University Clinic of Traumatology Skopje
It all began in the year of 1967, when then Clinic for Surgical Diseases was formed. Within this Clinic, several years later the Department for Traumatology developed. In the almanac “20 years of the Clinic for Surgical Diseases (1947-67)” it is stated: “Traumatology, which evidents more and more polytrauma is led by a team and a leader who had the opportunity to study this problematic in London and Birmingham…”, “Very complicated and often neglected patients are treated here who need reconstructive actions. Effort has always been made to maximally save the function of the limbs. Operations which involve complicated fractures in limbs are a special contribution, where there are no contraindications, so that the primary osteosynthesis can start immediately.
In the leader description, it is inevitable to recognize the character and work of MD Dusan Zerajik, the founder of contemporary traumatology thought in Macedonia. From today’s perspective we can fully agree with the goals of the injured patients’ treatment which have remained the same to date: functional and painless limb, capable of doing everyday life, work and sport activities. Of course, in order for these seemingly simple goals to be achieved, we need procedures and operational treatments which are prompt, adequate and based on the contemporary thought, that would return the injured patient back to their normal life and work – functioning.
The effort of pleiad surgeons- traumatologists ought to be commemorated here (Saveski, Todorov, Simeonov, Velkovski, Gavrilovski) who had many professional visits abroad and brought to Macedonia the contemporary methods of surgical treatment of the injured spine, of long bones as well as of the pelvic ring at almost the same time as they were introduced at both European and American traumotology stage. Therefore, the Clinic for Traumatology grew into a modern and contemporary institution which dictates the modern trends in the region especially in the fields of spine pathology (injuries, degenerative diseases and tumours) in terms of the transpedicular fixation as well as the methods of front and back decompression of the spine, open reposition and osteosynthesis of complex pelvis and acetabulum injuries, intramedular fixation of long bones, resolving complex intra-articular fractures in accordance with the AO school, including the most complicated injuries of the elbow, shoulder, wrist, ankle, talus and calcaneus. Moreover, the Clinic for Traumatology is the leader in our country in treating polytraumatised patients, patients with geriatric trauma and arthroscopic surgery, especially of the knee with surgery of anteriour cruciate ligament.
The professional collegium of traumatology invests maximal effort every day to maintain the highest possible standard in the care for the injured by tirelessly working in the afternoon and evening hours, when doctors on duty without any limitation engage in complex injuries which seek immediate treatment after they have been admitted to hospital. We would like to point out here the collaboration in this field that the Clinic for Traumatology builds with its colleagues anaesthesiologists from the Clinic for Anaesthesiology, Reanimation and Intensive Care. Last year the Clinic took 1700 patients out of which 1500 underwent surgical interventions.
The doctors make a huge effort to improve the new techniques for applying modern ostesynthesis implants, as a usage of minimally invasive ostesynthesis locking plates, new types of intramedular fixation, endoprosthetic procedures as well as modern implants in solving the problems with the spine, in terms of using vertebroplasty, displacement of vertebral bodies with the so called cage implants and other systems for anterior fixation of the spine.
A specific problem in the last couple of years have been the patients with fractures which have occurred as a result of decreased density i.e. bone quality or the so called low-energy fracture. The problems in solving these cases are known as fragility fractures in the literature, and are multiple. To begin with the right choice of operational technique and procedure, then osteosynthesis implant as well as parallel solution to the comorbid conditions like heart diseases, diabetes mellitus, degenerative diseases etc. which are a regular companion in these type of patients.
Also, the ambulance-polyclinic part is comprised of two ambulance rooms and one plaster room which function every working day with an increased capacity and frequency of ************ checks and interventions annually.
We have to acknowledge that as for a group of 10 specialists, it is a huge range of work which the Clinic for Traumatology succesfully deals with.
A large dose of enthusiasm is necessary, even pure altruism to perform this specific field of work. The results of our work, the pleasure after a successfully performed treatment of injuries and diseases which in a second and fully change the lives of our patients, is high. However, we still expect our society to recognize this effort that doctors at the Clinic for Traumatology make every single day, and acknowledge it adequately, by improving the total status of the surgeon in the society, which curently is not at the desired level.
Within the Clinic for Traumatology, the Spinal Centre is actively functioning, where most complex cases of spinal pathology are treated, including spine fractures, degenerative conditions of the spine, spine tumours and infections… And lately, with the help of foreign experts, corrections od spine deformities are intensively performed in all shapes, starting from juvenile, adolescent as well as degenerative forms of spine deformities.
We seriously approach the digitalization in our field, so intensive preparations are made to implement digitalization with the possibility to store and sort the radiological studies which are crucial in the evaluation of our work. The possibility of a software solution to sort and store the full medical records would significantly lessen the publishing activity.
MD Emilija Stojkovska Pemovska