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Giant Cell Tumor of the Phalanx of Finger: Case Reports Utomo, Pamudji; Idulhaq, Mujaddid; Mudigdo, Ambar; Sentana, Okkie Mharga
Indonesian Journal of Medicine Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Giant cell tumor (GCT) of bone arising from aphalanx of finger is extremely rare. Although, the occurrence of GCT in the hands is a rare, it has been reported that GCT of the small bones (small-bone GCT) carries a higher risk of local recurrence and metastasis than conventional GCT.Subjects and Method: We report two cases of GCT arising from a phalanx of a hand finger. First patient was treated with wide excision of the tumor and fusion with fibular bone graft with the help of a K-wire. Second patient was treated by excision of tumour (Curretage) with allograft bonegraft for bone defect.Results: At their most recent follow-ups (4 months, respectively), both were recurrence free and had returned to their previous occupational and recreational activities.Conclusion: The effectiveness of these methods in the treatment and prevention of recurrence is still under discussion and there is no gold standard for treating GCT.Keywords: GCT, phalanx of finger, excision, illiac crest bonegraft, allograftCorrespondence: Pamudji Utomo. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: utomodr@yahoo.com.Indonesian Journal of Medicine (2019), 4(1): 65-74https://doi.org/10.26911/theijmed.2019.04.01.11

Left Femoral Artery Occlusion due to Neglected Closed Fracture Distal Femur: A Case Report Utomo, Pamudji; Siswanto, Totok
Indonesian Journal of Medicine Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Distal femur fractures must always be considered for vascular disorders given the high risk. The incidence rate of femoral fractures is 1/10000 patients per year with the incidence rate of vascular injury around 0.10% -2.00%. Salter-Harris (SH) fracture classification is used in cases of fractures involving the growth plate (physeal plate) in children. Volkmann's ischemic contracture is caused by severe injury to the deep tissue and nerves. If tissue pressure is equal to or more than the perfusion pressure of the capillary, the microcirculation will be disrupted and ischemic occur. Normal myosit cells will be replaced by fibroblasts that tend to contract.Subjects and Method: A 10 years old boy had a traffic accident while riding a motorcycle 6 days before the patient came to the hospital. The patient could not walk, feeling pain and swelling on the left knee, the patient didn’t bring to the hospital immediately after the accident. On physical examination, there was angulation in the distal left femur, there was tenderness on palpation and unable to do dorsiflexion or moving the fingers of the left foot but still could feel touch stimulation on the pedis.Results: In our patient case with the diagnosis of left femoral artery occlusion et causa closed fracture distal femur (Salter-Harris type II) managed by surgery to release the femoral artery with internal fixation to the distal femur using Kirschner wire (minimally invasive) and massage to the femoral artery give optimal results.Conclusion: Surgery to release the femoral artery with internal fixation to the distal femur using Kirschner wire (minimally invasive) and massage to the femoral artery give an optimal result.Keywords: Salter-Harris fracture, femoral artery, Kirschner wire, Volkmann's ischaemic contractureCorrespondence: Pamudji Utomo. Department of Orthopaedics and Traumatology, Prof. Dr. R. Soeharso Orthopaedics Hospital. Email: utomodr@yahoo.comIndonesian Journal of Medicine (2019), 4(1): 75-81https://doi.org/10.26911/theijmed.2019.04.01.12

Bilateral Simultaneous Rupture of the Quadriceps Tendon in a Healthy Elderly Woman: A Case Report Utomo, Pamudji; Adriansyah, Denny
Indonesian Journal of Medicine Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Quadriceps tendon ruptures are uncommon injury that affects middle-aged women, predominantly it affects middle aged men. However, the bilateral quadriceps tendon rupture is extremely rare in the absence of systemic disease.Subjects and Method: We reported a case of bilateral quadriceps tendon rupture in a healthy 65 year old female. She felt pain in both knees since 4 months before entering the hospital. Local physical examination on both knees reveal the loss of normal contour of rectus femoris, tenderness at superior pole patella the ruptur site, and palpable defect within 2 cm of superior pole patella. Patient unable to extend knee against resistance, and unable to perform straight leg raise. The patient was carried out a surgical repair with consent.Results: After the surgery both knees were immobilized with knee extension splint for 6 weeks. Patient evaluation revealed no pain and progressive recovery of muscular strength after four months and could be able to walk and returned to normal activity.Conclusion: Surgery is needed to repair quadriceps rupture.Keywords: Quadriceps tendon, quadriceps rupture, repair tendon.Correspondence: Pamudji Utomo. Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: utomodr@yahoo.com.Indonesian Journal of Medicine (2019), 4(1): 54-58https://doi.org/10.26911/theijmed.2019.04.01.09

