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Management of Crush Injury’s Complications Using Hyperbaric Oxygen Therapy: Case Series Arikalang, Patrick S.; Hatibie, Mendy J.; Oley, Maximillian C.; Noersasongko, Albertus D.; Suharso, Tommy
e-CliniC Vol. 12 No. 2 (2024): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v12i2.46847

Abstract

Abstract: Crush injury occurs due to an external trauma mechanism that directly affects the skin, muscle, and bone tissue. Crush injuries can involve several parts of the body at the same time. When accompanied by handling, wound healing in crush injury can be long-term, so that it can affect the function of the patient. Various complications that can occur ranging from secondary infection, necrosis, recurrent bleeding, to compartment syndrome. We reported serial cases of crush injury with various clinical presentations and complications, varying in the age range of 16-65 years. All four patients were given multiple managements, such as open reduction external fixation and extensive debridement. There were complications such as secondary infection and delay in the wound healing process in patients who did not on time for follow-up. The four patients received additional treatment in the form of wound dressings hyperbaric oxygen therapy (HBOT) with 5-10 90-minute sessions under 2.4 ATA pressure for 10 consecutive days. Follow-up was carried out again within a period of one month to compare the wound condition before and after HBOT. The clinical condition was getting better, marked by the formation of granulation tissue. The state of hyperoxia in HBOT accelerated the inflammatory process and angiogenesis during the wound healing process characterized by the eradication of bacteria in the wound tissue and accelerated neovascularization formation. In conclusion, adequate therapy, wound dressing, and patient compliance affect patient outcome. Moreover, the addition of hyperbaric oxygen therapy has shown to accelerate the wound healing process and restore the patient's limb function. Keywords: crush injury; hyperbaric oxygen therapy; oxygen; wound healing
Perbandingan Range of Movement pada Pasien Post Total Knee Replacement Teknik Cruciate Retaining dengan Teknik Posterior Stabilized Arikalang, Patrick S.; Noersasongko, Albertus D.; Suharso, Tommy
Medical Scope Journal Vol. 7 No. 2 (2025): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v7i2.61248

Abstract

Abstract: Total knee replacement (TKR) is a common surgical procedure to treat pain and dysfunction in the knee joint due to osteoarthritis. Two techniques that are often used are cruciate retaining (CR) and posterior stabilized (PS). This study aimed to compare the range of movement (ROM) between the two techniques. This was a comparative study with prospective cohort design conducted at Prof. Dr. R. D. Kandou Manado Hospital. A total of 100 patients undergoing TKR were included, consisting of 12 patients with CR technique and 88 patients with knee PS. ROM technique was measured using goniometer. Statistical analysis used the Mann-Whitney test and linear regression. The results showed that the median age of patients was 66 years dominated by women (77%). There were no significant differences in ROM of knee flexion and extension between CR and PS techniques (p>0.05). Regression analysis showed that the PS technique tended to have a lower ROM than CR (6-7° for knee flexion), but statistically meaningless. The patient's age had a meaningful negative relationship with post-TKR ROM. In conclusion, the CR and PS techniques provide equivalent ROM results in post-TKR patients. The selection of techniques can be adjusted to the operator's expertise, the availability of implants, and hospital facilities. Follow-up research with longer duration and multi-flashlights is needed to evaluate long-term outcomes.    Abstrak: Total knee replacement (TKR) merupakan prosedur bedah yang umum dilakukan untuk mengatasi nyeri dan disfungsi pada sendi lutut akibat osteoartritis. Dua teknik yang sering digunakan yaitu cruciate retaining (CR) dan posterior stabilized (PS). Penelitian ini bertujuan membandingkan range of movement (ROM) antara kedua teknik tersebut. Penelitian ini merupakan studi komparatif dengan desain kohort prospektif yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Sebanyak 100 pasien yang menjalani TKR diikutsertakan, terdiri dari 12 pasien dengan teknik CR dan 88 pasien dengan teknik PS. ROM lutut diukur menggunakan goniometer. Analisis statistik menggunakan uji Mann-Whitney dan regresi linear. Hasil penelitian memperlihatkan median usia pasien ialah 66 tahun didominasi perempuan (77%). Tidak terdapat perbedaan bermakna pada ROM fleksi dan ekstensi lutut antara teknik CR dan PS (p>0,05). Analisis regresi menunjukkan teknik PS cenderung memiliki ROM lebih rendah dibandingkan CR (6-7° untuk fleksi lutut), namun secara statistik tidak bermakna. Usia pasien memiliki hubungan negatif yang bermakna dengan ROM pasca TKR. Simpulan penelitian ini ialah teknik CR dan PS memberikan hasil ROM yang ekuivalen pada pasien pasca TKR. Pemilihan teknik dapat disesuaikan dengan keahlian operator, ketersediaan implan, dan fasilitas rumah sakit. Penelitian lanjutan dengan durasi lebih panjang dan multi-senter diperlukan untuk mengevaluasi hasil jangka panjang. Kata kunci: total knee replacement; cruciate retaining; posterior stabilized; range of movement