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All Journal E-Jurnal Medika Udayana Tadulako Law Review ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Global Health research The Hip and Knee Journal
I Wayan Subawa
Departemen Orthopaedi Dan Traumatologi, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Indonesian Journal of Global Health research

 1 
Combination of Zadek Osteotomy and Achilles Tendon Re-Attachment in Severe Haglund Deformity: A Case Report Kusuman, Kevin; Subawa, I Wayan; Ismail, Mohamad Dimas
Indonesian Journal of Global Health Research Vol 7 No 2 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i2.5679

Abstract

Haglund deformity refers to a bony exostosis on the posterosuperior aspect of the calcaneus, often causing retrocalcaneal bursitis and Achilles tendinopathy. Conservative treatments, including physiotherapy and medication, may not relieve symptoms in severe cases. Surgical intervention is indicated when non-operative treatments fail. This report highlights a case of severe Haglund deformity managed with Zadek osteotomy and Achilles tendon re-attachment.Case Presentation: A 45-year-old female presented with 2 months of severe right heel pain and a 2-year history of a prominent bump. Physical therapy yielded no improvement. Clinical and radiographic evaluation confirmed Haglund deformity with insertional Achilles tendinopathy. Surgical treatment involved Zadek osteotomy, fixation with screws, and Achilles tendon re-attachment using a suture anchor. The combined approach addressed both the bony deformity and tendon degeneration. Post-operative outcomes showed significant improvement. At the 3-month follow-up, the patients Visual Analog Scale (VAS) pain score decreased from 7/10 to 1/10, and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot score improved from 55 to 90. The range of motion was near normal, and functional recovery was excellent. This case demonstrates the effectiveness of combining Zadek osteotomy and Achilles tendon re-attachment for treating severe Haglund deformity. This approach provided significant pain relief and functional recovery, making it a viable option for patients with similar conditions refractory to conservative management.
Comparison of Plating Versus Intramedullary Nailing in Metaphyseal Fractures: A Systematic Review and Meta-Analysis Darma, Anak Agung Ngurah Bagus Surya; Subawa, I Wayan
Indonesian Journal of Global Health Research Vol 7 No 2 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i2.5117

Abstract

Metaphyseal fractures are common orthopedic injuries that often require surgical intervention for optimal management. The choice between plating and intramedullary nailing as fixation methods remains a subject of debate among orthopedic surgeons, with considerations including fracture type, patient characteristics, and surgical outcomes. This study aim to compare the efficacy, safety, and outcomes of plating versus intramedullary nailing in the treatment of metaphyseal fractures.Methods: A comprehensive search was conducted across major electronic databases for relevant studies published up to 2023. Studies comparing plating and nailing techniques in metaphyseal fracture fixation were included. Data regarding study characteristics, patient demographics, surgical techniques, outcomes, and follow-up durations were extracted and analyzed using appropriate statistical methods. Our primary outcomes were union rate and time, functional outcome using patient reported outcome measure, and complications. Results: The initial search yielded a total of 687 studies, of which 7 studies met the inclusion criteria, consisting of a total of 758 skeletally-mature patients with metaphyseal fractures treated with either intramedullary nailing or plate fixations. The meta-analysis revealed that there is no evidence to draw definitive conclusions on which indicates the best method in treating metaphyseal fractures. Subgroup analyses were performed based on fracture type, patient age, and other relevant factors to further elucidate the comparative effectiveness of plating versus screwing.Conclusion: The meta-analysis findings indicated that using intramedullary nailing led to shorter surgical and complications when compared to plate fixation. Additionally, both treatments frequently resulted in similar union times and union-related issues. However, further randomized controlled trials (RCTs) are necessary to bolster the existing evidence base.
Comparison of Minimally Invasive Plate Osteosynthesis and Intramedullary Nailing for Tibial Shaft Fracture: A Systematic Review and Meta-Analysis Subawa, I Wayan; Darma, Anak Agung Ngurah Bagus Surya
Indonesian Journal of Global Health Research Vol 7 No 2 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i2.5130

Abstract

Tibia shaft fractures are thought to affect 4% of the elderly population. Both low energy and high energy mechanisms have the potential to damage the tibia. Two frequently utilized surgical procedures that are superior to other available choices (external fixation and conventional plate fixation) for the treatment of tibia shaft fractures are intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO). We compare minimally invasive plate osteosynthesis versus intramedullary nailing for tibial shaft fracture in terms of return to work, hospital stay, and complications over the duration of 1-2 years of follow-up.Methods: A PRISMA guided systematic review was done. A comprehensive literature search was performed to find study in English comparing between MIPO and IMN for tibial shaft fracture from January 2017 until August 2022. PubMed, Google Scholar, and Cochrane Library. The focus in this systematic review and meta-analysis is to compare outcome between MIPO and IMN for tibial shaft fracture. ((“Minimally Invasive Plate Osteosynthesis”, “Intramedullary Nailing”), AND (“Tibial Shaft Fracture”), AND (“Outcome Measure”)) were utilized in the search.Results: This meta-analysis included a total number of 214 patients with 91 patients undergoing MIPO and 123 patients undergoing IMN. The follow-up period was 1-2 years after the treatment. There were found no significant differences statistically in terms of hostpital stay, return to work, infection, malunion, and non union. Conclusion: Our investigations show that both IMN and MIPO are safe and effective methods in treating tibial shaft fractures, and our results show that both methods provide similar outcomes in length of stay, return to work, infection, malunion, and non-union aspects.
Co-Authors Agung Artha Wiguna Aryana, I Gusti Ngurah Wien Darma, Anak Agung Ngurah Bagus Surya Dewi, Kadek Ayu Candra Dhaifullah, M Rifqi Dharmayuda, Cokorda Gde Oka Dusak, I Wayan Suryanto Eka Wiratnaya Gabriel Audrey Wijaya Hans Kristian Nugraha, Hans Kristian Herryanto Agustriadi Simanjuntak I G A A Diah Pradnya Paramita I Gusti Lanang Ngurah Agung Artha Wiguna I Gusti Ngurah Wien Aryana I Ketut Suyasa I Made Suka Adnyana I Made Suwitra, I Made I Wayan Arthana I Wayan Jorden Junior I Wayan Suryanto Dusak Indraswari, Made Ratna Savitri Ismail, Mohamad Dimas Kardi Rahayu Kesumaputri, Komang Diah Kurnia Ketut Gede Mulyadi Ridia Ketut Siki Kawiyana Ketut Trisna Parama Kartika Kusuman, Kevin Made Suka Adnyana Meregawa, Putu Feryawan Ni Putu Ayu Pande Arista Dewi Ni Putu Sawitri Nandari Putu Astawa Putu Prabhawati DwiKrisna Putu Sinta Ratna Sari Dewi Sitranata, Madeline Juliand Sri Mahadhana, Sri Susila, Made Arya Vivi Paula Putri Wiguna, I Gusti Lanang Ngurah Agung Artha Wiratnaya, Gede Eka