Measuring patient satisfaction of healthcare service quality represents a significant element of a healthcare’s system (HS) overall evaluation. It is the starting point for creating policies in national healthcare. The purpose of this paper was to evaluate Romanian patients’ perception and satisfaction of the quality of the national HS as a whole and of its components. Exploratory and descriptive research was used. Data were collected through face-to-face interviews with Romanian patients, based on a questionnaire. Out of the 2305 respondents, 83% used the Romanian HS in the past 12 months and 58% of the respondents did not trust the system. The accommodation, food, and other facilities of Romanian hospitals were perceived as being at a low level. One third of the respondents were unsatisfied and very unsatisfied with respect to the overall impression of the Romanian HS. In addition, our research found a statistically significant relationship between confidence in the HS, age, and gender, and also between the overall impression on the HS, age and income.

The current study aims at presenting the results of the two methods of conservative treatment in clubfoot: the Romanian traditional method and the Ponseti method. The study population included 103 children (148 clubfeet) treated in our department between 1998 and 2005. Between 1998 and 2003, the conservative treatment protocol was based upon the Romanian method. The Ponseti method has been used since 2004. The main criterion for the assessment of the efficiency of the two conservative methods in clubfoot is the number of feet requiring surgical treatment - posteromedial release at 18 months. This criterion is clearly in favor of the Ponseti method: four feet (5%) needed posteromedial release in Ponseti group patients versus 13 feet (18%) in Romanian group patients (P=0.0193). The Ponseti method is safe, efficient in the conservative treatment of clubfoot and decreases the number of surgical interventions needed for the correction of the deformation compared with our traditional method.

Manipulation and casting according to the Ponseti method are the 'gold standard' for clubfoot treatment, and this method is endorsed by the American Association of Orthopaedic Surgeons. We conducted a retrospective study from January 2004 to December 2012 in our institution. All patients with idiopathic clubfoot were included, and a very strict analysis of the treatment outcomes, relapses and their treatment was carried out. A total of 382 children were included and followed up for a mean period of 6 years. The initial correction rate was 100%. At latest follow-up, the relapse rate was 19.03%, the initial correction being recovered by recasting, second or third percutaneous Achilles tenotomy or anterior tibial tendon lateral transfer. The Ponseti method is safe, efficient in the conservative treatment of clubfoot and decreases the number of surgical interventions, and the very good results are maintained through a 9 years follow-up period.

Elastic stable intramedullary nailing (ESIN) is a minimally invasive technique. According to this technique, two elastic nails are introduced through the metaphysis into the medullary canal, are advanced through the fracture site and impacted into the opposite metaphysis. These nails are preformed in a C-shaped manner, which allows for their precise orientation and the creation of an elastic system that resists deformation.