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Journal : Medical Scope Journal (MSJ)

Bone Defect of the Tibia: A Case Report Andriessanto Lengkong; Djarot Noersasongko; Haryanto Sunaryo; Tommy Suharso; Rangga Rawung; Stefan Kambey; Nurmalasari Amira
Medical Scope Journal Vol. 5 No. 1 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i1.44238

Abstract

Abstract: Defects in long bones including tibia are still difficult problems in orthopaedic field for both the physician and the patient. We reported a case of a 56-year-old woman who came to the hospital with the chief complaint of being unable to walk since she was nine years old after getting a motorcycle accident. The patient complained that her leg did not grow since then. The patient was fully conscious and hemodynamically stable. Physical examination revealed that there was a deformity of the left lower leg with shortening of the lower leg and absence of the tibial bone. The patient was diagnosed with left tibia bone defect, therefore, above-the-knee amputation was performed. The amputation must be viewed as an opportunity to re-establish or enhance the patient’s functional level and facilitate a return to near normal locomotion using a prosthesis after amputation. Soft tissue and muscle quality, bone condition, neurovascular conditions and function of the limb can be considered in the selection of therapy in bone defect. The level of amputation can be determined by assessing the bone condition, neurovascular condition, and the ability of muscle and skin flaps to close the wound. In conclusion, amputation can be the treatment of choice for patient with bone defect. Improving lower limb function is proven to maximize the patient quality of life. Keywords: bone defect tibia; above-the-knee amputation; transfemoral amputation
Efektivitas Terapi Oksigen Hiperbarik pada Nyeri Kronik Osteoartritis Lutut Benny G. Siahaan; Rangga Rawung; Mendy Hatibie
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46565

Abstract

Abstract: Osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage degeneration, subchondral bone changes, osteophyte formation, sinovitis or arthritis. The aim of osteoarthritis management is to reduce pain, increase joint function, and decrease disability. Hyperbaric oxygen therapy (HBOT) can inhibit astrocyte activation and inflammatory factor production, and maintain transmission and intergration of sensoric information through dorsal neurons, therefore, resulting in pain reduction. This study aimed to evaluate the effectiveness of HBOT in chronic pain of knee osteoarthritis. This was a parallel, two-arm, placebo-controlled, randomized clinical trial in adults with knee osteoarthritis at two hospitals in Manado, namely Badan Layanan Umum Rumah Sakit Umum Pusat Prof. Dr. R. D. Kandou and Rumah Sakit Siloam. The results obtained 44 patients suffered from knee osteoarthritis grade 1 dan 2 associated with chronic pain as subjects, divided into two groups namely intervention with HBOT and control groups. Determination of normality of numeric variables was performed with Shapiro-Wilk test. The statistic test confirmed that the distribution of VAS scores was relatively not different between before and after HBOT, and the control group (p=0.421 and p=0.634). In conclusion, hyperbaric oxygen therapy can be used to reduce chronic pain in knee osteoarthritis. Keywords: knee osteoarthritis; hyperbaric oxygen therapy; chronic pain   Abstrak: Osteoartritis (OA) merupakan suatu penyakit sendi degeneratif yang dikarakteristikkan dengan degenerasi kartilago progresif, perubahan tulang subkondral, pembentukan osteofit, dan sinovitis atau inflamasi sendi. Tujuan penatalaksanaan OA ialah untuk meredakan nyeri, meningkatkan fungsi, dan membatasi disabilitas Terapi oksigen hiperbarik (TOHB) dapat menginhibisi aktivasi astrosit dan produksi faktor inflamatorik serta mempertahankan transmisi dan integrasi informasi sensori melalui neuron dorsal sehingga nyeri menurun. Penelitian ini bertujuan untuk menilai efektifitas TOHB dalam penatalaksanaan nyeri kronik pada OA lutut. Penelitian ini didesain sebagai suatu parallel, two-arm, placebo-controlled, randomized clinical trial pada dewasa dengan OA lutut di dua rumah sakit di Manado, Badan Layanan Umum Rumah Sakit Umum Pusat Prof. Dr. R. D. Kandou dan Rumah Sakit Siloam. Sebanyak 44 pasien OA lutut grade 1 dan 2 dengan nyeri kronik menjadi subjek penelitian, yang dibagi secara acak atas dua kelompok: intervensi TOHB dan kontrol. Penentuan normalitas variabel numerik dilakukan menggunakan uji Shapiro-Wilk. Hasil statistik mengonfirmasi distribusi penurunan skor VAS relatif tidak berbeda bermakna sebelum dan setelah TOHB dan kelompok kontrol (p=0,421 dan p=0,634). Simpulan penelitian ini terapi oksigen hiperbarik kemungkinan dapat menurunkan nyeri kronik pada penderita osteoartristis lutut. Kata kunci: osteoartritis lutut; terapi oksigen hiperbarik; nyeri kronik
Non-Vascularized Fibular Bone Graft for Giant Cell Tumor of the Distal Ulna: A Case Report Albertus D. Noersasongko; Haryanto Sunaryo; Tommy Suharso; Andriessanto Lengkong; Rangga Rawung; Stefan Kambey; Patrick S. Arikalang
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51674

Abstract

Abstract: Cases of bone giant cell tumors (GCT) are rarely found, generally benign and locally aggressive tumors. Surgical resection is the universal standard for treatment of bone GCT. Non vascularized fibular graft (NVFG) is useful in the reconstruction of skeletal defects, especially in cases of scarred and avascular recipient sites and patient with tumor surrounded by poor tissue condition. We report a 53-year-old woman, with a lump in her left hand for three years. X-ray examination revealed a mass with firm border and regular edge that reached the epiphysis expansively with thinning of the cortex in the distal region of the left ulna. Tumor excision was performed with open reduction internal fixation (ORIF) and fibular bone graft. To date, GCT is one of the most obscure and intensively examined bone tumors, and its histological images do not predict the clinical outcome. Moreover, many unanswered questions regard to the treatment and prognosis without any consensus regarding the ideal treatment selection. NVFG osteosynthesis shows encouraging results, and adequate therapy, wound care and patient compliance affect the patient’s outcome. In conclusion, NVFG and internal fixation are effective options for post tumor excision, and osteosynthesis has encouraging result. Keywords: non vascularized fibular graft (NVFG); giant cell tumor; bone graft; ulna