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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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Stand-Alone Cervical Cage for Cervical Radiculopathy: A Retrospective Study Martiana, I Ketut; Tumbelaka, Reyner Valiant
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.v9i1.2020.17-21

Abstract

Background: Cervical radiculopathy is a clinical condition characterized by unilateral arm pain, numbness and tingling in a dermatomal distribution in the hand, and weakness in specific muscle groups. This condition can be treated with nonsurgical or surgical methods. This study aims to evaluate the outcome of the stand-alone cervical cage surgical method for cervical radiculopathy at our hospital institution from 2013 to 2017.Methods: This is a retrospective observational study on every patient who underwent a stand-alone cervical cage procedure for cervical radiculopathy at our hospital institution from 2013 to 2017. The study was conducted from December 2017 until April 2018. We evaluated the clinical outcome with the Neck Disability Index (NDI). The data were collected from medical records, and postoperative follow-up was done by house visits, phone calls, and outpatient visits.Results: Five male and one female subject with a mean age of 58 years (range, 45–65 years) underwent the procedure; one patient passed away three years postoperatively due to events unrelated to the operation; one patient could no longer be reached. Four patients had an increasing NDI score postoperatively. There were no postoperative complications.Conclusion: Stand-alone cervical cage appears to be a safe and effective treatment, providing a favorable clinical outcome for cervical radiculopathy at our hospital institution from 2013 to 2017.
JONES TENDON TRANSFER MODIFICATION WITH ERWIN RAMAWAN TECHNIQUE Erwin Ramawan; Teddy Heri Wardhana; Ansari Rahman
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.v8i2.2019.59-67

Abstract

Background: Drop hand is a clinical manifestation of radial nerve lesion that cause hand dysfunction. Jones tendon transfer is one of the therapeutic modalities in overcoming it with many modifications, but there is still no mutual agreement for which technique is the best. One of them is the Erwin Ramawan technique. The purpose of this study was to determine the differences in results before and after tendon transfer surgery with the Erwin Ramawan technique in patients with radial nerve lesions.Methods: Retrospectively, we evaluated patients with high-type lesions of radial nerve carried out by tendon transfer surgery using Erwin Ramawan, to reroute PL to EPL, so the thumb can do abduction and extension, then the FCR tendon is positioned parallel to the ECRB and EDC, then connected 45° direction. The outcome was evaluated using the DASH score and with the Robert G. Chouinard method.Results: The average DASH score in patients with high-type lesions of  radial nerve before surgery 56.83 ± 16.69 had a significant improvement (p <0.05) after tendon transfer surgery with Erwin Ramawan technique to 32.00 ± 11.88. Functionally, dorsiflexion from wrist postoperative is 75.00 ± 10.00 (excellent), palmarflexion 52.00 ± 24.65 (excellent). For finger, the metacarpophalangeal extension reaches 166.00 ± 19.49 (good). The distance from the fingertip to metacarpophalangeal crease is 0.10 ± 0.22 (good). On thumb, abduction reaches 40.00 ± 15.81 (excellent), interphalangeal extension 166.00 ± 11.44 (good).Conclusion: Based on these results, we found significant clinical differences before and after tendon transfer with the Erwin Ramawan technique.
Spastic Paraparesis in Young Men With Spinal Meningioma and Spinal Arteriovenous Malformation: A Case Report Leonard Christianto Singjie; Ivan Jeremia; Esdras Ardi Pramudita
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.46-52

