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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 103 Documents
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DISTAL TIBIAL RECONSTRUCTION WITH INTRAMEDULLARY NAIL COMBINED WITH T-PLATE FOLLOWING EN-BLOC-EXCISION OF GIANT CELL TUMOR OF DISTAL TIBIA: CASE-REPORT Mujaddid Idulhaq; Fajar Baskoro Gardjito; Ibnu Yudistiro
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 1 (2021): April 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i1.2021.22-27

Abstract

Background: Giant cell tumor is locally aggressive benign tumor that occur more common in distal femur, proximal tibia, and distal radius, and has tendency for recurrence and has capability for metastatize. Giant cell tumor in foot ankle are rare, and comprise less than four percent of giant cell tumor of the bone.Case Report: A 33 years old man presented with complains of pain and swelling in right ankle since 6 months ago with no history of trauma. Physical examination revealed increasing swelling over the distal-posteromedial aspect of lower leg and limitation ankle movements due to pain. Routine blood investigations showed slight increase of alkaline phosphatase. X-ray and Magnetic Resonance Imaging showed the lesion with morphology suggestive of giant cell tumor. Histopathology examination showed multinucleated giant cells and spindle shaped of mononuclear cells suggestive of giant cell tumor. The patient was treated with en-bloc-excision followed with distal tibial reconstruction using reverse intramedullary tibial nail combined with T-plate (tibio-talar arthodesis).Discussion: The main treatment of giant cell tumor of the bone is surgical removal to achieve tumor-free by eradication of the tumor, with various surgical techniques for reconstructing the cavity left. In this case we performed distal tibial reconstruction using reverse intramedullary tibial nail combined with T-plate.Conclusion: The patient at 12-month follow up is doing well, walking comfortably without any pain, has no limitation in range of motion with no signs of recurrence and good MSTS score (90).
LONG TERM FUNCTIONAL EVALUATION AUTOFIBULAR STRUT GRAFT IN CASE OF FRACTURES NECK FEMUR IN RSUD DR SOETOMO SURABAYA Sjarwani, Achmad; Irsyam, OK Ilham Abdullah
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 1 (2018): April 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i1.2018.55-64

Abstract

Background: Neck femur fracture has a poor prognosis due to its anatomical structure. Fractures that occur in the elderly often have a heavy comorbid so that the mortality rate in 1 year in this case reaches 30-50%. The techniques that have been developed at this time are not satisfactory results with non-union rate of about 30%.Purpose: Assessing the long-term effectiveness of fibular auto strut graft techniques for neck femoral fracture therapy.Methods: The study was conducted retrospectively using primary data in the form of clinical evaluation and secondary data in the form of medical record data and questionnaires of neck femur fracture patients who performed non-vascularized autofibular strutgraft therapy in the period January 2005 to August 2015 in operating room IRD RSUD Dr. Soetomo Surabaya. Patients were evaluated with Harris Hip Score.Result: Medical record data shows that surgery was performed in January 2005 until August 2015 in the IRD hospital operating room. Soetomo Surabaya with 15 patients that fit criteris inclusion. The final result of Harris Hip Score is excellent in 66.66% of patients, good in 20% of patients, and poor on 13.33% of patients. It can be seen that in large part, the technique of autofibular strutgraft (Surabaya Technique) gives good results to the sufferer.Conclusion: Autofibular strutgraft and reinforcement with cancellous lag screw on neck femur fracture can generally provide good functional results in long term evaluation. From the assessment of functional aspects, abnormal anatomical conditions, and Range of Motion (ROM), obtained satisfactory results. This supports autofibular strutgraft as a neck femur fracture therapy as a major therapeutic option at a young age.
DIFFERENCES OF BONE REGENERATION USING BOVINE HYDROXYAPATITE AND BOVINE HYDROXYAPATITE WITH FREEZE-DRIED PLATELET RICH PLASMA ALLOGRAFT IN BONE DEFECT OF FEMORAL WHITE RABBIT Mouli Edward; Henry Dominica; Ferdiansyah Mahyudin; Fedik Abdul Rantam
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i2.2020.34-54

