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All Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Journal Orthopaedi and Traumatology Surabaya (JOINTS) The Hip and Knee Journal
Erwin Ramawan
Department Of Orthopaedic And Traumatology, Faculty Of Medicine, Universitas Airlangga / Dr Soetomo Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Medicine & Pharmacology Neuroscience

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Comparison of clinical evaluation of post-operation patients of open reduction internal fixation (ORIF) plating proximal humerus using conventional methods and minimally invasive plate osteosynthesis (MIPO) in Surabaya Musa Arafah; Heri Suroto; Erwin Ramawan
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 2 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v4i2.3119

Abstract

ABSTRACT There are several kinds of approaches in the installation of implants for proximal humerus therapy. At present, minimally invasive surgery is gaining in popularity; this is supported by increasingly good technological developments to optimal the postoperative outcome is more optimal than conventional methods. This study used an analytic retrospective design with samples of post-ORIF Plating MIPO and posted ORIF due to proximal humeral fracture. Evaluation using the instrument of VAS Score, ASES Score, and measurement of range of motion. Statistical tests showed that there was a significant difference in the VAS score at the first evaluation (p = 0.002); the last review was not significant. In ASES Score, abduction, flexion, and external rotation, there were significant differences during the first and last evaluations. Adduction, extension, and internal rotation have no significance. The method of minimally invasive plate osteosynthesis (MIPO) on proximal humeral operative fracture therapy had a better clinical outcome and operating time than post-ORIF plating with conventional methods. As well, the MIPO method on proximal humeral fracture operative therapy based on radiological features has the same union rates compared to post ORIF plating with conventional methods. The method of minimally invasive plate osteosynthesis (MIPO) in operative therapy of neer 2 and 3 proximal humeral fracture has a better clinical outcome than conventional methods.Keywords: proximal humeral fracture, Minimal Invasive Plate Osteosynthesis (MIPO), Open Reduction Internal Fixation (ORIF)Correspondence to: musa_shi911@yahoo.com   
Comparison of subjective and functional results on the operative and non-operative application of clavicle fractures Haris Dwi Khoirur Rofiq; Erwin Ramawan
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 6, No 1 (2022): Journal Qanun Medika Vol 6 No 01
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v6i1.7543

Abstract

Abstract  A clavicle fracture is one of the most common bone injuries occurring in 2-5% of all adult fractures. Clavicle fractures rarely require surgery. Most of the cases were treated by conservative methods. Conservative treatment yields satisfactory results. However, some latest studies showed an incidence of nonunion of up to 15% and patient dissatisfaction of 31%. This study analyzed the outcome and incidence of complications between operative therapy compared to conservative treatment. This research design was a retrospective descriptive observative. The study population was all patients diagnosed with clavicle fracture of the middle third in RSUD Dr. Soetomo Surabaya from 2015 to 2019. The total sample was 153 patients, with 95 patients who underwent conservative measures and 58 patients who underwent surgery. From the results, there were significant differences between the mean SF-36 score [90.81 and 98.21 (p = 0.000)], the mean DASH score [6.94 and 2.42 (p = 0.000)] in patients with fractures clavicle middle third treated with conservative and operative treatment. The union and functional rates were also better in the operative group. This study shows that the operative treatment on clavicle fractures is superior compared to conservative therapy. Keywords: Clavicle fracture, operative treatment, DASH score, SF-36 scoreCorrespondence: dr.harisdwi@gmail.com
A biomechanical comparison of midshaft clavicle plate fixation between two screws and three screws on each side of the fractures Naufal Ranadi Firas; Erwin Ramawan
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 6, No 1 (2022): Journal Qanun Medika Vol 6 No 01
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v6i1.7626

