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All Journal Jurnal Prima Medika Sains Cermin Dunia Kedokteran Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Cermin Dunia Kedokteran
Winanto, Iman Dwi
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Humanities Health Professions Medicine & Pharmacology Nursing Public Health

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Treatment Outcome of Posteromedial Procedure for Neglected Clubfoot in Children Older than 2 Years of Age - Report of 3 Cases Winanto, Iman Dwi
Cermin Dunia Kedokteran Vol 48, No 12 (2021): General Medicine
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (267.804 KB) | DOI: 10.55175/cdk.v48i12.1579

Abstract

Background: A neglected clubfoot is a clubfoot that didn’t get early or adequate treatment; it is a major problem in developing countries. The posteromedial soft tissue release procedure is one of surgical technique in clubfoot treatment. Case : Three patients with neglected clubfoot were assessed before and after treatment. All patients were treated with posteromedial soft tissue release method followed by serial application of above-knee plaster of paris for three months. Result: Two cases had good correction, one case had fair correction. Conclusion: The posteromedial soft tissue release with proper follow up and splinting result in a cosmetically normal appearance and functionally acceptable pain-free foot in neglected clubfoot in children older than 2 years of ageLatar Belakang : Neglected clubfoot merupakan clubfoot yang tidak ditatalaksana atau mendapat tatalaksana awal tidak adekuat; kondisi ini sering ditemui di negara berkembang. Prosedur posteromedial soft tissue release merupakan salah satu teknik operasi dalam tatalaksana clubfoot. Kasus : Tiga pasien neglected clubfoot ditatalaksana dengan prosedur posteromedial soft tissue release diikuti aplikasi serial plaster of paris di atas lutut selama tiga bulan. Hasil : Dua kasus menunjukkan hasil koreksi baik dan 1 kasus hasil koreksi sedang. Simpulan : Prosedur posteromedial soft tissue release dikombinasi dengan ¬follow up serta teknik splinting yang adekuat memberikan hasil kosmetik yang baik serta kaki bebas nyeri pada kasus neglected clubfoot anak berusia di atas dua tahun.
Urgent release of constriction band syndrome of the leg with single-stage Z-plasty procedure in neonates: A case series Winanto, Iman Dwi; Sofyan, Jefryan; Muchtar, Muhammad Arafat; Guci, Ricovially Davya
Jurnal Prima Medika Sains Vol. 6 No. 2 (2024): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i2.5597

Abstract

The congenital constriction band syndrome (CCBS) is a group of fetal abnormalities with myriad of clinical presentation that is characterized by the presence of a fibrous band that encircles fetal tissues in utero. It is a rare disease with a reported incidence of 1/15,000 live births. The disease is treated with release of the constricting band with Z-plasty, where it is classically done as a two-stage procedure. Single stage z-plasty is a relatively new approach that still needs more reports regarding to its result. Our cases described successful release with a single stage Z-plasty reconstruction in the setting of an urgent surgery in neonates aged less than 48 hours.
Recurrent anterior dislocation of radial head treated with ulnar distraction osteotomy and reconstruction of annular ligament using palmaris longus tendon with bioabsorbable screw anchoring: A case report Winanto, Iman Dwi; Siregar, Alamsyah Faritz; Nugraha, Tesar Akbar
Jurnal Prima Medika Sains Vol. 6 No. 2 (2024): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i2.5663

