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Lukas Widhiyanto, dr., SpOT(K)
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Journal Orthopaedi and Traumatology Surabaya (JOINTS)
Published by Universitas Airlangga
ISSN : 2722712X     EISSN : 24608742     DOI : 10.20473/joints.v10i2.2021.39-45
Core Subject : Health,
Health Professions Medicine & Pharmacology
The JOINTS research topics are relating to education and training in the field of orthopedics and traumatology, including research reports, case reports, and literature reviews.
Arjuna Subject : Kedokteran - Ortopedi dan Kedokteran Kesehatan
Articles 6 Documents
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Search results for , issue "Vol. 11 No. 1 (2022): April 2022" : 6 Documents clear
Vacuum-Assisted Closure and Muscle Flap as An Alternative Modality for Infected Wound After Orif of Tibial Fracture: Case Report OK Ilham Abdullah Irsyam; Saraswati Hastika; Hendra Hendra; Andrew Budiartha Budisantoso; Tesar Akbar Nugraha
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.16-21

Abstract

Background: The blood supply of a bone can be decreased due to the use of an implant, leading to wound-bed bacterial colonization and the development of the SSI. The principle of vacuum-assisted closure (VAC) is to use a negative pressure environment in the wound to promote increased wound healing. The case shows that VAC application and muscle flap therapy provide the definitive healing of infected wounds after ORIF. Case Report: A 45 years-old male presented with a close comminuted proximal third right tibia fracture and tense skin. The fracture was openly reduced and internally fixated with plate fixation and a skin flap on the fracture area. Still, the wound could not be closed due to difficulty covering the wound, so a counter incision was made. After four days, the patient developed necrosis in the post-operation wound and subsequently underwent debridement and muscle flap with VAC application. Discussion: SSI can be treated by applicating of appropriate antibiotic and surgical procedures. In this case, the infection was treated using third-generation cephalosporin antibiotic, debridement, dissection, and re-elevation of gastrocnemius muscle flap covering the exposed plate area in inferior, split skin graft above the muscle flap and VAC above skin graft with 75 mmHg pressure. Conclusion: Debridement with muscle flap and application of VAC in the deep infected wound of open reduction and internal fixation was found to be successful methods in minimizing complications and obtaining an optimal outcome. This finding was associated with accompanying morbidities or a good wound healing process.
Agenesis of Medial Patellofemoral Ligament (MPFL) with Habitual Patellar Dislocation in Adolescent Woman with Cerebral Palsy – A Case Report Nurul Hidayah; Felix Giovanni Hartono; Bramta Putra Manyakori; Agus Sari Budaya
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.22-27

Abstract

Background: The current treatment for habitual dislocation and nonoperative treatment failure is surgical therapy. Therefore, this study describes chronic patella dislocation's comprehensive evaluation and management in an adolescent woman with cerebral palsy (CP).Case Report: A 15 years old female patient has suffered knee pain for almost three years. Furthermore, the physical examination revealed positive adam's forward bending test and left knee cap dislocation with positive patellar J-sign at 90°. Radiologic examination of the vertebrae and left knee shows scoliosis left thoracolumbar curved with 43 cobb angle and patellar shift. The patient was then diagnosed with habitual patellar dislocation, spastic diplegia type of CP, and neuromuscular scoliosis, consulted to the pediatric department, and then planned for medial patellofemoral ligament (MPFL) reconstruction. During the surgical examination, we discovered the MPFL Agenesis. Finally, lateral release and plication of the medial retinaculum were selected for surgery and planned to receive a Boston brace for scoliosis. After six weeks of follow up, the patient shows a reduction in pain.Discussion: Lateral release and MPFL reconstruction for patellar stabilization generate better results. However, in this case, the absence of the medial patellar facet and the medial femoral condyle enhances Lateral release and plication of the medial retinaculum more preferable to fixate the left patella and improve functional limitation.Conclusion: Comprehensive and immediate treatment for a patient with habitual patella dislocation and other predisposition diseases increases the chances of success.
Impact of One Year Covid-19 on Hand and Upper Extremity Injury: A Cross-Sectional Study Pamudji Utomo; Tito Sumarwoto; Naufal Aminur Rahman; Mochammadsyah Beizar Yudhistira
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.1-4

Abstract

Background: On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a worldwide pandemic. On March 31, 2020, Indonesia enacted a large-scale societal limitation. As a result, the number of patients seeking medical treatment for emergencies has decreased significantly. Home and fall accidents were the leading causes of a hand injuries, and this trend is anticipated to persist throughout the epidemic. Despite this, there is scarce information about the many forms and causes of hand and upper extremity injuries. This research aimed to see how COVID-19 affected hand and upper extremity injuries.Methods: The observational cross-sectional research was undertaken from March 2019 to February 2021. The Pre-COVID-19 phase was measured from March 2019 to February 2020, while the COVID-19 period was measured from March 2020 to February 2021. Patients who presented to Prof. Dr. R. Soeharso Orthopedic Hospital with hand and upper and lower extremity injury-related diagnoses from the emergency unit, outpatient, or inpatient were included in the study.Results: The overall number of patients in this study was 2644, with a mean total number of patients of 141.83 (SD 43.21) in the pre-COVID-19 era and 78.5 (SD 32.55) in the COVID-19 era, a significant reduction (p 0.001).Conclusion: There is a substantial drop in hand and upper extremity injury patients during the timespan of COVID-19 compared to the Pre-COVID-19. The findings might aid in the development of new ways for better understanding the service provisions needed in the case of injury during a pandemic.
Re-Fracture as Impact of Rigid Implant and Bone Osteoporosis: A Case Report Huda Fajar Arianto; Yunus Basrewan
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.28-32