Abstract

ABSTRACT The operative management of mid-clavicle fractures with plate and screw fixation is often performed, with either two or three screws on each side of the fracture. This research aimed to compare biomechanical stability on plate and screw fixation of the middle clavicle fracture with two screws and three screws on each fracture side. There were 12 samples of the fractured cadaveric clavicle in the middle and divided into two treatment groups. The first treatment group was given plate fixation and two screws on each side of the fracture, the second treatment group with plate fixation and three screws. Each group was given a repetitive load tensile force of 200 N, and the fracture shift was measured every ten times, 20 times, and 50 times. The statistical analysis showed a significant difference between plate fixation with two screws and three screws on the tensile force's repetition 20 times and 50 times. The lowest average displacement value after repetition of tensile forces is found in fixation with three screws. Biomechanically, the plate fixation system with three screws on each fracture side was more stable than the two screws in the middle clavicle fracture fixation.Keywords:            biomechanics, clavicle fracture, plate, screwCorrespondence:       nau.orthobaya@gmail.com
NEGLECTED COXITIS TUBERCULOSA MANAGEMENT IN CHILDREN Sulis Bayusentono; Erwin Ramawan; Henry Dominica
Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 1 (2019): April 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v8i1.2019.35-46

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Background: Tuberculosis is one of serious health problems throughout the world, including in Indonesia. The incidence of tuberculosis continue to increase annually, especially the case of bone tuberculosis which is part of tuberculosis extra pulmonary as much as 10-20%.Case: A case report of 2 years old girl, with a neglected posterior hip dextra et causa coxitis tuberculosa dextra in Dr. Soetomo General Hospital, in period October 2013 until September 2015. Data were taken from the retrospective medical record through the anamnesis, physical findings, radiological, and laboratory examinations.Discussion: A 2 years old girl diagnosed as Neglected Posterior Hip dextra et causa Coxitis TB dextra, carried out of open biopsy, debridement, and open repositioning through the anterior approach Smith Peterson. Do installation of K-Wires and external fixation with hemispica. Given anti-tuberculosis drug for 12 months. In the monitoring for 2 years post-operatively, the patient reported an improvement.Conclusion: Hip Tuberculosis have a variety of mànifestasi similar to other diseases. Biopsy of the bone tissue lesions is a gold standard diagnosis for coxitis TB. However interpretation of the early picture of pelvic radiology can be a predictor outcome in the case of coxitis TB.
JONES TENDON TRANSFER MODIFICATION WITH ERWIN RAMAWAN TECHNIQUE Erwin Ramawan; Teddy Heri Wardhana; Ansari Rahman
Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 2 (2019): October 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v8i2.2019.59-67

Abstract

Background: Drop hand is a clinical manifestation of radial nerve lesion that cause hand dysfunction. Jones tendon transfer is one of the therapeutic modalities in overcoming it with many modifications, but there is still no mutual agreement for which technique is the best. One of them is the Erwin Ramawan technique. The purpose of this study was to determine the differences in results before and after tendon transfer surgery with the Erwin Ramawan technique in patients with radial nerve lesions.Methods: Retrospectively, we evaluated patients with high-type lesions of radial nerve carried out by tendon transfer surgery using Erwin Ramawan, to reroute PL to EPL, so the thumb can do abduction and extension, then the FCR tendon is positioned parallel to the ECRB and EDC, then connected 45° direction. The outcome was evaluated using the DASH score and with the Robert G. Chouinard method.Results: The average DASH score in patients with high-type lesions of  radial nerve before surgery 56.83 ± 16.69 had a significant improvement (p <0.05) after tendon transfer surgery with Erwin Ramawan technique to 32.00 ± 11.88. Functionally, dorsiflexion from wrist postoperative is 75.00 ± 10.00 (excellent), palmarflexion 52.00 ± 24.65 (excellent). For finger, the metacarpophalangeal extension reaches 166.00 ± 19.49 (good). The distance from the fingertip to metacarpophalangeal crease is 0.10 ± 0.22 (good). On thumb, abduction reaches 40.00 ± 15.81 (excellent), interphalangeal extension 166.00 ± 11.44 (good).Conclusion: Based on these results, we found significant clinical differences before and after tendon transfer with the Erwin Ramawan technique.
Choosing between the Conventional Plates, Locking Plates, or Iliosacral Screws for Sacroiliac Joint Dislocation: A Biomechanical Comparison Study Trixie Brevi Putri; Erwin Ramawan; Mohammad Zaim Chilmi; Kukuh Dwiputra Hernugrahanto; Jifaldi AMD Sedar; Fundhy S I Prihatanto
The Hip and Knee Journal Vol 2, No 1 (2021): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1441.598 KB) | DOI: 10.46355/hipknee.v2i1.38

