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All Journal Majalah Kedokteran Sriwijaya Sriwijaya Journal of Surgery
Rendra Leonas
Fakultas Kedokteran Universitas Sriwijaya
Health Professions Medicine & Pharmacology Nursing Public Health

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KARAKTERISTIK PASIEN FRAKTUR SUPRAKONDILER HUMERUS PADA ANAK DI RSUP DR. MOHAMMAD HOESIN PALEMBANG PERIODE 2014-2017 M Farhan Habiburahan; Rendra Leonas; Joko Marwoto
Majalah Kedokteran Sriwijaya Vol 50, No 1 (2018): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v50i1.8539

Abstract

Fraktur suprakondiler humerus merupakan salah satu fraktur ekstremitas atas tersering pada usia anak-anak dengan prevalensi tinggi terhadap timbulnya komplikasi cidera neurovaskular maupun deformitas cubitus varus. Meskipun fraktur suprakondiler humerus umum dijumpai pada usia anak-anak, hingga saat ini data mengenai karakteristiknya masih sedikit di Indonesia. Penelitian ini bertujuan mengidentifikasi karakteristik pasien anak-anak dengan fraktur suprakondiler humerus di RSUP Dr. Mohammad Hoesin Palembang. Penelitian deskriptif kuantitatif. Sampel penelitian adalah rekam medik pasien anak-anak dengan fraktur suprakondiler humerus baik yang rawat jalan maupun rawat inap di RSUP Dr. Mohammad Hoesin Palembang periode Januari 2014 hingga Desember 2017 yang memenuhi kriteria inklusi untuk diidentifikasi karakteristiknya. Distribusi pasien terbanyak ditemukan pada kelompok usia 1-4 (34,6%) dan 5-9 tahun (34,6%)  serta jenis kelamin laki-laki (61,5%). Klasifikasi fraktur tipe fleksi (92,3%) ditemukan paling banyak diikuti oleh klasifikasi fraktur Gartland tipe 3 (57,7%). Kebanyakan pasien ditemukan dengan lengan kiri (57,7%) mengalami fraktur akibat trauma langsung (88,5%) pada sendi siku. Sebanyak 11 pasien (42,3%) mendapatkan penanganan di rumah sakit dalam rentang waktu < 1 minggu pasca trauma dan 2 pasien dengan riwayat pengobatan melalui traditional bone-setter. Semua pasien mendapatkan prosedur penanganan ORIF (open reduction internal fixation) dengan tambahan osteotomi pada 3 pasien (88,5%) karena komplikasi deformitas cubitus varus sebelum operasi. Fraktur suprakondiler humerus banyak ditemukan pada laki-laki dalam kelompok usia 1-4 dan 5-9 tahun. Masa pertumbuhan tulang, locus minoris suprakondiler humerus dan aktivitas pada anak laki-laki merupakan faktor-faktor yang mungkin memudahkan terjadinya fraktur suprakondiler humerus pada trauma ekstremitas atas. Keterlambatan penanganan dan jenis penanganan yang tidak tepat terhadap tipe fraktur menurut klasifikasi Gartland maupun klasifikasi ekstensi atau fleksi cenderung menyebabkan timbulnya komplikasi jangka panjang seperti deformitas cubitus varus. 
Perioperative Profile of Stand-Alone Cages in Anterior Cervical Discectomy and Fusion for Degenerative Cervical Stenosis: Reduced Bleeding and Hospital Stay Compared to Cage-Plate Constructs Handi Suntama Effendy; Rendra Leonas; Debby Handayati Harahap
Sriwijaya Journal of Surgery Vol. 8 No. 1 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i1.128