Abstract

Background: Hydroxyapatite is a bone graft that has osteoconductive properties for bone defects treatment. Platelet-rich plasma (PRP) has a capability of providing many bioactive molecules in physiological proportions. Hydroxyapatite given freeze-dried PRP is expected to create a graft that can strengthen the matrix while promoting osteoinduction. This study compares the effects of regeneration on the bone between bovine hydroxyapatite (BHA) and bovine hydroxyapatite with freeze-dried platelet-rich plasma (FD-PRP) as a bone graft in bone defect of the femoral white rabbit.Methods: The 12 equal New Zealand white rabbits aged 6-9 months are divided into two groups. Bone defects were made in the lower femoral meta-diaphysis with a diameter of 2.5 mm. The defects were filled with BHA with FD-PRP allograft in the treatment group and BHA in the control group. Both groups will be sacrificed in the third and sixth weeks, then evaluated histologically for microvascular structure, osteoblasts, woven bone, type-I collagen, osteocalcin, alkaline phosphatase, and immunoglobulin G.Results: During the evaluation in week 3 and 6, microvascular structure, osteoblast, and type-I collagen decreased in both groups with insignificant differences (p>0.05). Woven bone, osteocalcin, and immunoglobulin G increased in the treatment group but was not significant (p>0.05). Alkaline phosphatase increased higher in the treatment group, with a considerable difference in the sixth week (p=0.008).Conclusion: The elevation in the production of woven bone, osteocalcin, and alkaline phosphatase at the third and sixth-week evaluations highlight the possibility that administering BHA given FD-PRP may have contributed to the healing of bone defects.
THE PROFILE OF FRACTURE IN PATIENTS UNDER 17 YEARS OF AGE AT RSUD DR SOETOMO IN THE PERIOD OF 2013-2014 Satria Nur Sya'ban; Widati Fatmaningrum; Sulis Bayusentono
Journal Orthopaedi and Traumatology Surabaya Vol. 6 No. 1 (2017): April 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v6i1.2017.21-32

Abstract

Fractures in children are important problem nowadays. Governmental census lists people under 17 years old as the largest contributor to fracture cases in Indonesia. The rapid increase in motor vehicle use, a hallmark of economic growth in developing countries, led to sharp increase in road saturation and consequently, rise in traffic related injuries. Variables involved in pediatric fractures needs to be identified and mapped to provide basis for the creation of better preventive measures to reduce problem before it happens. Thus, the purpose of this research is to create a profile of fracture in patients under the age of 17 years’ old at RSUD Dr Soetomo. The research is descriptive study which is performed by analyzing medical records in RSUD Dr Soetomo against the following: Age, Sex, Type of fracture, Cause of fracture, Time of fracture, Location of fracture, and Duration between admission and treatment. Data is then tabulated and converted into a bar graph for easier analysis. The research found that fractures in children most commonly occur at the 10-14 years’ age group (41.8%), happens more frequently in boys than in girls (69.5%), is dominated by closed fractures over open fractures (75.9%), and is most often caused by traffic accidents (60.9%). Consequently, the location in which fractures are most prevalent is the “street” (63.1%). It is also found that the highest incidence of fractures cases happens within the 12.01-18.00 time-span (19.1%) and is treated within the first 8 hours of admission to the hospital (79.4%).
THORACIC SPINE CANAL STENOSIS WITH CAUDA EQUINE SYNDROME: CASE REPORT Primadenny Ariesa Airlangga; Arifin Arifin
Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 2 (2019): October 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v8i2.2019.86-92