A 25 Years Old Female with Meloheostosis: A Case Report Utomo, Pamudji; Warman, Fanny Indra; Idulhaq, Mujaddid; Mudigdo, Ambar
Indonesian Journal of Medicine Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Melorheostosis is a rare sclerosing bone dysplasia characterized by its classic radiographic feature of flowing/dripping candle wax. It usually affects one limb, more often the lower extremity, and rarely the axial skeleton. The etiology remains unknown and various theories have been proposed to explain the pathogenesis of this disease. It often has an insidious onset in early adult life. Symptoms include pain, oedema, and limitation of joint movement.Case presentation: A patient aged 25 year old male complaint of pain on the left lower extremity for the last 3 years. There is muscle atrophy at left extremity, bowing of the thigh, awelling at the foot. There is palpable mass at the left bottom, solid consistency and fixed. There are also limitation ROM of hip, knee and ankle. From the radiography examination showed inhomogen thickening of the periosteal cortical and endosteal, dripping candle wax appearance, and sclerotic lesion at soft tissue.Conculsion: X-ray is a sufficient method for diagnosis of melorheostosis.Other imaging techniques are essential for decision about therapeutic intervention (CT or MRI). Laboratory findings are usually in physiological range. Symptomatic therapy proved to be sufficient in subjective symptoms management.Keywords: Melorheostosis, sclerosing bone dysplasia, dripping candle waxCorrespondence: Pamudji Utomo. Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: utomodr@yahoo.com.Indonesian Journal of Medicine (2019), 4(1): 59-64https://doi.org/10.26911/theijmed.2019.04.01.10

Functional Knee Score in Knee Osteoarthritis with Tibial Defect Performed Total Knee Arthroplasty with Screw Augmentation Mariyanto, Ismail; Idulhaq, Mujaddid; Utomo, Pamudji; Gardjito, Fajar Baskoro; Perdana, Arief Indra
Indonesian Journal of Medicine Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Long-standing knee osteoarthritis also is a common cause of severe bone deficiency (especially proximal tibia). Total knee arthroplasty is indicated in patient with knee osteoarthritis who did not able to perform activity daily living. This study aimed to evaluate the functional knee score of the patient with knee osteoarthritis who performed total knee arthroplasty with screw augmentation.Subjects and Method: This was an analytic observational study conducted at Soeharso Orthopaedic Hospital, Surakarta, Central Java, from January to December 2016. A sample of 30 patients with knee osteoarthritis with tibial defect who performed total knee arthroplasty with screw augmentation was selected for this study. The dependent variable was functional knee score. The independent variable was knee arthroplasty with screw augmentation. Knee function was measured by knee society score. The difference of knee function score between before and after total knee arthroplasty with screw augmentation was analyzed by t test.Results: There were 30 patients (25 females and 5 males) with age between 54 to 73 years old. Mean of knee society score post operative (mean= 82.7; SD= 6.29) was higher than pre operative (mean= 30.5; SD= 6.74) and it was statistically significant (p=0.001).Conclusion: Knee society score after total knee arthroplasty with screw augmentation is higher than before surgery.Keywords: functional knee score, osteoarthritis, screw augmentationCorrespondence: Fajar Baskoro Gardjito, Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital/Prof. Dr. R. Soeharso Orthopaedic Hospital. Email: baskovic9237@gmail.com.Indonesian Journal of Medicine (2018), 3(3): 134-138https://doi.org/10.26911/theijmed.2018.03.03.02

Correlation between Schizas Score, Degree of Disability, and Neurogenic Claudication in Lumbar Spinal Stenosis Prasetya, Arief Indra Perdana; Gardjito, Fajar Baskoro; Prijosedjati, R. Andhi; Utomo, Pamudji; Handojo, Handry Tri
Indonesian Journal of Medicine Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Magnetic Ressonance Imaging (MRI) is one of modality to diagnosed lumbar spinal stenosis (LSS) however there were some mismatch between the degree of canal stenosis to functional score of LSS. There are some methods to measure the degree of canal stenosis, on of them is Schizas Score. To asses functional score of patients with LSS, there are some tools can be used. Oswesstry Disability Index (ODI) and Neurogenic Claudication Outcome Score (NCOS) are questionnaire commonly used in LSS. This study aimed to analyze the correlation between the degree of stenosis grading using Schizas Score to the degree of disability using ODI score and Neurogenic Claudication using NCOS.Subjects and Method: This was an analytic observational study conducted at Prof. Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Central Java. A sample of 35 patients with LSS in were assessed by filling ODI and NCOS questionnaire, then evaluate the lumbar axial MRI to identify the Schizas Score. The data were analyzed by Spearman test.Results: There was a significant correlation between Schizas Score to ODI score and NCOS. Schizas score increased ODI score (r= 0.91; p<0.001). Schizas score decreased NCOS (r= -0.90; p<0.001).Conclusion: Schizas score is correlated with ODI score and NCOS.Keywords: lumbar spinal stenosis, Schizas score, ODI, NCOSCorrespondence: Arief Indra Perdana Prasetya. Resident of Orthopaedic and Traumatology Specialist Program, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: absolutellydarkknight@gmail.com.Indonesian Journal of Medicine (2019), 4(2): 116-121https://doi.org/10.26911/theijmed.2019.04.02.05

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