Adina, Dr. Şiugan Lăcrimioara, ATI specialist doctors.