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Christina A. Damopolii
Universitas Sam Ratulangi

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Medical Rehabilitation in Patient with Post ORIF et causa Neglected Epiphyseal Fracture Distal Radius-Ulna Sinistra: A Case Report Christina A. Damopolii; Joudy Gessal; Jonathan P. Suyono
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.44765

Abstract

Distal radius-ulna fracture is one of the most common human osseous injuries, with incidence rate increasing worldwide. There are two peaks of prevalence: the first around the 10th and the second around the 60th year of life. During childhood, they are among the most common pediatric fractures accounting for 19.9 to 35.8% of all pediatric fractures. We reported a case of a boy 13 years old diagnosed as post open reduction internal fixation distal radius ulna et causa epiphyseal fracture. He came to rehabilitation outpatient clinic with chief complaint pain on his left forearm. He underwent a surgery two weeks ago at the distal radius ulna. The surgeon did osteotomy on ulna and then fixated with plate and screw. On physical examination, there were pain and range of motion limitation mainly on the forearm and wrist joint. The patient was treated with low level laser therapy at the surgical wound to promote healing and decrease edema, initial digital motion exercise along with active range of motion of the uninvolved joints. He was also educated about icing and medicamentation if pain still persisted. Once adequate bony healing had occurred, active, active-assisted, progressive passive wrist motion, and strengthening exercise using resistance were performed to maximize the result. At the end of rehabilitation program, there was great improvement on pain and also range of motion improvement. Albeit, there was still a slight range of motion limitation on ulnar deviation and wrist extension by 5 degrees. In conclusion, rehabilitation program is very beneficial in treating post-surgery patient using modalities and exercises to improve functional function. Keywords: epiphyseal fracture; radius-ulna; medical rehabilitation
Penanganan Rehabilitasi Medik pada Pasca Artrodesis Kaki Charcot Tanpa Komplikasi Christina A. Damopolii; Joudy Gessal; Devan Perwira
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44762

Abstract

Impact of diabetes on the occurrence of Charcot's foot provides conservative treatment to the benefits of arthrodesis. Charcot foot is a debilitating joint disease characterized by progressive multiple bone destruction, dislocations, and severe deformities of the foot and ankle. Its prevalence may increase in the general high-risk population. Initial treatment of Charcot foot is often conservative and involves the use of bracing, casting, and special orthopedic shoes. This intervention allows the patient to functionally ambulate without resorting to more invasive interventions. Arthrodesis is an effective limb-saving method for patients with Charcot neuroarthropathy who have severe deformity and instability. This technique is usually used for chronic cases with irreversible deformity and/or joint instability to increase plantar pressure and balance of the foot and to minimize the risk of foot ulceration and amputation. In conclusion, non-weight bearing treatment dan immobilisation are the most effective rehabilitation management for active-phase Charcot foot accompanied by surgery consideration to maximize the functional of the foot. Keywords: Charcot foot; diabetes; arthrodesis; rehabilitation management   Abstrak: Diabetes berdampak terhadap terjadinya kaki Charcot dengan penanganan secara konservatif hingga tindakan artrodesis. Kaki Charcot merupakan salah satu penyakit sendi yang merusak dan ditandai dengan progresifitas kerusakan tulang multipel, dislokasi dan deformitas parah pada kaki dan pergelangan kaki dengan prevalensi yang meningkat pada populasi dengan risiko tinggi. Perawatan awal kaki Charcot seringkali konservatif dan melibatkan penggunaan bracing, casting, dan sepatu ortopedi khusus. Intervensi ini memungkinkan pasien untuk ambulasi secara fungsional tanpa menggunakan intervensi yang lebih invasif. Artrodesis merupakan metode penyelamatan anggota tubuh yang efektif untuk pasien dengan neuropati Charcot yang memiliki deformitas parah dan ketidakstabilan. Teknik ini biasanya digunakan untuk kasus kronis dengan deformitas ireversibel dan/atau ketidakstabilan sendi untuk meningkatkan tekanan dan keseimbangan plantar kaki dan untuk meminimalkan risiko ulserasi dan amputasi kaki. Simpulan studi ini ialah penanganan non-weight bearing dan imobilisasi merupakan penanganan rehabilitasi untuk kaki Charcot fase aktif dengan pertimbangan tindakan pembedahan untuk memaksimalkan fungsi kaki. Kata kunci: kaki Charcot; diabetes; arthrodesis; penanganan rehabilitasi