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All Journal Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Archives of The Medicine and Case Reports
Khrisna Purwa Satyaksa
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Health Professions Medicine & Pharmacology Nursing Public Health

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Liquid Nitrogen-Recycled Autograft Augmented with a Non-Vascularized Fibular Strut for Refractory Pediatric Osteosarcoma: A Case Report of the Cryo-Immunological Reconstruction Mujjadid Idulhaq; Khrisna Purwa Satyaksa; Rachmad Faisal
Archives of The Medicine and Case Reports Vol. 6 No. 4 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i4.827

Abstract

Reconstruction of large segmental bone defects following limb salvage surgery for osteosarcoma presents a significant challenge in pediatric populations, particularly in resource-limited settings where expandable endoprostheses are inaccessible. This study evaluates the efficacy of a biological reconstruction technique using Liquid Nitrogen-treated recycled autograft augmented with a fibular strut, known as the Modified Capanna Technique. We present the case of an 8-year-old female with Enneking Stage IIB high-grade osteoblastic osteosarcoma of the distal femur. The patient exhibited a refractory response (Huvos Grade II) to a neoadjuvant non-methotrexate chemotherapy regimen. Wide resection was performed, followed by a specific cryo-protocol: the tumor-bearing bone was frozen in Liquid Nitrogen (−196°C) for 20 minutes, thawed physiologically, augmented with an intramedullary non-vascularized fibular strut, and stabilized with a locking compression plate. At 12 months postoperative, the patient achieved solid radiographic union with a Radiographic Union Scale for Tibial fractures score of 11/12. No local recurrence or distant metastasis was detected. The Musculoskeletal Tumor Society score improved from 10% pre-operatively to 80% post-operatively, reflecting independent ambulation. A comparative analysis revealed that the procedure cost was approximately 12% of a standard imported megaprosthesis. In conclusion, the liquid nitrogen-recycled autograft, when mechanically augmented, offers a theoretically sound and cost-effective limb salvage solution. It provides immediate anatomical restoration and potential cryo-immunological benefits, making it a viable alternative for refractory cases in developing healthcare systems.
Profile and Clinical Outcome Lateral Condyle Humerus Fracture in Children’s Patients in National Orthopedic Hospital (2022-2024) Hendra Cahya Kumara; Khrisna Purwa Satyaksa
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 10 No 01 (2026): Qanun Medika Vol 10 No 01 January 2026
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v10i01.27789

Abstract

The lateral condyle fracture is the second most prevalent elbow fracture in pediatric populations. Fractures of the distal humerus present challenges regarding diagnosis, treatment, and associated complications. This study aimed to describe the demographic characteristics, treatment modalities, and radiologic outcomes of pediatric lateral condyle humerus fractures managed at Prof. Soeharso Hospital between January 2022 to July 2024. This was a descriptive, retrospective study of pediatric patients diagnosed with lateral condylar humerus fractures during the study period. Patients were classified according to sex, age, treatment method, and outcomes. Data were obtained from hospital medical records and analyzed using Microsoft Excel. Between January 2022 and July 2024, 23 pediatric patients were identified, consisting of 15 boys and 8 girls. The majority of patients (n = 12, 52.2%) were aged 6–10 years. Most patients (n = 21) underwent surgical treatment, while two were treated conservatively. All surgical cases were managed with open reduction and internal fixation (ORIF): 20 patients with 2–3 Kirschner wires and one with a screw. Follow-up radiographs at 6–12 months postoperatively showed bone union in 15 patients, malunion in five, and nonunion in one. Among the conservatively treated patients, one developed a malunion and one a nonunion. In conclusion, pediatric patients treated at Prof. Dr. R. Soeharso Orthopaedic Hospital with open reduction and internal fixation achieved satisfactory union rates and remain the preferred technique for managing displaced lateral condyle fractures in children.
Co-Authors Hendra Cahya Kumara Mujjadid Idulhaq Rachmad Faisal