Abstract

Background: Compared to trauma cases, the publication of non-traumatic events is much less, although the incidence is estimated to be as much as a traumatic event. This case report presents spinal cord tumors together with arteriovenous malformation (AVM) in young men, where there are no previous case reports that the authors can find.Case Report: A 22-year-old male patient with complaints of pain in the back (NPRS 8-9), followed by difficulty moving the lower limb accompanied by a burning sensation, problem in defecation, and urination. We found motor weakness in the lower extremities (1/1), positive pathological reflexes, and sensibility disorders on physical examination.Discussion: According to history taking, physical examination, and MR Imaging, the spastic paraparesis symptom in this patient is likely due to a spinal cord tumor, which is meningioma (according to histopathological examination). Where back pain rarely presents in the patient with spinal AVM. Laminectomy and tumor destruction were the gold standards of therapy, and the symptom was relieved.Conclusion: A complete examination is the main key in determining the appropriate therapy for the patient's disease. In this case, the manifestation of spastic paraparesis was likely to be caused by meningioma rather than spinal AVM. Laminectomy and extirpation of the spinal meningioma were done as the gold standard of therapy, and the symptom was relieved. In contrast, spinal AVM was not performed­ and is still under observation.
Open Surgery for Patellar Tendon Rupture and Tibial Tuberosity Avulsion Fracture in Pre-Existing Osgood Schlatter Lesion: A Case Report Shianita Limena; Anak Agung Ngurah Ronny Kesuma; I Komang Mahendra Laksana
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.59-63

Abstract

Background: In Osgood Schlatter Disease, despite being a self-limiting disease during adolescence, various complications of Osgood Schlatter Disease could also present in adulthood. An uncommon injury pattern requires surgical treatment. This study aims to understand the implementation of surgery in managing complications case of Osgood Schlatter Disease.Case Report: We present a rare case of complete patellar tendon rupture and tibial tuberosity avulsion fracture following a low-energy motor vehicle accident landing on his left knee in a 42 years old active male, who later discovered is having a pre-existing Osgood Schlatter Disease. This patient is treated with an open surgery fixating the tibial tuberosity using a single lag screw and eight tension wires, followed by primary repair of the patellar tendon, including its retinaculum.Discussion: Weakened structure from pre-existing Osgood Schlatter lesion may cause uncommon and profound injury pattern that requires surgical treatment. Conservative treatment no longer has a place in this case. The various surgical treatment methods have been reported; however, surgical modification technique is performed accordingly due to the complicated case presentation.Conclusion: Surgical treatment is the most suitable treatment option in managing this uncommon injury pattern complication of Osgood Schlatter Disease.
Fixation of A Closed Displaced Midshaft Clavicle Fracture by Intramedullary K-Wire: A Case Report Devuandre Naziat; David Haryadi
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.64-69

Abstract

Background: Fractures of the clavicle record for practically 50% of all injuries in the shoulder girdle. In recent years, the treatment paradigm for clavicle fractures has shifted from nonoperative treatment toward operative treatment, especially in fractures with significant displacement or shortening. Case Report: A 16 years old female presented to the emergency room with an injury on her right shoulder after a motorcycle accident. The radiograph showed a displaced midshaft clavicle fracture, classified as Robinson 2B1.  Operative measures were performed using intramedullary K-Wire. Discussion: There is no universally agreed gold standard for clavicle fracture fixation. The majority of midshaft clavicle fractures with a displaced fragment can be successfully repaired without surgery. On the other hand, conservative therapy of Robinson type 2B clavicle fracture has been linked to a higher rate of nonunion and a decrease in strength and endurance of the shoulder. In this patient, on the two-week follow-up after wire removal surgery, the patient regained full shoulder range of motion without any limitation on activities of daily living with a minimal post-operative scar.Conclusion: We recommend that intramedullary fixation using K-wires is a useful technique in displaced midshaft clavicle fracture as it is effective, has a good cosmetic outcome, and is well-suited for the BPJS era as it had the low-cost burden.
Functional Outcome by Evaluation of DASH Score on Drop Hand Patient Treated with Jones’ Tendon Transfer: A Retrospective Study Sumarwoto, Tito; Hadinoto, Seti Aji; Pradhana, Adhitya Indra
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.39-45

