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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Andalas Damianus Journal of Medicine Dental Journal (Majalah Kedokteran Gigi) Universa Medicina Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) Indonesian Journal of Medicine Majalah Kedokteran Andalas Journal Orthopaedi and Traumatology Surabaya (JOINTS) Indian Journal of Forensic Medicine & Toxicology Jurnal Widya Medika
Komang Agung
Departemen/SMF Orthopaedi Dan Traumatologi, Fakultas Kedokteran Universitas Airlangga/RSUD Dr. Soetomo
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Universa Medicina

 1 
Open reduction in neglected elbow dislocation in children: a case series Irianto, Komang Agung; Parung, Raymond; Sukmajaya, William Putera
Universa Medicina Vol 38, No 1 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (646.794 KB) | DOI: 10.18051/UnivMed.2019.v38.63-68

Abstract

BackgroundElbow deformity in children due to neglected proper fracture management is a devastating condition. The stiffness and pain complicated the function in daily activity. Successful management of neglected elbow dislocation is a challenging problem for orthopedic surgeons. In this study, we aimed to evaluate results of open reduction for neglected elbow dislocation in children.Case DescriptionThis is a case series of 13-14 years old neglected elbow dislocations, for up to 15 months. Open reduction after external distractor and followed by intensive rehabilitation was implemented. Clinical and functional outcome were evaluated within 4-7 years. Initial average elbow flexion was 53,3°, extension was 0°, arc of flexion was 53,3°, arc of pronation-supination was 150° and Mayo Elbow Performance Index (MEPI) was 80. Clinical and functional outcome were evaluated within 4-7 years. At follow-up after open reduction, the improvement in whole range of movement was significant. Average elbow flexion was 118,3°, extension was 36,67°, arc of flexion was 81,67°, arc of pronation-supination was 133°. The average improvement of flexion was 65°, arc of flexion was 31,67°, and arc of pronation-supination was 8,3°. The average loss of flexion was 15,5%, arc of flexion was 44,2%, and arc of pronation-supination was 10,7% compared with uninjured side. The average Mayo Elbow Performance Index (MEPI) was 96,67; all with excellent results.ConclusionPlanned and well execution open reduction in pediatric neglected elbow dislocation may bring back the painless movement within normal daily function.
Effective perioperative scoring in orthopedic surgery to prevent Covid-19 infection Irianto, Komang Agung; Adityawardhana, Taufan
Universa Medicina Vol. 40 No. 2 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.99-109

Abstract

BackgroundThe pandemic has placed health-care workers (HCW) under an unprecedented strain where surgeries are being delayed and health care workers’ deaths because of COVID-19 are prominent and causing staff shortages. An effective, fast, and concise approach to preoperative screening is very much needed. Hospitals are suggested to develop their own algorithm to minimize delays and complications. The objective of this study was to optimize HCW safety by developing a working system based on the hospital’s service capability in treating orthopedic surgeries. Methods A retrospective study was conducted involving 305 HCW. Data were collected on the application of a novel elective and emergency orthopedic surgery clinical pathway and scoring method based on questionnaires, and laboratory and radiographic chest examinations for several months to ensure the safety of HCW. HCW COVID-19 status was routinely checked as the indicator of HCW’s safety. Results Mean age of all patients was 47.0 ± 22.41 years. The screening process was done in a series of questionnaires and laboratory examinations, with the majority of patients (82 or 35.9%) having a score of 0. Patients with a score of 3 or more and testing positive for COVID-19 were immediately referred to a hospital having adequate facilities to prevent delays. There were 51 patients (16.7%) with positive rapid test results, and 21 patients (6.8%) with positive PCR tests. There were 4 (1.3%) COVID-19 positive HCW. Conclusions Despite COVID-19 being a new threat, we have shown that developing an effective perioperative clinical pathway could eventually optimize healthcare worker safety.
Release of retromalleolar flexor retinaculum and combined flexor digitorum longus and flexor hallucis longus Z-plasty in checkrein deformity: a case report Irianto, Komang Agung; Leonarto, Enrico; Handoyo, Henry Ricardo
Universa Medicina Vol. 42 No. 3 (2023)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2023.v42.368-373

Abstract

BackgroundCheckrein deformity is a rare abnormality comprising flexor hallucis longus (FHL) tendon entrapment in the posterior foot due to post-traumatic or ischemic retraction of the FHLtendon following soft tissue trauma. The diagnosis is essentially clinical, but complemented by imaging to rule out unrecognized causes and evaluate the fracture healing process. This case report is the first Indonesian study to describe release of the flexor retinaculum and Z-plasty (lengthening) of flexor digitorum longus (FDL) and FHL tendons through a medial retromalleolar approach to repair the deformity. Case DescriptionWe present the case of a 51-year-old male who complained of clawing of his right first and second toes. The interest of this study lies in the fact that this patient had never experienced ankle or distal tibial fractures, only a trivial injury two years back when the patient kicked a stone at work and had a bruise on his right second toe with no fracture. Exploration of FHL tendons was performed at the level of the midfoot. The patient was planned for surgery with a medial retromalleolar ankle approach, which facilitates the release of the flexor retinaculum, in conjunction with a Z-tenotomy on the FHL and FDL tendons. ConclusionA correction was achieved, and two months post-surgery there were no recurrences of the deformity. However, this surgical procedure requires more cases to support an evaluation of its effectiveness. We suggest that exploration at the ankle and midfoot should be the primary surgical intervention in similar cases of checkrein deformity.
Co-Authors . Sindrawati Achmad Fachrizal Adhinanda Gema Adityawardhana, Taufan Ameria Pribadi Andro Pramana Witarto Anggita Dewi Brahmana, Febrian Carlos Binti David Nugraha Dionisius Bramta Putra Gestana R Wardana Handoyo, Henry Ricardo Hizbillah Yazid I. G. Ng. Dodo M. Ranuh Ilham Abdullah Irsyam Kimberly Clarissa Oetomo Laskar Pradnyan Kloping Leonarto, Enrico Martanto, Tri Wahyu Nabila Ananda Kloping Oen Sindrawati Parung, Raymond PK, Laskar Ronaa Nuqtho Hidayatullah Sukmajaya, William Putera Sulis Bayusentono Thalca Hamid William Putera Sukmajaya Yudhistira Pradnyan Kloping