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Multiple Hereditary Exostosis of Distal Ulna with Dislocation of Radial Head: A Case Report Utomo, Pamudji; Idulhaq, Mujaddid; Brilianto, Bagus Iman
Indonesian Journal of Medicine Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Multiple hereditary exostosis of the forearm is typically formed in the distal ulna causing disturbances in the growth of the ulna and functional disability. Multiple hereditary exo­stosis inhibits the growth of the ulna leading to an acquisition of a varus deformity in the ra­dius which sometimes leads to dislocation of the radial head, the development of limitations in the pronation-supination of the forearm, and cos­me­tic problems. This study aimed to report the mul­ti­ple hereditary exostosis of distal ulna with dis­location of radial head.Case Presentation: We present a case of a 14 year-old girl with main complaint of a bony prominence on her right elbow which limits the elbow flexion range of motion. 3D CT-Scan re­vealed a dislocation of radial head, shortening and posterior bowing of ulna. We performed excision of the prominent radial head, recons­truction, and temporary arthrodesis of the elbow.Results: The forearm deformity in patients with multiple hereditary exostosis related to the cross-sectional area of the distal ulnar physis was only one-quarter of the distal radius, the distal ulna is more involved in the condition. There was more longitudinal growth at the distal ulnar physis than at the distal radial physis, the distal ulnar physis contributed more total Ulnar Length than the distal radial physis did to Radial length. Known surgical interventions including simple excision, ulnar lengthening, corrective radial os­teo­­tomy, hemi-epiphyseal stapling of the distal radius, the Sauve-Kapandji procedure.Conclusion: Simple excision could improve the range of movement of the forearm but would not halt the progression of disease, particularly in younger patients. It was not effective in con­troll­ing progression of the deformity. Mature patients did not recur, but in patients that had been excis­ed before puberty the results were varied and unpredictable.Keywords: multiple hereditary exostosis, radial head dislocation, excisionCorrespondence: Pamudji Utomo. Department of Orthopaedics and Traumatology Prof. Dr. R.Soeharso Ortho­paedics Hospital, Surakarta. Email: utomodr­@yahoo.com.Indonesian Journal of Medicine (2020), 05(01): 63-69https://doi.org/10.26911/theijmed.2020.05.01.10
Treatment of Severe Knee Flexion Contracture After Below Knee Amputation Using Hinged Ilizarov Ring External Fixator: A Case Report Brilianto, Bagus Iman; Mariyanto, Ismail
The Hip and Knee Journal Vol 3, No 2 (2022): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (464.561 KB) | DOI: 10.46355/hipknee.v3i2.126

Abstract

Flexion contracture of the knee is a common complication found after Below Knee Amputation (BKA). This condition is caused by muscle imbalance and prolonged stump malpositioning after BKA. Acute surgical correction of this deformity associated with high rates of complications. A 39-years-old man with chief complaint flexion contracture after BKA 3 months before. Physical examination showed flexion contracture deformity with knee range of motion at 90° to 120° with no possibility of further knee extension. This condition prevented him to use prosthesis and start walking exercises. Gradual correction of flexion deformity was performed using hinged Ilizarov ring external fixator with the rate of distraction was 1mm/day to prevent soft tissue and neurovascular complications. After 90 days of distraction, full extension of the knee joint was achieved with no complications. Gradual correction of knee flexion contracture using hinged Ilizarov device greatly reduced the complications risk of acute deformity correction with open surgery. This technique provides more advantage of minor operative trauma with a gradually controlled correction, permitting the soft tissue to regenerate, thus lowering the risk of neurovascular complications.
CHALLENGING DIAGNOSIS FROM PARONYCHIA TO GLOMUS TUMOR Rahim, Fitrahadi Nugraha; Meliala, Charles Apulta; Brilianto, Bagus Iman; Setiasti, Anglita Yanti; Irawan, M. Naseh Sajadi Budi; Primadhi, R. Andri
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 1 (2025): APRIL 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i1.43154

Abstract

ABSTRAK Tumor glomus, juga dikenal sebagai angioneuromioma, adalah neoplasma jinak yang muncul dari badan glomus, suatu struktur yang berfungsi dalam pengaturan suhu tubuh. Tumor jinak yang langka ini telah dilaporkan di sejumlah lokasi di tubuh, paling sering terlihat di area subungual jari-jari tangan. Hanya sedikit yang telah dilaporkan di daerah kaki, terutama jempol kaki. Trias klasik berupa nyeri spontan, nyeri tekan, dan hipersensitivitas dingin umumnya ditemukan sebagai presentasi klinis dari jenis tumor ini. Seorang wanita berusia 33 tahun datang ke rumah sakit kami dengan keluhan nyeri kronis dan sensitivitas suhu dingin, di jempol kaki kanannya dengan kesulitan memakai sepatu selama 9 tahun terakhir. Hasil rontgen dan pemeriksaan laboratorium normal. Pemeriksaan lebih lanjut dengan pencitraan resonansi magnetik dilakukan dan menunjukkan lesi jaringan lunak berbatas teratur dengan hipointensitas di T1 dan hiperintensitas di T2. Pengangkatan lesi dilakukan dengan eksisi dan laporan histopatologi mengonfirmasi diagnosis tumor glomus pada jempol kaki. Tindak lanjut di klinik rawat jalan menunjukkan bahwa pasien telah bebas nyeri selama 5 minggu setelah operasi. Tumor glomus sebagai kemungkinan penyebab nyeri kronis pada jari kaki sering kali terlambat didiagnosis dan salah didiagnosis sebagai paronikia karena jarang muncul secara klinis, terutama pada jempol kaki. Tujuan dari laporan kasus ini adalah untuk meningkatkan kesadaran dokter dan ahli bedah tentang tumor ini sebagai kemungkinan diagnosis.