Garuda - Garba Rujukan Digital

Analysis of Social Support Role Systems in the Long-Term Outcomes of Ponseti-Treated Clubfoot Patients at RSUP H. Adam Malik Medan Nico Sutanto; Otman Siregar; Iman Dwi Winanto
International Journal of Health, Economics, and Social Sciences (IJHESS) Vol. 7 No. 2: April 2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7350

Congenital talipes equinovarus (clubfoot), if left untreated, can result in significant physical disability. While the Ponseti method has demonstrated high efficacy as a primary treatment modality, its long-term success depends substantially on consistent postoperative management and brace compliance, factors potentially influenced by social support systems. This study examines the impact of social support structures on treatment outcomes in clubfoot patients managed with the Ponseti technique at a tertiary referral center. We conducted a cross-sectional analytical study involving 80 pediatric clubfoot cases (mean age: 29.05±35.11 months; male predominance: 57.5%). Through structured interviews and retrospective medical record review, we evaluated multiple dimensions of social support (family engagement, community resources, healthcare accessibility) and their correlation with long-term therapeutic outcomes (recurrence rates, bracing adherence, functional assessments). Statistical analysis employed chi-square tests and multivariate logistic regression models. Our findings revealed significant associations between robust family support systems (p=0.015) and community-based assistance programs (p=0.032) with favorable long-term outcomes. Multivariate analysis identified consistent primary caregiver involvement (p=0.008; prevalence ratio [PR]=4.12) and access to rehabilitation services (p=0.022; PR=2.89) as independent predictors of treatment success. Socioeconomic indicators showed no statistically significant correlation. These results underscore the critical role of multidimensional social support in optimizing Ponseti method outcomes. We recommend integrating family education initiatives and community support networks into standard clubfoot management protocols. Further multicenter prospective studies are warranted to validate these findings across diverse sociocultural contexts.

Duration of Preoperative Anti-Tuberculosis Treatment (OAT) and Clinical Outcomes Post-Surgery in Spinal TB Patients: A Systematic Review and Meta-Analysis Gusnur Gazali Ashari; Benny; Iman Dwi Winanto
International Journal of Health, Economics, and Social Sciences (IJHESS) Vol. 7 No. 2: April 2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7352

Spinal tuberculosis (TB) is a rare but severe infection that can lead to deformities, back pain, and neurological deficits. Preoperative administration of anti-tuberculosis drugs (OAT) is commonly used to reduce bacterial activity and inflammation before surgery. However, the optimal duration of OAT preoperatively is still debated. This study aims to systematically review and analyze the relationship between preoperative OAT duration and clinical outcomes post-surgery in patients with spinal TB. A systematic review and meta-analysis were performed on studies comparing the effects of different OAT durations preoperatively in spinal TB patients. Data were collected from PubMed, Scopus, and EMBASE. Key outcomes evaluated included Visual Analog Scale (VAS) for pain, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), wound healing, and bone fusion.The meta-analysis showed that preoperative OAT duration of 1 to 2 weeks significantly reduced inflammation, with a notable decrease in ESR and CRP post-surgery (p = 0.006 for ESR, p = 0.02 for CRP). However, no significant differences in functional recovery or wound healing were observed between shorter (1-2 weeks) and longer (2-4 weeks) OAT durations. Bone fusion results were similar across both groups. A shorter duration of OAT preoperatively (1-2 weeks) is effective in reducing inflammation and improving postoperative recovery, though it does not significantly impact bone healing or fusion. Thus, a shorter preoperative OAT regimen can be considered a viable option in managing spinal TB patients.

Comparison of Healing Outcomes Between K-Wire Pin and Screw Fixation in Lateral Humerus Condyle Fractures in Pediatric Population: A Systematic Review and Meta-Analysis Tommy Mandagi; Iman Dwi Winanto; Reza Mahruzza
International Journal of Health, Economics, and Social Sciences (IJHESS) Vol. 7 No. 2: April 2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i2.7526

Lateral condylar humerus fractures are common pediatric elbow injuries, often resulting from trauma or falls. These fractures are typically seen in children aged 6 to 10 years and require appropriate fixation to prevent complications like malunion and nonunion. This systematic review and meta-analysis compare the outcomes of K-wire pin and screw fixation methods for pediatric lateral condylar humerus fractures. Data from studies published in the last decade were analyzed, focusing on clinical outcomes such as healing time, complications (delayed union, non-union, infection, stiffness), and functional recovery. Results show no significant difference in delayed union or non-union between the two methods. However, screw fixation was associated with a higher risk of non-union and avascular necrosis, although these differences were not statistically significant. In contrast, K-wire pin fixation was linked to a significantly higher risk of infection (RR 6.53) and stiffness (RR 1.77) compared to screw fixation. No significant difference was found in lateral overgrowth, fishtail deformity, or cubitus varus. These findings suggest that while screw fixation offers greater stability, K-wire pin fixation may be more prone to complications. Clinicians should carefully consider fracture type and patient-specific factors when choosing the fixation method.

