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Lukas Widhiyanto, dr., SpOT(K)
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INDONESIA
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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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
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
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.
Prolotherapy Perineural Injection in Carpal Tunnel Syndrome with Bifid Median Nerve: A Case Report Tresna Angga Basunanda; Arfano Januar Sangkai
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.61-69

Abstract

Background: Carpal tunnel syndrome (CTS) is a common neuropathy condition caused by entrapment of  the median nerve. Perineural injection therapy with 5% dextrose or prolotherapy becoming a common method for treating carpal tunnel syndrome. Although it is effective, some anatomical variaton of the median nerve could effect the outcome of the prolotherapy in CTS. Case Report: A 43-year-old woman suffered from diurnal, nocturnal numbness and paraesthesia of the first, second, third and radial surface in the fourth finger of the right hand. She also complained pain in the same area with the VAS score of 8, and muscle weakness. Physical examination showed positive Tinel’s sign, Phalen’s sign and Durkan’s compression test. The Boston questionnare score showed a symptom average of 3.27 and a difficulty average of 3.25. USG examination showed that the patient had a bifid median nerve anatomy variaton. Discussion: Variation of median nerve branches has been reported as one of the prevalence of median nerve entraptment. In this case, a bifid median nerve variation was found through the USG imaging. Prolotherapy has been reported to be an effective method to treat carpal tunnel syndrome. But the bifid median nerve could affect the effectiveness of prolotherapy injection. Conclusion: In the case of a bifid median nerve, it is necessary to modify the injection technique so it would be more able to reach the whole of the bifid median nerve.
Giant Cell Tumor of The Proximal Phalanx of The Index Finger of The Hand: A Rare Case Report Mouli Edward; Ferdiansyah Mahyudin; Muhammad Hardian Basuki; Yunus Basrewan; Caesar Haryo Bimoseno
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.49-55

Abstract

Background: Giant cell tumor (GCT) of bone is a relatively common type of benign tumor involving the epiphyseal region of tubular bones, but GCT rarely occurs at hand (1–4% of all GCT). GCT within the hand tends to be more aggressive and recurs more rapidly in hand than in other locations. Most authors prefer curettage or resection with reconstruction to maintain anatomical and functional integrity.Case Report: A 27-year-old man with a chief complaint of an enlarged lump and pain in the index finger of his left hand. These lumps appeared three months ago. Plain radiographs showed lytic, eccentric, geographic lesions with well-defined borders and narrow transition zones. Magnetic resonance imaging (MRI) showed a primary aggressive bone tumor with extension to the surrounding soft tissue. Fine Needle Aspiration Biopsy (FNAB) revealed the lesion as a Bone Giant Cell Tumor. The patient then underwent local resection and reconstruction using an allograft. Range of movement (ROM) measurements and DASH scores were evaluated.Discussion: Radiographic and MRI examinations showed characteristic cortical breach, and FNAB showed multinucleated giant cell spread. After treatment, the patient was found to be pain-free, have an improved ROM, and reduced disability. There was no recurrence observed. Conclusion: Despite the tendency for hand GCT to be more aggressive, local resection and reconstruction using an allograft with adjuvant hydrogen peroxide can reduce recurrence and disability.
Do NSAID/COX-2 Inhibitors Increase Nonunion After Fracture Surgery? Dilemma and Consideration In Use Azmi
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.70-77

Abstract

Background: Nonunion accounts for 2% to 10% of fracture complications, diminishing quality of life and increasing mortality risk. Several factors, including smoking, metabolic disorders, dietary inadequacy, and nonsteroidal anti-inflammatory drugs (NSAIDs), may predict nonunion development. NSAIDs are frequently used to treat postoperative pain, including in orthopedic conditions, particularly for fracture pain management. However, NSAID/cyclooxygenase (COX)-2 inhibitor use has been controversial for many years. Many orthopedic surgeons avoid using them in fracture surgery due to their potential adverse effects on osteogenesis and subsequent nonunion risk.Literature Review: An updated literature review was conducted using digital databases such as PubMed, Cochrane, Ovid-SP, Springer Link, and Science Direct, with the search terms "NSAIDs" OR "COX-2 inhibitor" AND "nonunion" AND "fracture surgery." Seven publications that met the inclusion criteria were summarized. This review revealed that while NSAIDs/COX-2 inhibitors have been shown to temporarily inhibit fracture union in some studies, the safety of NSAIDs following fracture fixation without notable interference in bone healing has been demonstrated in others. The association of COX-2 inhibitors or non-selective NSAIDs with nonunion remains unclear.Summary: Prolonged NSAID use interferes with successful bone healing. Short-duration (<2 weeks of treatment) and low-dose NSAID use are considered safe and efficacious for postoperative fracture pain.
Full Endoscopic Surgery of Bullet Removal of The Spine: A Case Report Wildan Malik; Nugroho Setyowardoyo
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.56-60