Abstract

Background: Cases of thoracic stenosis with cauda equina syndrome are rare. The thoracal canal is relatively narrow compared with cervical and lumbar, so the less pressure on the lower thoracal region is the thoracic vertebral height 11 which is the initial release of the cauda equine nerve root can cause complaints of cauda equina syndrome.Case: A 50-year-old male presented pain in both legs for 3 years, accompanied by weakness in the legs, numbness in the buttocks, and erectile dysfunction. Thoracal MRI examination shows severe spinal stenosis at 11th-12th thoracal vertebra with ligamentum flavum hypertrophy. Second patient, a 70-year-old man complained of weak legs since 1 week, accompanied by low back pain, numbness in the buttocks, and difficulty defecating. Thoracal MRI examination shows severe spinal stenosis in the 10th-11th thoracal vertebra. Both patients immediately underwent selective decompression surgery, laminotomy, and flavectomy at thoracal level showed satisfactory results based on improvement in clinical symptoms.Discussion: Leg weakness, hypoesthesia in the buttocks and pubic area, erectile dysfunction is the cauda equina syndrome. The exit of the first cauda equine nerve can be placed at 11th thoracic vertebra, so the presence of stenosis at that level and bellow can cause symptoms of the cauda equina syndrome. MRI examination is needed to ensure that there is severe spinal stenosis at the level of the thoracal-lumbar spine, according to the level of neurological disorders. The surgery of decompression is immediately carried out in the case of cauda equina syndrome because it is an emergency state.Conclusion. In cases with complaints of the cauda equina syndrome, thoracic stenosis can be the cause due to stenosis of the lower thoracic region which is the initial root of the cauda equina nerve. Confirm accurate diagnosis is with MRI.
THE EFFECT OF TRANEXAMIC ACID INJECTION ON HEMOGLOBIN LEVEL, ALBUMIN LEVEL, AND PAIN ON PATIENT RECEIVING TOTAL KNEE REPLACEMENT Dwikora Novembri Utomo; Teddy Heri Wardhana; Ahmad Hannan Amrullah; Hamzah Hamzah
Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 1 (2019): April 2019
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v8i1.2019.1-11

Abstract

Background: The high number of knee osteoarthritis cases could lead arthroplasty more frequent. Total Knee Replacement (TKR) surgery procedure is at risk of massive bleeding. Bleeding can affect albumin levels and the onset of intra-compartment pressure on the nerves. The use of tranexamic acid could be done to reduce bleeding.Objective: Proving the effect of intravenous tranexamic acid administration on patients who will undergo TKR surgery.Methods: The experiment was conducted experimentally using primary laboratory data obtained before and after surgery in patient which will be performed TKR operation starting from April 2017.Result: There are 64 patients who had undergone total knee replacement surgery. The mean preoperative hemoglobin in the tranexamic acid group and without tranexamic acid was 13.06±1.46g/dl and 12.44±0.87g/dl. The mean hemoglobin after surgery was 10.29 ±1.14 g/dl and 9.16±0.97 g/dl. In the group receiving tranexamic acid, 32 (100%) reported low postoperative VAS scores, did not require blood transfusions and did not require albumin transfusion. Groups not receiving tranexamic acid, 32 (100%) moderate postoperative VAS scores, 4 people (12.5%) required the blood transfusion, and 3 (9.4%) required transfusion of albumin.Conclusion: The results of this study showed that the group given tranexamic acid had higher hemoglobin levels after surgery than the untreated group of tranexamic acid; there was no difference in albumin levels after surgery in both groups; the administration of tranexamic acid will decrease the amount of blood loss, decrease the degree of pain, and decrease the need for blood transfusions after total knee replacement surgery.
CYTOTOXIC EFFECT OF FREEZE DRIED BOVINE CARTILAGE POWDER AND PLATELET RICH PLASMA (PRP) TO MESENCHYMAL STEM CELL (MSCs) Dwikora Novembri Utomo; Anthoni Yusbida
Journal Orthopaedi and Traumatology Surabaya Vol. 6 No. 2 (2017): October 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v6i2.2017.63-70

Abstract

Cartilage repair is a challenging clinical problem because the damage is an irreversible condition. Many studies had been performed using several kinds of natural or synthetic scaffold. Attempts to repair articular cartilage using scaffold usually found many problems, lacks the physical structure and mechanical properties necessary to ensure long-term efficacy to cartilage defect. Furthermore, scaffold frequently cause toxicity to the host. Therefore, this study was performed in vitro to test the toxicity effect of scaffold freeze dried bovine cartilage powder and platelets Rich Plasma (PRP). This research was conducted using pure experimental research design in 4 groups of animal stem cells which being added with scaffold freeze dried bovine cartilage scaffold provided with platelet rich plasma. This study using posttest only control group design. The result being processed with MTT assay and spectrophotometer for counting the viable stem cells. There was no significant difference in the amount of macrophage between control and the freeze dried bovine cartilage scaffold provided with PRP (p=0,128). With this result in the number of macrophages between the control with freeze dried bovine cartilage scaffold provided PRP, it can be concluded that these biomaterials have biocompatibility.
Antibiotic Susceptibility of Bacteria Isolated from Open Fracture Grade III Presenting to Dr. Soetomo General Academic Hospital Surabaya Wibisono, Raden Taufan Mulyo; Utomo, Dwikora Novembri; Widodo, Agung Dwi Wahyu
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 1 (2021): April 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i1.2021.1-10