Abstract

Introduction: Radial head dislocation in children may be either congenital, an isolated injury or more commonly part of a complex injury to the elbow. Isolated traumatic radial head dislocation in children is a rare and easily missed condition.The reported case shows various treatment and intervention with ulnar osteotomy and annular ligament reconstruction in order to reach the definitive reduction of recurrent dislocation of radial head. Case Presentation: Male 9 years old with anterior dislocation of the radial head, came with difficulty on flexing his elbow due to bony prominence on his anterior elbow. He had recurrent radial head dislocation with redundant annular ligament. From the physical examination there was a prominent radial head on anterior region of elbow. From x-ray examination we found anterior dislocation of ulnar head without any fracture or deformity of ulna. Patient underwent ulnar distraction osteotomy to achieve radial traction and allow stable reduction of radial head. After 5 months he had reconstruction of annular ligament with palmaris longus tendon graft and anchoring with bioabsorbable screw in order to reduce and stabilize the radial head. Conclusion: In this case we found ulnar osteotomy may gave improvement for the reduction of the radial head. But additional annular ligament reconstruction give stability of the radial head which will held in place with full range of motion of the elbow. So this combined procedures hopefully can gave best achievement and satisfactory results of the children and last a lifetime.
HUBUNGAN FAKTOR MATERNAL DAN SOSIAL EKONOMI DENGAN JUMLAH SERIAL CASTING PONSETI PADA PASIEN CLUBFOOT: RELATIONSHIP OF MATERNAL AND SOCIOECONOMIC FACTORS WITH SERIAL PONSETI CASTING NUMBER IN CLUBFOOT PATIENTS Sutanto, Nico; Siregar, Otman; Winanto, Iman Dwi
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 24 No. 2 (2025): Juli 2025
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v24i2.912

Abstract

Clubfoot adalah kelainan kongenital yang dapat menyebabkan disabilitas jika tidak ditangani. Metode Ponseti merupakan terapi utama yang efektif, tetapi jumlah serial casting yang dibutuhkan bervariasi, dipengaruhi oleh faktor maternal dan sosioekonomi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang memengaruhi jumlah serial casting Ponseti pada pasien clubfoot di RSUP H. Adam Malik Medan. Studi ini menggunakan desain penelitian cross-sectional dengan 80 subjek yang didiagnosis clubfoot. Analisa menggunakan uji Fisher exact. Data dikumpulkan melalui wawancara dan rekam medis, kemudian dianalisis menggunakan uji chi-square dan regresi logistik. Rerata usia subjek penelitian adalah 29,05±35,11 bulan, dengan 57,5% laki-laki. Hasil analisis bivariat menunjukkan bahwa jenis transportasi yang digunakan pasien berhubungan signifikan dengan jumlah serial casting Ponseti (p=0,020). Analisis multivariat menunjukkan bahwa faktor transportasi (p=0,011, PR=3,662) dan keluarga perokok (p=0,047, PR=2,774) merupakan faktor dominan yang memengaruhi jumlah serial casting Ponseti. Sementara itu, faktor lain seperti jenis kelamin, pekerjaan orang tua, tingkat pendidikan, dan kondisi ekonomi tidak menunjukkan hubungan yang bermakna. Faktor lingkungan, terutama akses transportasi dan kebiasaan merokok dalam keluarga, berperan dalam menentukan jumlah serial casting Ponseti. Penelitian selanjutnya disarankan menggunakan desain prospektif multicenter dengan variasi demografi yang lebih luas serta analisis lebih mendalam terhadap faktor transportasi dan kebiasaan merokok.
Treatment Outcome of Posteromedial Procedure for Neglected Clubfoot in Children Older than 2 Years of Age - Report of 3 Cases Winanto, Iman Dwi
Cermin Dunia Kedokteran Vol 48 No 12 (2021): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i12.171