Abstract

Background: The increasing life expectancy of the world population associated with osteopenia and osteoporosis leads to low-energy fractures, especially in the lower limb. The overture of locking plates has widened the area of close fracture fixation, and it is essential to justify and optimize their usage. This study aims to report the potential postoperative re-fracture after implant removal and as a consequence of bone osteoporosis.Case report: We present a re-fracture of proximal femur case in 60 years old female after a trivial fall into her right femur. This patient underwent a removal implant surgery a week before in the same spot where she fell. The open surgery was made with the same incision, and we do the Open Reduction Internal Fixation for her. Discussion: The major design of the fixation tool is to secure the fracture with less effect on native axial load stress from the whole bone. Stress shielding caused due to firm bone-implant results in its resorption. The bone degradation underneath gives rise to the plate's collapse, resulting in repeated bone breakage. Early discharge, continued weight-bearing training for proximal femur fractures were associated with speedy improvement in daily activities. The photodynamic polymer liquid was the latest technology for bone stabilization.Conclusion: Rigid bone plates can cause stress shielding, and when the implants are removed, re-fracture easily happens. Therefore, discharge of patients quickly for weight-bearing training in proximal femur fractures was encouraged to promote better healing.
Better Functional Outcomes in Plate Fixation of Midshaft Clavicle Fracture in Dr. Soetomo General Academic Hospital Edward, Mouli; Benedicta, Steesy; Wardhana, Teddy Heri
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.10-15

Abstract

Background: Clavicle fractures are common, with treatment trends shifting from conservative to operative. While malunion often has minimal functional impact, nonunion rates and associated complications remain a concern. This study evaluates functional outcomes between plating and conservative approaches for midshaft clavicle fractures.Methods: A total of 531 cases with a midshaft clavicle fracture presented to the emergency room between January 1, 2014 and December 31, 2018 at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Patients with a head injury, multiple traumas, re-fracture, malunion, open fracture, and pathological fracture were excluded. 161 patients remained. A conservative group (84 patients) was treated using an arm sling, and an operative group (77 patients) with Open Reduction and Internal Fixation (ORIF) and S-plate. Clinical and functional scores were evaluated retrospectively a minimum of 6 months after treatment. Shoulder function was evaluated using the Constant Shoulder Score and Manual Muscle Test.Results: 117 (72.7%) patients were male, with a mean age of 35.4 ± 12.33 years old. The right side was dominantly injured. The Manual Muscle Test score in the operative group was five, and in the conservative group, four. The Constant Shoulder score in the operative group was 93.38 ± 7.529, and in the conservative group, 86.60 ± 7.560 (p < 0.001). The DASH score in the operative group was 10.05±6.98 and in the conservative group, 23.67±3.49 (p < 0.001).Conclusion: In our study, surgery on clavicle midshaft fractures showed significant improvement and satisfaction compared to conservative treatment. Patients gained better function.
The Effect of Culture Techniques of Hypoxic Stem Cell Secretome on The Number of Growth Factor TGF-β, BMP-2, VEGF Edward, Mouli; Mahyudin, Ferdiansyah; Manyakori, Dionysius Bramta Putra
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 1 (2022): April 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i1.2022.5-9

Abstract

Background: Mesenchymal stem/stromal cell (MSC) therapy is now an effective therapeutic modality for treating various diseases. In its application, stem cells require signaling molecules, including growth factors, cytokines, and chemokines. Signaling molecules function in an orderly manner and are greatly influenced by the physiological environment. Stem cell culture techniques with hypoxic conditions can produce growth factors similar to those found in fracture conditions. This study aimed to evaluate the differential expression of growth factors in cultured normoxic and hypoxic bone marrow stem cell (BMSCs).Methods: This in vitro laboratory experimental study examined normoxic and hypoxic BMSC cultures. BMSCs were harvested from rabbits, propagated in vitro, and cultured under normoxic and hypoxic conditions. Vascular endothelial growth factor (VEGF), Transforming growth factor-β (TGF-β), and Bone morphogenetic protein-2(BMP-2) levels were measured using ELISA.Results: VEGF, TGF-β, and BMP-2 expression showed significant differences between the normoxia and hypoxia groups. The VEGF, TGF-β, and BMP-2 expressions were higher in the hypoxia group compared with the normoxia group (p < 0.05).Conclusion: The expression of TGF-β1, VEGF, and BMP-2 growth factors in cultured BMSCs was significantly different between normoxic and hypoxic conditions. TGF-β1, VEGF, and BMP-2 expression increased under hypoxic conditions.

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