Abstract

Background: Open fractures are a typical case in the orthopedics field. Infection in an open fracture can cause osteomyelitis. An antibiotic susceptibility testing of patient specimen bacteria with open fractures aimed to determine suitable antibiotic agents with which to treat the infectious diseases caused by these bacteria.Methods: This research is a descriptive study to assess antibiotic susceptibility in cases of open fracture grade III in Dr. Soetomo General Academic Hospital, Surabaya. Total sampling was performed on the microbiological culture results of patients diagnosed with open fracture grade III after debridement from October 2018 to September 2019. The identification of the microbes was based on Gram-positive and Gram-negative categories, and the classification was based on susceptibility to antibiotics, whether sensitive, intermediate, and resistant.Results: The examination of the data from the microbiological culture results of patients with a diagnosis of open fracture grade III after debridement from October 2018 to September 2019 in Dr. Soetomo General Hospital Surabaya resulted in 56 research subjects who met the criteria. Acinetobacter baumannii was the most common bacterial species found in the microbiological examination of patients with open fractures, at 15.84%. Cefazoline and ceftriaxone showed low susceptibility. Levofloxacin showed a relatively good value of susceptibility against both Gram-positive and negative bacterial groups.Conclusion: The antibiotic susceptibility pattern of bacteria from specimens in open fracture grade III patients in Dr. Soetomo General Academic Hospital Surabaya varies between each species of bacteria isolate.
CORRELATION BETWEEN HARRIS HIP SCORE (HHS) AND BODY MASS INDEX (BMI) IN PATIENTS WITH FEMORAL NECK FRACTURE AFTER HEMIARTHROPLASTY Hutagalung, Muhammad Bayu Z; Rahman, Safrizal; Azharuddin, Azharuddin
JOINTS (Journal Orthopaedi and Traumatology Surabaya) Vol 7, No 1 (2018): April 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v7i1.2018.12-19

Abstract

Femoral neck fracture is an intracapsular hip fracture. Hemiarthroplasty is one of the treatment options that replaces femoral aspect of hip joint with a prosthesis, while leaving the acetabulum intact. The treatment’s goal is to return the patient to premorbid capacity. Harris Hip Score (HHS) is an assessment for the outcome of hip surgery which contains: pain, functional capacity, deformity and range of motion (ROM). The purpose of study is to determine relation of BMI and Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty. This study is analytic-observational study with cross-sectional design conducted in June-September 2014 in Orthopedic’s Polyclinic of General Hospital dr. Zainoel Abidin Banda Aceh. Respondents in this study is 26. Comparative assessment of outcome was analysed by Kruskal-Wallis test with Mann-Whitney test as Post-hoc analysis and correlative assessment was analysed by Spearman test. Comparative assessment present significant relation of BMI (p = 0,006; r=0.458) with Harris Hip Score (HHS) in patients with femoral neck fracture after hemiarthroplasty.
The Clinical and Radiological Outcome of Bovine Hydroxyapatite (Bio Hydrox) as Bone Graft Arifin; Mahyudin, Ferdiansyah; Edward, Mouli
Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 1 (2020): April 2020
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v9i1.2020.9-16

Abstract

Background: Bone grafting is a surgical procedure that involves transplanting material to enhance bone healing through osteogenesis, osteoconduction, and osteoinduction. While autografting has long been considered the gold standard, it has limitations, including a restricted supply and donor site morbidity. These limitations, along with those associated with allografts, have led to the development of bovine hydroxyapatite (BHA) as a bone graft substitute. This study aimed to evaluate the clinical and radiological outcomes of BHA.Methods: This descriptive study used a consecutive sampling design, including all trauma patients who received BHA at our hospital between 2016 and 2018. The BHA was obtained from the tissue bank at our institution. The clinical and radiological outcomes were evaluated, and the data was tabulated and analyzed descriptively.Results: Of the 56 patients who underwent surgery with BHA, most (80.36%) had excellent outcomes, 12.5% had good outcomes, 3.57% had fair outcomes, and 3.57% had poor outcomes.Conclusion: Bovine hydroxyapatite can be considered an alternative bone graft to support the bone healing process.

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