Non – Operative Treatment Outcome of Hematogenous Osteomyelitis of the Femur in Infants: A Case Series Iman Dwi Winanto; Yudha Satria
International Journal of Health, Economics, and Social Sciences (IJHESS) Vol. 7 No. 4: October-2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i4.9022

Introduction: Osteomyelitis is a bacterial infection involving bone, its marrow, and the adjacent structures. The most common mechanism of infection in children is hematogenous, thus called hematogenous osteomyelitis (HO). There is an absolute requirement of antibiotic therapy. Surgery is considered in some cases. This is a report presenting 2 cases of distal femur HO in infants treated non – operatively with intravenous antibiotic alone. Case Presentation: Case 1: A one month old male infant was admitted due to swollen knee with pus producing sinus on the medial side for the last one month, without any systemic manifestation. Laboratory showed leucocytosis and increased erythrocyte sedimentation rate (ESR). Cytology showed granulomatous inflammation. Plain radiograph showed bone destruction with periosteal reaction and MRI showed heterogenic hyperintense lesion with penumbra sign on the distal femur. Intravenous Ampicillin Sulbactam 225 mg/6h and Amikacin 50 mg/24h were given for 7 days were given, continued with oral of Co-Amoxiclav 3 x 2.5 mg/ day for another week. The patient showed marked clinical and laboratory improvement after therapy; Case 2: A three-month old male infant with similar sign and symptoms was admitted, but it was on the right limb. Laboratory showed leucocytosis, increased ESR, and increased C-reactive protein (CRP). Plain radiograph and MRI examinations showed similar results with the first case. Intravenous Ceftriaxone 350 mg/12h for 7 days, continued with Cefadroxil 2 x 150 mg / day for another week was given. The similar clinical and laboratory outcomes with the first were achieved. Discussion: Whether or not surgical intervention is required, the successful treatment of all forms of osteomyelitis requires appropriate antibiotic therapy. Studies have shown that appropriate antibiotic therapy alone without surgical intervention may suffice for 90% of cases of HO. In some cases of complicated HO, surgical incision and drainage (including multiple procedures) may be indicated. Conclusion: HO in infant patients may be adequately treated by antibiotic alone with satisfactory result. Drug of choice, course of administration, and duration of treatment are important factors. Nevertheless, surgery should also be considered in a failed conservative treatment.

Neglected SCFE Treated with Modified Dunn Procedure: A Case Series Luthfi Walikram; Iman Dwi Winanto; Jefryan Sofyan
International Journal of Health, Economics, and Social Sciences (IJHESS) Vol. 7 No. 4: October-2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/ijhess.v7i4.8873

Introduction: Slipped Capital Femoral Epiphysis (SCFE) is a condition of the proximal femoral physis that causes metaphyseal displacement that can lead to femoroacetabular impingement and premature osteoarthritis. The management of SCFE so far had significant complications of avascular necrosis so that the Modified Dunn procedure was developed to allow the visual control of the epiphyseal vascular blood supply. Cases Description: We report 2 cases of SCFE in two 14-year-old males who had previous trauma and then underwent open epiphyseal reduction and fixation with modified Dunn procedure. Postoperative evaluation showed there were no cases of avascular necrosis. In addition, the anatomy of the femoral epiphysis was successfully restored, as indicated by a residual slip angle ranging from 4° to 8°, which was considered minimal and not clinically significant. Discussion: The modified Dunn procedure with a retinacular soft tissue flap approach provides the opportunity to perform anatomical reduction of the displaced femoral epiphysis while allowing visual monitoring of femoral head perfusion through the retinacular tissue. When performed by an experienced operator and with careful and precise surgical technique, this procedure has been shown to produce favorable outcomes, both in terms of low AVN rates, functional improvement, and prevention of osteoarthritis progression. Conclusion: These findings suggest that the modified Dunn technique may be an effective and safe option in the management of SCFE, especially in patients with moderate to severe degrees of slippage. With this approach, not only joint stability can be maintained, but also the anatomical shape of the femoral head can be restored as close to normal as possible.

Title

Found 5 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 5 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 5 Documents
Search