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Perbandingan Penanganan Clubfoot Metode Kite-Lovell dengan Ponseti Primadhi, Andri; Ismiarto, Yoyos D.
Majalah Kedokteran Bandung Vol 41, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar

Clubfoot banyak terjadi pada bayi baru lahir dan akan menghambat anak untuk berjalan. Bila kelainan ini tidakÂ ditangani dengan benar, akan menetap sampai dewasa dan mempengaruhi kualitas hidupnya. UmumnyaÂ penatalaksanaan inisial clubfoot menggunakan cara konservatif, walaupun pemilihan metode manipulasi masih menjadi kontroversi. Penanganan clubfoot di RS Hasan Sadikin Bandung (RSHS) menggunakan metode Kite-Lovell dan Ponseti, yang berbeda dalam teknik manipulasinya. Sejumlah penelitian menyebutkan bahwaÂ penatalaksanaan clubfoot dengan metode Ponseti lebih baik dibandingkan Kite-Lovell. Penelitian iniÂ membandingkan hasil penanganan clubfoot menggunakan kedua metode tahun 2001-2005. Penelitian iniÂ menggunakan desain cross sectional dengan data yang diambil dari rekam medis pasien clubfoot di RSHS, terdiriÂ dari karakteristik pasien, metode, serta kemajuan pasien tersebut, diukur menggunakan skoring Dimeglio. Jumlah pasien ada 64 anak, atau 103 kaki karena tidak semua anak memiliki kelainan bilateral. Hasil penelitianÂ menunjukkan bahwa jumlah pasien laki-laki lebih dominan yaitu 36 anak (56%). Bila digolongkan menurut usiaÂ saat pertama kali berobat, persentase terbanyak ialah pada kelompok usia paling dini, yaitu 0-3 bulan (34 anak).Â Sebanyak 71 kaki (69%) ditangani dengan metode Kite-Lovell sedangkan sisanya dengan metode Ponseti. DenganÂ skoring Dimeglio, tidak ditemukan perbedaan yang bermakna pada hasil penanganan antara kedua metode, tetapiÂ angka keberhasilan akan lebih tinggi bila penanganan dilakukan pada usia lebih dini.Kata kunci: Clubfoot, metode Kite-Lovell, metode PonsetiComparison Between Kite-Lovell Method and Ponseti in ClubfootTreatmentClubfoot is anomalies frequently seen in the newborns. This limits the child's walking ability. Without adequateÂ treatment, it will interfere the patient's living. Treatment consists of conservative and operative. ConservativeÂ treatment is initial choice, with controversies about its methods. Conservative treatment consists of Kite-Lovell and Ponseti methods. There is difference between them in the matter of manipulation. Numbers of study said that theÂ Ponseti methods gave better result than Kite-Lovell. This study was to compare about the two methods performed inÂ Hasan Sadikin General Hospital in the year of 2001-2005. The design was cross sectional. Data collected from theÂ medical records from 2001 to 2005, including characteristic, methods used, and clinical improvement that measuredÂ by Dimeglio scoring system. This research included 64 children, or 103 foot, due to not all the children had bilateralÂ clubfoot. The results showed that male patients were dominant (56%). According to age at initial treatment, the mostÂ common was 0-3 years, i.e. 34 children. Seventy-one feet (69%) were treated with Kite-Lovell methods, and the restsÂ by Ponseti methods. Using Dimeglio scoring, we measured the initial and final scores, and there was no significantÂ difference between them, but the results are better if done at younger age.Â Key words: Clubfoot, Kite-Lovell method, Ponseti methodÂ DOI:Â http://dx.doi.org/10.15395/mkb.v41n4.255

Antibiotic Use Pattern in Orthopaedics and Traumatology Ward: A 6 Month Survey in A Tertiary Hospital Ethelie, Stanislaus Gerald; Tjahjadi, Adi Imam; Primadhi, Andri
International Journal of Integrated Health Sciences Vol 7, No 2 (2019)
Publisher : International Journal of Integrated Health Sciences