Abstract

Background: In the past decade, the endoscopic technique has been applied as a feasible and less invasive approach to orthopedic surgeries. Minimally invasive, full-endoscopic surgery has gained considerable attention in managing air gun injuries to the spine. Sacrum injuries among air gun wounds are rare and few have been published in case reports. Here, we present the management of air gun-bullet injury to the pediatric spinal spine in a 5-year-old child using endoscopic surgical intervention.Case Report: A 5-year-old girl was accidentally shot in the lower back with an air gun. The CT scan imaging shown a retained projectile in the pedicle of S1 vertebrae without vascular injury or unstable vertebral fracture. A minimally invasive, full-endoscopic surgical technique was applied to remove the bullet in this patient. On post-surgical follow-up, the patient was in a good recovery state.Discussion: Surgical intervention is needed for decompression, stabilization, and diminished risks of lead toxicity. The percutaneous endoscopic approach is the least invasive intervention performed to ensure a targeted approach through the anatomical openings of the spine and through intervertebral discs and bone structures, thereby further reducing spinal instability, blood loss, and infection risk.Conclusion: The endoscopic operation of minimally invasive surgical techniques is an effective operative approach not only limited in spinal stenosis cases, but also in air gun injuries.
Characteristics of CTEV Patients at Orthopedic and Traumatology Outpatient Clinic in Datu Beru General Hospital Takengon Central Aceh Period August 2018-July 2022 Ongko Setunggal Wibowo; Subhan Thaib
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.33-39

Abstract

Background: Congenital Talipes Equinovarus (CTEV) is a congenital disorder commonly occurring in newborns. The word talipes equinovarus comes from Latin: tali mean ankle, pes means foot, equino means plantar flexion, and varus means midline deviation. CTEV cases occur 1-2: 1000 live births, cases in males are more frequent than in females and can occur unilateral or bilateral. Bilateral conditions occur in half of the total number of cases. The aim of this study is that, in the future, especially parents know about this disorder so there will be no misinformation. Methods: This study uses a descriptive research method with a cross-sectional design that aims to determine the characteristics of CTEV patients at the Orthopedic and Traumatology Outpatient Clinic in Datu Beru General Hospital Takengon Central Aceh for August 2018-July 2022. Sampling was carried out by non-probability sampling and using the purposive sampling technique. This is a non-random sampling technique with specific considerations from the researcher (inclusion and exclusion criteria). Results: The number of births in Central Aceh Regency from August 2018-July 2022 amounted to 15,206. The incidence of CTEV in that period was 22 cases with a ratio of 1.4: 1000 live births. Conclusion: Males 15 cases (53.6%) and females 13 cases (46.4%). The age of patient's brought by parents was mostly1-6 months, with as many as 12 cases (42.9%). Bilateral conditions were 13 cases (46.4%), and 15 (53.6%) were unilateral. On average, patients with CTEV were corrected 5.2 times using the Ponseti method.
Epidemiology of Genu Varum Patients In Dr. Soetomo General Academic Hospital Surabaya 2010-2018: A Retrospective Study Hidayatullah, Ronaa Nuqtho; Martanto, Tri Wahyu
Journal Orthopaedi and Traumatology Surabaya Vol. 11 No. 2 (2022): October 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v11i2.2022.40-48

Abstract

Background: Genu varum is a condition where the legs bend inward, resembling the letter "O," leading to gait disturbances and other lower-limb deformities. Data on genu varum, particularly regarding its prevention, is still lacking. This study aimed to identify the epidemiological characteristics of patients with genu varum to improve prevention, management, and prognosis, and to provide data for future research.Methods: This descriptive study employed a retrospective research design. Total sampling was used, including all genu varum patients from the Department of Orthopedics and Traumatology database at Dr. Soetomo General Academic Hospital Surabaya between 2010 and 2018. Data was collected from medical records and patient home visits.Results: Thirty-one patients were included in the study, with 21 males (68%) and 10 females (32%). The mean age of the patients was 4.3 years, with an average age at first complaint of 1.8 years. The average birth weight was 3.49 kg, and the average body mass index was 26.3. Langenskiold stage distribution was as follows: I (3%), II (70%), III (3%), IV (8%), V (3%), and VI (13%). Eighteen patients (58%) had bilateral Blount disease, seven (23%) had unilateral Blount disease, and six (20%) had physiological genu varum. Eighteen patients underwent conservative treatment, and 13 underwent operative treatment.Conclusion: Blount disease is the most common cause of genu varum at Dr. Soetomo General Academic Hospital, particularly in the infantile group. The majority of patients were male and received conservative treatment.

Page 7 of 11 | Total Record : 103

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