Surgical intervention for the first time at Bihor County Hospital. The patient, a 16-year-old teenager

The long bone of the arm (the humerus) was fractured and the two segments were displaced.

“The teenager needed surgery to reattach the fractured bone fragments, the classic solutions for the orthopedic treatment of pediatric fractures involving either the fitting of a plate with screws or the use of elastic rods. In this case, however, due to the age of over 15 years, the patient’s growth cartilage was closed, which is a factor of incompatibility with the mentioned surgical options”, said Lisa Crăiuț, the spokesperson of the Bihor County Hospital.

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. Under radiological control, closed orthopedic reduction of the fractured bone was performed, 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, surgeons inserted the rod to secure 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 to install 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 one of high complexity, 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 source mentioned above also transmitted.

At the moment, 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.

The young man was already able to resume his usual daily activities, including going to school. In six months, he will have to return to have the rod removed.

Compared to other surgical treatment options, this operative technique involves 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 in Bihor county, due to the high level of complexity, it is only done in the large medical centers in the country (Cluj-Napoca, Bucharest, Timișoara, Iași, Pitești). At the Bihor County Emergency Clinical Hospital, this operative technique was introduced by Dr. Alexandru Pîrvan, pediatric orthopedics specialist. Dr. Pîrvan learned this technique at the Center Hospitalier de Luxembourg (CHL), where he did part of his residency training.

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

Within the Clinical Section of Pediatric Surgery and Orthopedics, led by Dr. Daniel Băloiu, primary physician of pediatric surgery and orthopedics, increasingly diversified and complex surgical interventions are performed, covering vast pathologies of the pediatric patient (0-18 years) . Thanks to the support of the hospital manager, Dr. Gheorghe Carp, the department has the equipment and materials that allow surgical treatment to be performed according to the most advanced techniques, emphasizing a minimally invasive approach, which allows for the best and fastest recovery of patients.