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Background: This study examines the comparison of biomechanical strengths of three kinds of the most familiar implants available in Indonesia: conventional and locking sacroiliac plates and screws, also iliosacral screws. Despite the common thought that iliosacral screws are preferred compared to conventional plates and screws due to its biomechanic superiority, this study tested whether the locking plates and screws could offer an alternative.Materials and Methods: This study was an in vitro experimental study with a Randomized Post Test - Only Control Group Design using pelvic bones from male cadavers aged 20-50 y.o. Twelve samples were divided into three treatment groups and one control group. Group P1 was fixed with two conventional plates, P2 was fixed with two locking plates, P3 was fixed with two iliosacral screws, and control group K with sacroiliac joint was intact. Each group was given an increasing load until a vertical shift of the sacroiliac joint ≥ 2.0 mm was obtained.Results: The average force load for 2 mm displacement among the fixation systems being tested shows a statistically significant difference (p0.05). Load failure force for 2 mm displacement in the locking plate and screw group has the highest average (591.33 ± 56.08 N) compared to the iliosacral screw group (583.67 ± 73.56 N) and conventional plate and screw group (574 ± 106.05 N).Conclusions: Biomechanically, the fixation system using two locking anterior sacroiliac plates and screws is more stable than the iliosacral screws and conventional sacroiliac plates and screws.
BIOMECHANICAL COMPARATIVE STUDY BETWEEN TENSION BAND WIRING, DOUBLE ENDO BUTTON AND HOOK PLATE FOR ACROMIOCLAVICULAR JOINT INJURY Ramawan, Erwin; Afrian MDS, Jifaldi
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 1 (2018): April 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i1.2018.65-76

Abstract

Background: The treatment for acromioclavicular joint injury are debatable, there are fixation options include tension band wiring, AC joint reconstruction and hook plate These fixations are capable of providing a stable fixation, but controversy still exists that mentions the superiority of each of these fixationsPurpose: To compare biomechanical stability of 3 fixation include tension band wiring, double endo button, and hook plate to provide a scientific basis of the fixation.Methods: This research is an experimental in vitro. Using 27 acromioclavicular joints cadaver divided into three groups that performed tension band wiring fixation, double endo button and hook plate. Each fixation evaluated with 10, 20, 50 and 100 times repetitions with 100N traction force.Results: Tension band wiring gives the smallest displacement. In 10 times repetition average displacement of tension band wiring 0.056 mm (p = 0.000) compared to double endo button 1.622 mm and hook plate 0.867 mm. In 20 times repetitions, tension band wiring 0.1667 mm (p = 0,000) compared to double endo button 3.1778 mm and hook plate 1.1111 mm. In 50 times repetition, tension band wiring 0.3111 mm (p = 0.000) with double endo button 4.7778 mm and hook plate 1.3556 mm. In 100 times repetitions, tension band wire 0.556 mm (p = 0.000) while double endo button 5.4444 mm and hook plate 1.4556 mm.Conclusion: Tension band wiring have a good stability compared to double endo button and hook plate. But all of fixation provide stability for acriomioclavicular joint motion.
Co-Authors Afrian MDS, Jifaldi Ansari Rahman Fundhy S I Prihatanto Haris Dwi Khoirur Rofiq Henry Dominica Heri Suroto Jifaldi AMD Sedar Kukuh Dwiputra Hernugrahanto Mohammad Zaim Chilmi Musa Arafah Naufal Ranadi Firas Sulis Bayusentono Trixie Brevi Putri Wardhana, Teddy Heri