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All Journal Biomedika Indonesian Journal of Medicine Journal Orthopaedi and Traumatology Surabaya (JOINTS)
Pradhana, Adhitya Indra
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Two-Stage Reconstruction Surgery on Cervical Deformity Caused by Spondylitis TB Ermawan, Rieva; Utomo, Pamudji; Pradhana, Adhitya Indra; Islami, Umar Kharisma
Indonesian Journal of Medicine Vol. 5 No. 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (772.222 KB)

Abstract

Background: Of all form of spinal tuberculo­sis (TB), cervical involvement is immensely rare and merely found in 3-5% of all cases. Kyphotic deformity in spondylitis TB was caused by ver­tebral destruction in the anterior segment due to infection that lead to hyperemia, bone marrow edema, and osteoporosis. Treatment of spinal TB was divided into two sections which run simultaneously, medicament and surgery. The use of cage for spinal surgery has shown its effectivity in supporting the anterior segment of vertebrae and providing long term stability. The purpose of this study was to compare functional out­come of two patients with cervical deformity caused by spondylitis TB that underwent two-stage reconstruction surgery with expandable and non-expandable cage. Case Presentation: Two patients were re­ported with cervical deformity caused by spon­dylitis TB in Orthopedic Hospital Prof. Dr. R. Soeharso, Surakarta. Both patients had their neurological status, Cobb angle, decompres­s­ion effects and post-operative fusion rate assessed. The patients were diagnosed with cervical deformity due to spondylitis TB showing the involvement of C4-5 in the first patient and C3-5 in the second one. Both underwent two-stage reconstruction surgery and were evaluated right after. There was no decadence in their post-operative neurological function. In the first patient, pre-operative Cobb angle was 44oand becoming 18o post-operatively. The pre-operative Cobb angle of the second patient was 14o and becoming 3o post-operatively.Results: Assessment of post-operative decom­pression effects and fusion rate were carried out by CT scan and both patients showed a favorable result even when they both were given a different cage. Although both cages had their own advantages based on surgical consi­deration, we prefer to used expandable cage due to minimal dissection needed.Conclusion: Two-stage reconstruction surge­ry using whether expandable or non-expand­able cage to treat cervical deformity caused by Spondylitis TB gave equally satisfactory out­come.Keywords: Spondylitis, tuberculosis, cervical deformityCorrespondence: Adhitya Indra Pradhana. Prof. Dr. R. Soeharso Orthopaedic Hospital. Jl. Jenderal Ahmad Yani, Surakarta 57162, Central Java, Indonesia. Email: adhityaindrapradhana@gmail.comIndonesian Journal of Medicine (2020), 05(02): 116-124https://doi.org/10.26911/theijmed.2020.05.02.04
SURGICAL TREATMENT OUTCOME OF AMNIOTIC BAND SYNDROME (ABS) INVOLVING THE FINGER AND LEG WITH INFECTION OF A FOUR-MONTHS MALE CHILD: A CASE REPORT Kumara, Hendra Cahya; Utomo, Pamudji; Islami, Umar Kharisma; Pradhana, Adhitya Indra
Biomedika Vol 12, No 2 (2020): Biomedika Agustus 2020
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v12i2.10562

