Todorov, Risto
Preferred name
Todorov, Risto
Official Name
Todorov, Risto
Main Affiliation
Email
risto.todorov@medf.ukim.edu.mk
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Item type:Publication, COMPARISON OF TWO DIFFERENT PLATE TYPES IN THE MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS OF DISTAL TIBIA FRACTURES(Macedonian Association of Anatomists and Morphologists, 2023); ; Distal tibia fractures present a unique challenge for the surgeon due to the subcutaneous position of the tibia with a thin soft tissue envelope. The development of the technique for minimally invasive percutaneous plate osteosynthesis (MIPPO) is a well-accepted step towards this direction. In our study we explore the benefits and shortcomings of two different plate types used with this technique: the 3.5 mm anatomically pre-shaped titanium plate, and the 4.5 mm LC-DCP. The study was a prospective – retrospective clinical intervention case control study of 100 patients with closed, unstable, extraarticular and partially articular fractures of the distal tibia and fibula, classified as AO type 43A1, 43A2 and 43А3. Patients were divided in two groups of 50 patients. Group A were patients prospectively treated with a 3.5 mm pre-shaped plate, and Group B were patients with retrospectively collected data treated with a 4.5 mm LC-DCP. Patietns age was 38.15 years with 68 male and 32 female patients. Operation duration in Group A was 57.14 ± 8.30 and 66.67 ± 5.55, in Group B which was statistically significant. Partial and full weight bearing, as well as time to union in both groups was achieved within a similar timeframe. Functional according to Johner and Wruh's criteria and showed that most patients in both groups (61) had excellent results (Group A: 32, Group B: 29) and 21 had good results (Group A: 10, Group B:11). Rate of complications were comparable between the two groups, in regard to superficial infection, deep infection and ankle stiffness. Only complication parameter which showed a significant difference between the two groups was rate of implant irritation, which was higher in the 4.5 mm LC-DCP group. Both 3.5 mm and 4.5 mm plates are reliable when used with a MIPPO technique. This method is minimally invasive, preserves the periosteal blood supply and ensures optimal conditions for biological repair of distal tibia fractures, regardless of the type of plate used. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Insulin Resistance, Glycemia and Cortisol Levels in Surgical Patients who Had Preoperative Caloric Load with Amino Acids(Macedonian Academy of Sciences and Arts/ Walter de Gruyter GmbH, 2015); ; ; ; Surgical stress response, results in elevated levels of anti-insulin hormones and reduced insulin secretion. This hormonal state may be detrimental for surgical patients due to the presence of insulin resistance and hyperglycemia. Additionally, pre-operative fasting favors this conditions. The aim of this study is to analyze the impact of pre-operative caloric load, with 440kJ from amino acid infusions on the levels of glucose, cortisol and insulin resistance in surgical patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SLAP lesion type IX: case series and a review of literature(Springer Science and Business Media LLC, 2023-04); Nabergoj, MarkoPurpose: A type IX SLAP (superior labrum anterior to posterior) lesion involves 360° of the glenohumeral labrum. Only rare reports have been published analyzing the risk factors of this lesion and the success of its arthroscopic management. The aim of our study is to evaluate predisposing factors that lead to SLAP IX and to assess the clinical outcome after arthroscopic treatment. Our treatment algorithm is also presented. Methods: We report on a series of six patients treated in our institution between January 2014 and January 2019 who underwent shoulder arthroscopy and were intraoperatively found to have a SLAP lesion type IX. Arthroscopic labral repair and biceps tenodesis were indicated in all patients. American Shoulder and Elbow Surgeons (ASES) Shoulder Score, Rowe Score and Constant Murley Shoulder Score (CS) were used for clinical evaluation. Patients were evaluated preoperatively and at 12 weeks, 1 year and 2 years postoperatively. Results: We analyzed six patients of which 83% were males (5/6 patients). The average age at the time of surgery was 37.16 (range 30-42 years). The dominant arm was affected in 50% of patients (3/6 patients). A significant postoperative improvement was seen in all six patients. 83% (5/6) of patients returned to their pre-injury activity level. Average values of all three measured scores show a significant increase comparing preoperative to postoperative period (P-value < 0.05). All patients were able to return to work. Conclusions: The final diagnosis was established intraoperatively as 83% (5/6) of radiology reports differed from subsequent arthroscopic findings. The mechanism of injury in all our cases was high energy trauma with traction, arm in abduction or anteflexion. We observed great success with arthroscopic treatment as high percentage of our patients returned back to work and sports. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Arthroscopy in Acute Ankle Fractures: A Weber Classification-Based Analysis(ISRES Publishing, 2025-10-01); Ankle fractures are common orthopedic injuries, often treated with open reduction and internal fixation (ORIF). However, 21% to 45% of patients report unsatisfactory outcomes, possibly due to intraarticular pathology. This study aimed to assess these injuries arthroscopically and statistically analyse their prevalence and relation to the Weber classification. A prospective cohort study was conducted on 48 patients with acute ankle fractures at the University Clinic for Surgical Diseases “St. Naum Ohridski” from January 2020 to January 2023. Patients underwent standard preoperative radiographic examinations and were classified according to the Weber classification, followed by arthroscopic intraarticular examination and ORIF. The arthroscopic examination evaluated syndesmotic injury, chondral lesions, loose bodies, and deltoid ligament injuries. Forty-eight patients were studied, with intraarticular pathology found in 33 cases (68.75%). For Weber fractures: type A had 58.33%, type B had 72.73%, and type C had 84.21% of intraarticular pathology. Syndesmotic injury appeared in 33.33% of type A, 50% of type B, and 41.67% of type C fractures. Chondral lesions occurred in 41.67% of type A, 54.55% of type B, and 66.67% of type C fractures. Loose bodies were detected in 8.33% of type A, 18.18% of type B, and 25% of type C fractures. Deltoid ligament injuries were observed in 16.67% of type A, 27.27% of type B, and 41.67% of type C fractures. The study concludes that arthroscopy during ORIF in ankle fractures is valuable for diagnosing intraarticular pathology. It highlights the Weber classification's importance, noting that type C fractures have a higher chance of such involvement. Understanding arthroscopy's diagnostic value in these cases helps surgeons decide on concurrent interventions during ORIF, potentially improving patient outcomes. Further research may investigate how arthroscopy-guided interventions affect clinical outcomes.