Abstract

Introduction: Anterior cervical discectomy and fusion (ACDF) is a common surgical treatment for degenerative cervical stenosis. Stand-alone cages (SAC) and cage-plate constructs (CPA) are frequently used, with comparable reported fusion rates. This study aimed to compare the perioperative profiles, specifically intraoperative bleeding and length of hospital stay, alongside fusion rates, between ACDF-SAC and ACDF-CPA for single-level degenerative subaxial cervical stenosis in an Indonesian population. Methods: A retrospective cohort study was conducted using medical records from February to March 2025, including patients who underwent single-level ACDF-SAC or ACDF-CPA for degenerative subaxial cervical stenosis between June 2022 and June 2024 at Dr. Mohammad Hoesin General Hospital, Palembang. Twenty-one patients (10 ACDF-SAC, 11 ACDF-CPA) were included. Data on demographics, operative level, intraoperative bleeding, length of hospital stay, and 6-month fusion rates were analyzed. Results: No significant differences were observed in age (p=0.056), gender (p=0.635), or BMI (p=0.708) between groups. The ACDF-CPA group had significantly more procedures at the C5-6 level (p=0.010). Intraoperative bleeding was significantly lower in the ACDF-SAC group (86.90 ± 30.00 cc) compared to ACDF-CPA (183.27 ± 58.74 cc; p=0.000). Length of hospital stay was shorter for ACDF-SAC (4.70 ± 1.49 days) versus ACDF-CPA (6.27 ± 1.19 days; p=0.015). Fusion rates were 100% for ACDF-SAC and 90.9% for ACDF-CPA (RR=2.000; 95% CI 1.290–3.100; p=1.000), a non-statistically significant difference. The single non-fusion occurred at C3-4 in the ACDF-CPA group. Conclusion: In patients undergoing single-level ACDF for degenerative subaxial cervical stenosis, the use of stand-alone cages was associated with significantly less intraoperative bleeding and shorter hospital stays compared to cage-plate constructs, without compromising 6-month fusion rates. These findings suggest potential perioperative advantages for the ACDF-SAC technique.
Systemic Neuroinflammatory Signatures in Lumbar Spinal Stenosis: An Exploratory Correlation of Serum IL-1β and hs-CRP with Schizas Morphological Grading Arazy Gifta Prima; Rendra Leonas; Theodorus
Sriwijaya Journal of Surgery Vol. 9 No. 1 (2026): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v9i1.142

Abstract

Introduction: The clinical-radiological paradox in lumbar spinal stenosis (LSS) suggests that anatomical compression alone fails to explain symptom severity. Emerging evidence points to a bio-active stenotic environment driven by chronic neuroinflammation. This study aimed to investigate whether the morphological severity of stenosis, graded by the Schizas classification, correlates with systemic inflammatory biomarkers (Interleukin-1β and high-sensitivity C-reactive protein) after strictly controlling for pharmacological confounders. Methods: A prospective, cross-sectional exploratory pilot study was conducted on 30 patients with degenerative LSS. To isolate stenosis-induced inflammation, strictly non-obese patients (BMI <30 kg/m²) underwent a verified 7-day NSAID/steroid washout period. Stenosis severity was graded on MRI using the Schizas classification. Due to small sample size in extreme stenosis, Grades C and D were merged into a severe stenosis cohort. Serum IL-1β and hs-CRP were quantified via ELISA. Statistical analysis utilized Kruskal-Wallis tests and bootstrapped multivariate linear regression (1,000 resamples) to control for Age, BMI, and multicollinearity (VIF). Results: The cohort was stratified into Grade A (n=10), Grade B (n=11), and Severe Grade C/D (n=9). Systemic inflammatory markers demonstrated a significant stepwise elevation corresponding to morphological severity. Median IL-1β levels rose from 5.60 (IQR 4.9–6.4) pg/mL in Grade A to 11.20 (IQR 9.1–13.8) pg/mL in the Severe group (p<0.001). Similarly, hs-CRP increased from 2.15 mg/L to 4.90 mg/L (p=0.003). Bootstrapped regression confirmed that Schizas severity remained a significant independent predictor of IL-1β (β=0.46, p=0.012) and CRP (β=0.49, p=0.009) with acceptable variance inflation factors (VIF < 2.5), validating the model despite age-related correlations. Conclusion: Morphological severity of the dural sac significantly correlates with systemic inflammatory burden. Severe mechanical compression appears to induce a spillover effect, creating a detectable peripheral inflammatory signature. These biomarkers may serve as objective adjuncts to MRI in conflicting clinical scenarios.
Co-Authors Arazy Gifta Prima Debby Handayati Harahap Handi Suntama Effendy Joko Marwoto M Farhan Habiburahan Theodorus