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n2.1522

Objective: To determine and describe the antibiotic use pattern in the orthopedics and traumatology ward of Dr. Hasan Sadikin General Hospital Bandung as a tertiary hospital in West Java, Indonesia.Methods: A retrospective cross-sectional study using the total sampling method was performed on the medical records of orthopedics and traumatology patients treated using antibiotics during the period of January 1, 2016 and June 31, 2016.Results: From the 261 subjects who met the inclusion criteria, it was discovered that the most common antibiotics used were in the following order: cefazolin (54.41%), ceftriaxone (21.84%), and cefotaxime (10.35%). Most antibiotics (75.86%) were given as prophylaxis. Antibiotics were most often administered for 2-3 days (42.53%), intravenously (97.7%), andÂ with a dose of 2x1 gram (92.16%).Conclusion: The most frequently used antibiotics in the orthoaedics and traumatology ward of Dr. Hasan Sadikin General Hospital (RSHS) was cefazolin, which was mostly used as a pre-surgical antibiotic. The use of third-generation cephalosporin antibiotics as pre-surgical antibiotics is still observed during this study.Â

Effects of Low-level Laser Therapy on Fibroblast Density in Achilles Tendon Rupture Healing Cakra Andhika; Raden Andri Primadhi; Hermawan Nagar Rasyid
International Journal of Integrated Health Sciences Vol 9, No 1 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v9n1.2232

Objective: To investigate the effect of low-level laser therapy (LLLT) on fibroblast proliferation as a part of the tendon healing cascade. Methods: This was an unpaired comparative experimental animal laboratory study with one control groups and two experimental groups, each consisted of 10 Sprague Dawley rats. The experimental groups 1 and 2 were given infrared irradiation for 15 minutes and 30 minutes per day, respectively, after having their achilles tendon partially cut. Histological assessment was carried out to assess the fibroblast density in healing site after three weeks on intervention. Results: The median values of fibroblast density in group 1, group 2, and control group were 1, 2, and 1, respectively, with a p-value of 0.014. No significant difference (p = 0.123) was identified on Mann-Whitney test between the fibroblast density of group 1 and group 2. The same was also true forgroup 1 and control group (p = 0.315). A significant difference was found between group 2 and control group (p = 0.005). Conclusions: A regime of LLLT irradiation of 30 min/day for two weeks (1080 J cm-2) improves the fibroblast proliferation amidst tendon healing in a partially injured achilles tendon in a rat model, which is not seen in the regime with a 15 min/day duration. This emphasizes the significance of irradiation time to improve tendon healing, despite the deficient understanding of the mechanism.

Neglected Posterior Subtalar Dislocation: A Case Report and Operative Technique Aditya Priherdadi; Raden Andri Primadhi
Majalah Kedokteran Bandung Vol 53, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n2.2009

Posterior subtalar dislocation is an exceedingly rare entity. Early anatomic reduction, initially by closed means, is crucial. Failure to recognize this condition or any occurrence of neglect will complicate the management and worsen the outcome. There are a handful of case reports on posterior subtalar dislocation and even less for neglected cases. This study reports a neglected subtalar dislocation in a 26-year-old male who worked as a driver and had experienced high-energy trauma due to car collision. This patient was managed by open reduction and pinning, and was followed up 2 months later with a good outcome. This technique was selected to be able to achieve functional motions without pain.