Abstract

Background: A neglected clubfoot is a clubfoot that didn’t get early or adequate treatment; it is a significant problem in developing countries. The posteromedial soft tissue release procedure is one of the surgical techniques in clubfoot treatment. Case: Three patients with neglected clubfoot were assessed before and after treatment. All patients were treated with posteromedial soft tissue release method followed by serial application of above-knee plaster of parts for three months. Result: Two cases had a good correction, one case had a fair correction. Conclusion: The posteromedial soft tissue release with proper follow up and splinting results in a cosmetically normal appearance and functionally acceptable pain-free foot in neglected clubfoot in children older than two years of age. Latar Belakang: Neglected clubfoot merupakan clubfoot yang tidak ditatalaksana atau mendapat tata laksana awal tidak adekuat; kondisi ini sering ditemui di negara berkembang. Prosedur posteromedial soft tissue release merupakan salah satu teknik operasi dalam tatala ksana clubfoot. Kasus: Tiga pasien neglected clubfoot ditatalaksana dengan prosedur posteromedial soft tissue release diikuti aplikasi serial plaster of paris di atas lutut selama tiga bulan. Hasil: Dua kasus menunjukkan hasil koreksi baik dan 1 kasus hasil koreksi sedang. Simpulan: Prosedur posteromedial soft tissue release dikombinasi dengan ¬follow up serta teknik splinting yang adekuat memberikan hasil kosmetik yang baik serta kaki bebas nyeri pada kasus neglected clubfoot anak berusia di atas dua tahun
Mechanical Lateral Distal Femoral Angle (MLDFA), Medial Proximal Tibia Angle (MPTA), and Mechanical Axis Deviation (MAD) Value in Young Adults in North Sumatera Winanto, Iman Dwi; Ismiarto, Yoyos Dias
Cermin Dunia Kedokteran Vol 49 No 4 (2022): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i4.215

Abstract

Introduction. Reference value to determine the angle of lower extremity is only based on clinical measurement and radiological assessment, which is limited to tibiofemoral angle (TFA). Although this examination can estimate the lower extremity angle, it is not satisfactory for a comprehensive analysis. Material and Method. A descriptive study in RSUP Haji Adam Malik Hospital in August - September 2019 to measure mechanical lateral distal femoral angle (MLDFA), medial proximal tibia angle (MPTA), and mechanical axis deviation (MAD). Results. Thirty nine subjects were included in this study. The mean age was 26.77±4,65 years old (range: 22 to 39 years); 69,2% were male (n = 27) and 30,8% were female (n = 12). The average mechanical lateral distal femoral angle (MLDFA) was 87,93o±2,16o. The average medial proximal tibia angle (MPTA) was 86,28o±2,26o. The average mechanical axis deviation (MAD) was 1.56±1,48 mm. Our results of MLDFA and MPTA measurement, but not in MAD, are consistent with study conducted by Farr, et al. Conclusion. Our MLDFA, MPTA, but not MAD measurement results are similar to studies involving Caucasian population. Pendahuluan. Nilai acuan sudut pada ekstremitas bawah hanya berdasarkan pemeriksaan klinis dan radiologis, yang terbatas pada sudut tibiofemoral. Pemeriksaan sudut tibiofemoral (STF) tunggal tidak cukup untuk analisis komprehensif ekstremitas bawah. Bahan dan Cara. Penelitian deskriptif di RSUP Haji Adam Malik pada bulan Agustus – September 2019 untuk mengukur sudut mekanik lateral distal femur (SMLDF), sudut medial proksimal tibia (SMPT), dan deviasi aksis mekanik (DAM). Hasil. Sejumlah 39 subjek diteliti. Usia rata-rata 26,77 ± 4,65 tahun (22 - 39 tahun); 69,2% pria (n = 27) dan 30,8% wanita (n = 12). Nilai rata-rata sudut mekanik lateral distal femur (SMLDF) adalah 87,93º ± 2,16º. Nilai rata-rata sudut medial proksimal tibia (SMPT) adalah 86,28º ± 2,26º. Nilai rata–rata deviasi aksis mekanik (DAM) adalah 1.56 ± 1,48 mm. Pada penelitian ini, hasil pengukuran SMLDF dan SMPT sesuai hasil penelitian Farr, et al, tetapi hasil pengukuran DAM tidak sesuai. Simpulan. Nilai SMLDF dan SMPT pada penelitian ini tidak berbeda dengan penelitian pada populasi Kaukasia.
Co-Authors Guci, Ricovially Davya Muchtar, Muhammad Arafat Nugraha, Tesar Akbar Siregar, Alamsyah Faritz Siregar, Otman Sofyan, Jefryan Sutanto, Nico Yoyos Dias Ismiarto