"We are worried together with our patients," orthopedic traumatologist Kostyantyn Palahniuk

"If you don't film the operation, you didn't operate" is the logic that the modern world and the role of social media in it leads to. We talked to Kostiantyn Palahniuk, Head of the Department of Orthopedics and Traumatology, orthopedic traumatologist at Odrex Medical Home . Kostiantyn told us about the human side of the doctor's work, students and teachers, quick results, and the most interesting things in his profession. Watch the full version of the interview and read the shortened version on the Intranet.

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Medicine is transforming quite fast. Can you tell us the difference between the medical schools?

We have a very, very high-tech profession. We are dependent on instruments: the newer the instruments and the more of them, the more useful they are for the surgeon, and the better we perform operations. Earlier, when endoscopy was already being used all over the world, we were just starting out. We tried hard to catch up with the rest of the world. Now, maybe, we have overtaken it somewhere.

What are the advantages of endoscopy as opposed to open surgery?

It depends on what we are doing. If we are talking about endoscopy of the knee joint, then the area where you make an incision is where you can see. With an endoscope, you can see the entire joint. If we're talking about the shoulder or hip joint, endoscopy allows the doctor to see all parts of it. And an incision? If you make it from the outside, you can only see the outer part of the joint.

Let's go back to the old school and the new school. There are colleagues 20 years older and maybe 10 years younger. Do they have different approaches to medicine? We are not saying that the old school is bad, by any means, but we are saying whether there is a difference between them. Many people have certain reservations - at first they were afraid to go to very young doctors, now they are afraid to go to older ones. What is the difference?

You can't say whether a doctor is young or old, new school or old school. You have to look at the qualifications of the doctor himself. There may be a young, very promising doctor who is studying dynamically and likes his specialty. And there are older doctors who also look to the future of medicine and use it every day. And then there are doctors who are just as used to it as they are working.

Doctors have to constantly learn. And there is such a thing as postgraduate education. What does it look like in traumatology, how is it represented?

I look at new implants that are used all over the world. I constantly go to conferences or exhibitions to see something new. It is very interesting to see what is new in the world. Last year I was in Germany, then America, the Emirates, China. I was in Turkey, Italy - I traveled a lot and looked at what is new in the world. In the world of implants, in the world of our medicine. I watched new techniques on kadavras, how to make bunions on the feet, or surgery for hallux valgus. I was very interested in new techniques.

Speaking of hallux valgus, I have already heard that you are starting to treat it with a new method. Can you tell us about it?

I was once very interested in an image at the American Association of Trauma Surgeons. How is it possible to do this? The head is held on by two screws, it has to break, it has to come off - it's not allowed. I show the doctors in our department that this is very risky, it should not be done. Then I look at the long-term results of our foreign colleagues and see very good results. I look at America, then France, Italy - they are doing it everywhere. And we are still using the old methods. And that method allows you to take shoes, almost orthopedic, but you can call it that, the same as we use in everyday life, only to have a hard sole.

PHOTO: Intent / Natalia Dovbysh

What do you like about traumatology? I noticed how you talk about the component of endoprostheses, a certain mechanization...

I am more interested in observations: before and after. Because the result is the most important thing. If we used to immobilize something, put plasters on it, fix it, I have a completely different philosophy now. We need to make sure that the patients' muscles and ligaments work, and that they recover quickly. Because if a patient has immobilized a limb at least a little bit, we see very pronounced muscle atrophy. And we don't want to see this. There are some interesting cases that were not done by us in the past. Five or six surgeries were needed to remove a tumor on the hip. We printed a bone fragment on a 3D printer, and it took root. The patient is now running with the bone fragment. This is a very interesting case, and it is already being used in many places. For example, in the military, if the injuries are severe and the bone cannot be restored. There were cases when the bone did not heal, and we thought about how to fix it. A very small element for fixation. We put in a rod to fix the bone, then performed bone grafting. Then you look at the patient, take a picture, close your eyes - oh, there is growth. It's beautiful. After a month or two, everything heals, and you feel better. We see that our patients are also worried. They are the first to worry about their condition and their future. We are with them all the time.

Are there quick results in orthopedics and traumatology now?

Yes, we do. If we, for example, make a prosthesis, we put people on their feet the next day. Some clinics try to get you back on your feet in three hours. Whether it's necessary or not. Marketing that they put you on your feet two hours after surgery. They set records. We have a philosophical approach to this: if an elderly woman is there, she needs to stay in bed rest. We do not set records, but we make sure that patients move.

You know the Ukrainian healthcare system from the inside. Would you like your relatives or children to go to work in medicine? Is it a comfortable environment to work in?

It is a very heavy load on a doctor's brain. You have to listen to sick people all the time. I have a day off, and I don't want to hear anyone. I just want to walk quietly, enjoy nature. I just want to not listen to anyone. You are so overwhelmed by information or communication with sick patients. This is a very difficult specialty. Everyone wants to operate. But you have to find a patient, operate, cure, rehabilitate and restore them completely. There are many factors at each stage. The patient has a lot of questions for the doctor. Why is it so? And sometimes it happens that everything did not go so smoothly. Or the wound doesn't heal properly, or the patient has a pain somewhere. You worry about the patient, think about what else you can do to help them use their joint. And this is such a psychological burden.

Марія Литянська