Teknik Rekonstruksi Turndown Flap Tendon Achilles dan Flap Fasiokutan Sural pada Ruptur Tendon Achilles yang Disertai Kerusakan Masif Jaringan Lunak: Laporan Kasus Hermawan Nagar Rasyid; Andri Primadhi; Renaldi Prasetia
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Ruptur tendon achilles adalah cedera yang paling sering terjadi pada tendon ekstremitas bawah, meskipun merupakan tendon yang terbesar dan terkuat. Penelitian ini bertujuan menjelaskan teknik operasi dengan modifikasi augmentation pada penatalaksanaan ruptur tendon Achilles yang disertai kerusakan pada jaringan lunak yang luas. Kasus pada penelitian ini adalah seorang pasien (usia 30 tahun) dengan ruptur terbuka tendon Achilles akut dan terinfeksi, serta hilangnya tendon sampai dengan 5 cm, kecacatan tendon yang tidak menempel di bagian distal dan hilangnya sebagian tulang calcaneus. Kerusakan kulit diukur setelah dilakukan debridemen dengan rentan antara 8 cmx5 cm sampai dengan 15 cmx10 cm. Ruptur pada tendon dijahit dengan gastrosoleus turn down flap ke tulang calcaneus. Reverse sural artery digunakan untuk menutupi kulit. Flap yang dibuat berhasil hidup. Pasien dapat berjalan normal, dapat berdiri dengan ujung kaki, fleksi plantar yang aktif, dan dapat kembali beraktivitas dalam 2 bulan setelah operasi. Pasien memiliki rentang gerak penuh ke segala arah. Simpulan, debridemen, rekonstruksi tendon dalam satu tahap, dan reverse flow sural artery flap memberikan hasil yang memuaskan pada kasus robekan luas tendon Achilles dan kerusakan jaringan lunak yang luas. [MKB. 2016;48(1):58–62]Kata kunci: Gastrosoleus turn down flap, ruptur, sural artery flap, tendon Achilles Achilles Tendon Turndown Flap Reconstruction and Fasciocutanous Sural Flap in Severe Tendon Achilles Loss with Massive Tissue Defect: a Case ReportAbstractAchilles tendon rupture is the most common ruptur of tendon in the lower limb despite being one of the toughest tendons. This rupture presents a complex problem to the treating surgeon especially if it is associated with tendon and soft tissue loss. The case in this study is one patient (male, age 30-year old) with a spectrum of acute and infected open tendon-achilles rupture that includes loss of tendon of up to 5 cm, tendon defect with no distal attachment, and partial loss of the calcaneum. The skin defect measured after debridement ranged from 8 x 5 cm to 15 x 10 cm. The ruptured tendon was sutured using gastrocnemius-soleus turn down flap technic to calcaneus bone. A reverse sural artery was used to provide soft tissue cover. The flap survived. The patient had normal gait, were able to stand on tip toes, had active plantar flexion, and had returned to his original occupation 2 months after reconstruction. He had full range of movement at the ankle. Augmented repair of Achilles tendon rupture with large soft tissue defect using gastrocnemius- soleus turn down flap and sural artery flap are stable enough to allow early weight-bearing with favorable clinical result for this patient. Conclusions is single stage tendon reconstruction and reverse flow sural artery flap give good functional outcome in complex Achilles tendon rupture with tendon and soft tissue loss. [MKB. 2016;48(1):58–62] Key words: Achilles tendon, gastrocnemius-soleus turn down flap, rupture, sural artery flap

Efek olahraga lari terhadap ketegangan otot Gastroknemius-Soleus David Simorangkir; Andri Primadhi
Jurnal Sistem Kesehatan Vol 4, No 2 (2018): Volume 4 Nomor 2 Desember 2018
Publisher : Universitas Padjadjaran

