"Ilizarov method is expensive, but changes children's lives"

The head Neuroorthopaedic Clinic Ilizarov Center in Russia's Kurgan Prof. Dr. Dmitry Popkov has for years been helping children born with severe anomalies to their bone and joint system. He was recently in Belgrade once again.

Branislava Gigovic-GrubicSource: B92
(Photo: Private archive)
(Photo: Private archive)

When was the Ilizarov method introduced?

Effectively, the Ilizarov method was introduced in the early 1950s. The first scientific publications refer to the 1050s. The method gained its modern concept in mid-70s. Today, the elements and principles of the Ilizarov method continue to be developed. But, as you can see, this method has stood the test of time.

Popkov came to the University Children's Clinic (in Tirsova St.) to perform surgeries on several children, paid for by the state's Budgetary Fund for Treatment of Children Abroad.

For years, children with these problems have been going to Kurgan with their parents, which cost the budget a lot of money. That is why an agreement has been made for Dr. Popkov to come to Serbia several times a year and operate on children at the University Children's Clinic.

In the coming period, the number of interventions in Serbia should be increased with the idea that the entire practice of treatment and therapy be transferred to Serbia, which would reduce the stress on children and parents who must travel to Kurgan several times.

Up until now,50 children have been through the cooperation program of Serbia and the Russian Center. Altogether, 11,000 children are operated at the Center in Kurgan each year.

"An agreement has been reached between the Ministry of Health of Serbia and the Center Ilizarov in 2015 for the treatment of some severe forms of congenital pathologies of the musculoskeletal system. Since then, we have carried out the treatment of 29 patients in Kurgan, and another 21 patients that I operated on at the University Children's Clinic in Belgrade," Dr. Popkov told B92.net.

These operations are very expensive. How important it is for the patients in our country, the Serbian government pays for them? Also, how can the parents of the children who need your help contact you?

This treatment is indeed very costly for several reasons - the length of hospitalization, the expensive surgical implants, the external fixators, the complex operations...

In my opinion, by providing treatment for such a group of patients at the expense of the state, the Serbian government not only performs a formal function, it also preserves people's faith in justice, humanism, in the fact that your society, your state can provide conditions for the lives of people with severe diseases.

In addition, parents understand that their state is not refusin to fight for the quality of life of its young citizens under any circumstances, and will not refuse in the future. In my opinion, this is of paramount importance to all members of society.

In order to contact me as an official adviser to the Ministry of Health, it is best to contact the University Children's Clinic in Belgrade, where all the documents for examinations and consultations will be prepared. We have close cooperation with Dr. Siniwa Ducic's team.

What is the Ilizarov method and how much it can help children born with some kind an anomaly?

The Ilizarov method is a necessary element of contemporary orthopedics and traumatology. During the last 10-12 years, it has been modified and modernized, but its basic principles remain unchanged. It is impossible to describe it briefly. It would be like presenting the quantum theory on two pages in a scientifically popular journal.

However, it can be said that the Ilizarov method is extremely effective in correcting congenital and acquired deformities, shortenings and anomalies in the development of extremities, from complex and severe traumas.

It can be combined with other elements of surgery - microsurgery, intramedullary osteosynthesis, tendon plastic, which improves their effect.

The Ilizarov method is very complex, requires the acquisition of experience in its use, and analysis of one's own and others' results.

To what type of anomalies is this method applied to?

Practically, it is applied to the deformation and shortening of the upper and lower extremities of each etiology, in systemic diseases of the skeleton (Ollier disease, osteogenesis imperfecta - in combination with telescopic constructions, in pathologic growth failure), in acquired and congenital pseudoarthrosis, bone disorders in chronic osteomyelitis, posttraumatic deformities, in the failure of other methods of orthopedic surgery.

But the method has limitations in orthopedic complications of neurological diseases. The Ilizaroa method does not replace the joint prosthesis."

What were some of the toughest cases that you have had to deal with?

"These are patients with large congenital shortenings, with Ollier disease, with innate false joints and osteogenesis imperfecta - all of which are cases where a combination of external fixation (the Ilizarov apparatus) is needed in combination with other methods of orthopedic surgery. Here, the treatment is multi-degree, multifaceted, complex, often long-term, but the results achieved greatly alter the potential and the quality of life of children.

(Photo: Private archive)
(Photo: Private archive)

You have already been n Serbia several times. What is your view of the current level of orthopedic surgery practice here?

I have many contacts with colleagues orthopedists, neurologists, pediatricians, nurses, kinesiotherapists, physiotherapists, anesthesiologists in Serbia. You have a very open, multilateral, good medical community.

There is a great need to introduce new methods approved in Europe, the United States and Russia.

Doctors are pleased to adopt new knowledge and are ready to apply iz. Young doctors know English well, they know where to look for information about diagnosis and treatment in our specialty. As a member of the Scientific Committee of the European Pediatric Orthopedic Societies, I included a team of the University Children's Clinic (orthopedic department) in a multi-centeric prospective study on the issues of correction and extension of the extremities.

How did you start partnership with the University Hospital in Belgrade and will this cooperation continue? How satisfied are you with this cooperation?

The proposal for cooperation was initiated by the Ministry of Health and the University Children's Clinic in Belgrade. In the future, joint clinical work should be continued, first of all in Belgrade, in order to eliminate the long separation of children from the environments they are used to in Serbia. This also contributes to increasing the expertise of colleagues from the university clinic.

In addition, it is advisable to expand educational activities as well as scientific cooperation. I must say that we have already submitted three joint studies in scientific journals indexed by PubMed. Two have already been accepted for publication, while the third is being reviewed.

Will you train Serbian surgeons to operate using the Ilizarov method?

Of course. Also, in my opinion, one should think about university lectures on this part of orthopedics that refers to external fixation, its modern modifications. I would also dare to think about basic research in the field of bioactive implants applicable in combination with external fixation.

How important is for surgeons and doctors to constantly follow breakthroughs in medical practice?

There are two aspects here. First, it is important to know and understand modern methods of treatment. To see the perspective for their development. This preserves the competency of the doctor and the institution in which they works.

The second is a critical attitude towards the latest approaches that should not be considered as yet another trend, a fashion. Here the doctor must rely on their own experience, as well as on their colleagues' experience. I believe that only team work allows avoiding errors or minimizing their negative consequences.


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Interviews Monday, October 1, 2018 11:56 Comments: 0