Abstract

Background: Drop hand, resulting from radial nerve injuries, causes functional and structural disabilities. Tendon transfer becomes the last option when nerve repair fails to achieve restoration. The most popular method is the Jones tendon transfer to restore wrist dorsiflexion and extension of the thumb and fingers. The Disabilities of the Arm, Shoulder, and Hand (DASH) score measures functional outcomes in patients with upper extremity injuries. This study aimed to assess the functional outcome and evaluate the DASH score in drop hand patients who underwent Jones tendon transfer surgery at Prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta. Methods: Data collected from medical records between January 2014 and June 2016 were evaluated based on functional outcome and DASH score. Eleven patients were included, comprising ten male patients (90.9%) and one female patient (9.1%). The mean age of the patients was 27.4 years. The right arm was the most frequently injured, accounting for eight patients (72.7%), while the left arm was injured in three patients (27.3%). Results: The DASH score evaluation indicated minimal disability in ten patients (90.9%) and moderate disability in one patient (9.1%). The average score was 12.48, indicating that most patients could cope with most daily living activities postoperatively.Conclusions: Surgical intervention for drop hand due to radial nerve palsy using the Jones tendon transfer technique yielded a satisfactory functional outcome based on the DASH score.
Internal Fixation of Type I Capitellum Fracture with Headless Screws: A Case Report Charlie Sanjaya; I Ketut Gede Arta Bujangga
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.70-76

Abstract

Background: Capitellum fractures are relatively rare. Distal humeral fractures that include capitellum and trochlea constitute approximately 6% of all distal humeral fractures and 1% of all elbow fractures. Despite the rarity of these injuries, an increasing number of clinical series have emerged, enhancing our understanding of these fractures.Case Report: A 26-year-old woman came to the emergency department with complaints of swelling and localized pain on the lateral side of her left elbow 2 hours after she fell off her motorcycle. Routine imaging such as plain radiographs and computed tomography scanning confirmed the fracture. She underwent open reduction and internal fixation surgery, stabilization of articular fragments with headless screws, and was fixated by a back slab and arm sling. The patient was also encouraged to do early elbow mobilization to avoid contractures and joint stiffness, routine follow-up every two weeks for a ROM evaluation. Preoperative Mayo Elbow-Performance Index score (MEPI) was 15, and postoperative 100.Discussion: The aim of capitellum fracture treatment is anatomical reconstruction and fixation to reduce the risk of non-union. In this case, we performed open reduction, secured two headless screws, which allow rigid fixation at the fracture site, provide fracture site compression through variable thread pitch design, and remained not removed later. These screws are suitable for use in anteroposterior and posteroanterior directions.Conclusion: The patient at two months follow-up has shown significant improvement. Accurate reduction, stable fracture fixation, and early postoperative mobilization were reported to provide good results with a MEPI score of 100.
Proximal Fibular Autograft Reconstruction after Resection Giant Cell Tumor Distal Fibula Mujaddid Idulhaq; Muhammad Luthfi Azizi
Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 2 (2021): October 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v10i2.2021.53-58

Abstract

Background: Giant cell tumor (GCT) is a destructive bone tumor. The predilection of the GCT is mostly on the epiphysial of long bones. GCT of the distal fibula is a very rare case that becomes challenging in surgical management. The chosen surgical management is crucial and still under debate.Case Report: A 38-years-old male complaint of a painful lump in the lateral side of his left ankle for three months. Plain radiographs demonstrate a lytic lesion involving distal fibula, appropriate with 2nd-grade Campanacci. MRI showed a mass centered on the distal fibula with intermediate to high T2 signal, low T1 signal, and homogenous contrast enhancement. The patient underwent a wide excision and reconstruction of the distal fibula with a fibular head graft from the ipsilateral side. After fifteen months of evaluation, the result was excellent. The patient can full-weight-bearing with a full range of ankle joint movement, return to daily activities without pain, and no signs of recurrence. Functional status measured by the MSTS and CAIT showed good results, with total scores was 28 and 27.Discussion: Ten centimeters distal fibula is a crucial component to form stability of the ankle. Reconstruction of the distal fibula after wide excision requires the bone graft and is considered to maintain ankle stability. It can be achieved using autograft from fibula or iliac crest.Conclusion: Reconstruction of distal fibula GCT with proximal fibular autograft showed a great result. This method is a viable option as it provides good pain relief and functional improvement.
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.

Page 6 of 11 | Total Record : 103

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