Abstract

ABSTRACTAmniotic band syndrome is an uncommon congenital disorder without any genetic or hereditary predisposition factor. It involves fetal entrapment in strands of amniotic tissue and causes an array of deletions and deformations. The aim of this article was to report surgical treatment outcome of amniotic band syndrome finger and infected intrauterine leg amputation. A case of four months male child with complaint of incomplete formation and constricting band on his left leg was reported. On the stump of left leg initially there was a small lump. Over time the size of the stump grew bigger and infected wound appeared. Other deformities were constricting band on proximal phalanx of the middle finger of left hand, acrosyndactyly of first and second toe of right foot and congenital scrotalis hernia. We performed a release surgery of constriction ring band of proximal phalanx of the middle finger of left hand with z-plasty incision and below knee amputation for left leg. We followed up patient in one year after operation. The patient complained no pain and no sign of infection. Patient could walk normally and independently with good activity daily living. We concluded that procedure with z-plasty incision had good result and avoided morbidity. Below knee amputation procedure and application of suitable prosthesis provided satisfying outcome on patient activity daily living and ambulation. Key words: Amniotic band syndrome, intrauterine amputation, z-plasty, infectioABSTRAKSindrom amniotic band merupakan kelainan bawaan yang jarang terjadi dan tanpa adanya kecenderungan faktor genetik atau keturunan. Kelainan ini diakibatkan terlilitnya janin dalam untaian jaringan amnion dan menyebabkan berbagai jenis kehilangan dan kecacatan. Tujuan dari artikel ini adalah melaporkan luaran tatalaksana operasi sindrom amniotic band pada jari tangan dan amputasi pada tungkai yang terinfeksi intrauterine. Pasien adalah seorang anak laki-laki empat bulan dengan amputasi tungkai bawah kiri disertai constriction band pada bagian proksimal. Pada ujung tungkai bawah kiri didapatkan benjolan dengan ukuran minimal yang makin lama ukuran sisi distal menjadi lebih besar dan tampak luka dengan nanah. Kelainan bentuk lainnya adalah constricting band pada phalanx proksimal jari tengah tangan kiri, acrosyndactyly jari kaki pertama dan kedua kaki kanan serta congenital hernia skrotalis. Kami melakukan operasi release constriction ring band phalanx proximal jari tengah tangan kiri dengan irisan z-plasty dan below knee amputation tungkai kiri. Follow up pasien setelah operasi satu tahun. Tidak ada keluhan nyeri, tidak ada tanda infeksi, pasien dapat berjalan normal dan aktivitas sehari-hari dengan mandiri. Kesimpulan bahwa prosedur dengan irisan z-plasty memberikan hasil yang baik dan menghidari morbiditas pasien. Prosedur below knee amputation dan penggunaan prosthesis yang tepat memberikan hasil yang memuaskan pada aktivitas sehari-hari dan ambulasi pasien. Kata kunci: Sindrome amniotic band, amputasi intrauterine, z-plasty, infeksi 
Functional Outcome by Evaluation of DASH Score on Drop Hand Patient Treated with Jones’ Tendon Transfer: A Retrospective Study Sumarwoto, Tito; Hadinoto, Seti Aji; Pradhana, Adhitya Indra
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.39-45

Abstract

Background: Drop hand, resulting from radial nerve injuries, causes functional and structural disabilities. Tendon transfer becomes the last option when nerve repair fails to achieve restoration. The most popular method is the Jones tendon transfer to restore wrist dorsiflexion and extension of the thumb and fingers. The Disabilities of the Arm, Shoulder, and Hand (DASH) score measures functional outcomes in patients with upper extremity injuries. This study aimed to assess the functional outcome and evaluate the DASH score in drop hand patients who underwent Jones tendon transfer surgery at Prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta. Methods: Data collected from medical records between January 2014 and June 2016 were evaluated based on functional outcome and DASH score. Eleven patients were included, comprising ten male patients (90.9%) and one female patient (9.1%). The mean age of the patients was 27.4 years. The right arm was the most frequently injured, accounting for eight patients (72.7%), while the left arm was injured in three patients (27.3%). Results: The DASH score evaluation indicated minimal disability in ten patients (90.9%) and moderate disability in one patient (9.1%). The average score was 12.48, indicating that most patients could cope with most daily living activities postoperatively.Conclusions: Surgical intervention for drop hand due to radial nerve palsy using the Jones tendon transfer technique yielded a satisfactory functional outcome based on the DASH score.
Co-Authors Ermawan, Rieva Hadinoto, Seti Aji Islami, Umar Kharisma Kumara, Hendra Cahya Sumarwoto, Tito Utomo, Pamudji