Berlari merupakan olahraga paling populer di dunia. Sebanyak 36% pelari menderita cedera muskuloskeletal. Perubahan ketegangan otot merupakan salah satu faktor predisposisi cedera, seperti tendinitis achilles dan plantar fasciitis. Penelitian ini mencoba mengetahui korelasi olahraga berlari dengan ketegangan otot betis yang diukur dengan derajat gerak sendi pergelangan kaki pada sampel pelari dan non-pelari. Studi cross sectional melibatkan 32 sukarelawan dibagi dalam kelompok pelari dan bukan pelari. Sudut dorsifleksi pergelangan kaki diukur menggunakan goniometer kemudian data dipresentasikan dalam angka. Analisa perbandingan ketegangan otot gastroknemius dan soleus menggunakan uji Mann-Whitney. Hubungan jarak tempuh berlari terhadap ketegangan otot dinilai menggunakan Spearman Rank. Kelompok pelari memiliki rerata sudut 8,25° dan 13,75° untuk dorsifleksi oleh gastroknemius dan soleus, dan kelompok bukan pelari dengan rerata 12,68° dan 16,06° dengan perbedaan signifikan (p<0,05) pada antara kedua kelompok tanpa korelasi signifikan antara jarak tempuh lari dan ketegangan otot yang terbentuk pada kelompok pelari. Pelari secara signifikan memiliki ketegangan otot gastroknemius-soleus dibandingkan bukan pelari. Aktivitas berulang selama berlari menyebabkan perubahan struktur jaringan pada otot.Kata kunci : gastroknemius, ketegangan otot, pelari, pergelangan kaki, soleus

Indications and Complications of Orthopedic Hardware Removal in an Indonesian Tertiary Hospital: A Descriptive Study Shadrina Affifa Azzahra; Raden Andri Primadhi; Titing Nurhayati; Muhammad Naseh Sajadi; Achadiyani Achadiyani
International Journal of Integrated Health Sciences Vol 10, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v10n1.2695

Objective: To acquire clinical data regarding indications of implant removal and complications in orthopedic metal implant removal. Methods: This was a cross-sectional observational descriptive study using patient medical records. The inclusion criterion was all patients who underwent orthopedic metal implant removal during 2018-2020 while the exclusion criterion was unintentional implant removal due to subsequent injury or loosening. Data regarding anatomic regions, indications, and complications were collected and presented in tables.Results: In 112 patients participated in this study consisting of 75 (67%) men and 37 (33%) women, the implants were mainly located in thigh, lower leg, and ankle (53% combined). The most common indication for metal implant removal was conversion (31%), followed by infection (25%) and patient's request (20%). The only complication observed in orthopedic metal implant removal in this study was disturbed wound healing in a small percentage of the patients (16%). Most patients (84%) did not experience any complication due to metal implant removal.Conclusions: Indications for metal implant removal may vary, with or without symptoms. Disturbed wound healing is a complication observed in metal implant removal. Despite the advantages of removal, further analysis and guidelines are needed to avoid unnecessary hardware removal considering the risk of complications.

Profile and Frequency of One Hundred Ankle Osteoarthritis Cases in an Indonesian Tertiary Hospital Muhammad Farhan Ibrahim; Kurnia Wahyudi; Raden Andri Primadhi
Majalah Kedokteran Bandung Vol 54, No 2 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v54n2.2636

Osteoarthritis is one of the most common cases in orthopedics and traumatology clinic. Ankle osteoarthritis is less common than osteoarthritis of hip and knee. Limited data and literature resulted in suboptimal treatment strategy. The purpose of this study was to describe the profile and frequency of ankle osteoarthritis at Dr. Hasan Sadikin General Hospital Bandung, a tertiary referral hospital in Indonesia. A cross-sectional descriptive observational study was conducted on all patients diagnosed with ankle osteoarthritis enrolled in the medical record database at Dr. Hasan Sadikin General Hospital Bandung, Indonesia in November 2020–November 2021. Results showed that the majority of the patients were female (52%), aged ≥60 years old (44%), graduated from senior high school education (56%), and housewives (30%). The 100 patients were proportionally distributed with most of them were categorized as suffering from secondary osteoarthritis with post-trauma predominance. From the perspective of body mass index, 85% patients were classified as above normal. As many as 76% of patients presented to the hospital in an advanced stage. With the high rate of posttraumatic ankle osteoarthritis, concerns should be given more to the ankle trauma management, as well as to the population with high body mass index. Increased health promotion for general population and health care providers is also needed to reduce the tendency of late presentation at the health care facility.

Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus Henry Ricardo Handoyo; Andryan Hanafi Bakri; Andri Primadhi
JURNAL WIDYA MEDIKA Vol. 5 No. 1 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i1.1999

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

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