Dr Ivan Gerov says that he didn't choose the orthopaedics, but instead he was chosen by the specialty. His professional development is a mixture of hard work and happy coincidences that turned him into one of the most respected specialists in the field. After a debut at the Children's Traumatology Clinic in Pirogov Hospital, he gained valuable experience in some of Bulgaria's best hospitals, and had specialised in Japan and the UK. He is currently a consultant at First Children's Consultative Clinic, Sofia, and heads the Orthopaedy and Traumatology Unit at Uni Hospital, Panagyurishte. He also accepts patients in Sofia, in St Pantaleimon Hospital. His professional interests are in the field of general and paediatric traumatology, treatment of poorly healed fractures, foot and ankle surgery, and also sport traumatology where he applies his experience as a physician of several of the national volleyball teams.
What traumas are common in physically active amateurs and how can they be avoided?
Young people are mainly affected by bone traumas, caused by a sudden jump or start. Overuse injuries are very common as well, for example, stress fractures. Anterior cruciate and knee ligaments, and menisci are torn. Often, a joint is displaced, and it should be healed properly to avoid a future arthrosis. Physically active men and women of the age of 35-50 have other problems. They still feel young and are very enthusiastic in sport. Their bodies, however, are not that young anymore. The result are torn ligaments, tendovaginitis, damages of the rotator cuff. It is not in the wrong warm-up or the training itself, but in the fact that the tissues have changed. To avoid this, one has to be aware of his or her age and to not overdo himself or herself. For all the ages that do actively sport to keep fit, I recommend recreational sport – a sport activity for pleasure, the more physiological the better: walking, running, swimming, gymnastics. The less equipment a sport needs, the better it is.
Why some fractures cannot heal properly and how are they treated?
Today we apply many modern materials and implants, but even the best of them, if they are being used wrongly, would prevent the bone from healing. Bad results are caused by bad surgical technique, bad bone quality and biological factors like lack of sufficient tissue coverage or accompanying illnesses such as diabetes, atherosclerosis, blood vessel damages, metabolic disorders. Treatment of unhealed fractures is always surgical, with the reproduction of the biology and the anatomy similar to the real conditions. The first and most important goal of reconstructive surgery is to keep the function of the limb, so it could move properly. The aesthetics, whether the extremity is aligned, is secondary, but if certain conditions are met, we work for this, too.
What should we know and should do to avoid the need of an orthopaedist?
Orthopaedics deals with the disorders in the development of the musculoskeletal system, with its congenital diseases and with the results of degenerative changes of the spine and the joints – knee and hip joints replacement for example. The more naturally and simply we live, the healthier and happier we will be. This is the solution, not some magical pill or shoe insoles. Toddlers should walk barefoot and should do feet exercises to avoid flat feet. Something we do in our daily life, however, can also make us ill. When sitting at the desk, the angles between the feet and the lower leg, between the lower leg and the thighs, and between the thighs and the body, should be 90º. The hands need support, and the screen should be at an eye level, or slightly higher. In essence – less is more.
St Pantaleymon Hospital: Sofia, Mladost 3, 63 Aleksandar Malinov Blvd, by Aleksandar Malinov metro station
phone: +359 888 361 218