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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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Diastasis of Symphysis Pubis In 18-Years Old Female Patient Treated With Conservative Pelvic Binder: Case Report Trisna Angga Basudana; Mifta Nurmalasari; Austana Nur Hafizh; Muhammad Hanun Mahyuddin
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.23-30

Abstract

Background: Pelvic trauma is commonly associated with high-velocity force-like road traffic accidents and carries high rates of complications, including diastasis of the symphysis pubis. The diastasis of symphysis pubis prevalence rate has been reported at 13-16%. This case report aimed to review the effectiveness of conservative pelvic binders in diastasis of the symphysis pubis in the emergency setting.Case Report: An eighteen years old female patient was referred to the Emergency Unit because of a motorcycle accident. She revealed worsening abdominal pain, unable to move both legs and swollen and bruised vulva. The patient is fully conscious, and the vital sign revealed low blood pressure of 89/56 mmHg. The AP pelvis X-ray showed diastasis symphysis pubis marked 3.87 cm wide. Immediate resuscitation was performed, stabilizing the pelvis using a conservative pelvic binder. X-ray evaluation showed surprisingly successful results as the symphyseal gap reduced to 0.66 cm. Discussion: In this case, the symphyseal gap was >2.5 cm, indicating surgical treatment. Recent studies suggest conservative therapy has good outcomes in the symphyseal gap >2.5 cm. Considering the patient's young age and no comorbidities, it was assumed that the healing process would occur quickly, so conservative treatment was chosen first. However, further evaluation is still needed due to the limitation of the follow-up from the patient. Conclusion: Conservative treatment using a pelvic binder called gurita is effective for emergencies with inadequate medical equipment.
Closed Reduction Percutaneous Pinning Compared with Open Reduction Internal Fixation in Treating Supracondylar Fractures: A Systematic Review I Made Yedi Wisnawan; I Kadek Yoga Premana; Anak Agung Ngurah Krisna Dwipayana
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.36-42

Abstract

Background: Supracondylar fractures are one of the most frequent pediatric bone fractures. There are well-known treatments for this fracture. The most commonly used procedure is closed percutaneous reduction pinning, and open reduction internal fixation is for irreducible fractures. This study aims to evaluate and review those two procedures in treating a supracondylar humeral fracture in children by evaluating the clinical and functional outcomes.Methods: Systematic review and meta-analysis (PRISMA) were conducted. Using Boolean operators, literature was searched through PubMed, Google Scholar, Science Direct, and Cochrane Library. The outcomes assessed by Flynn's criteria include functional aspects, cosmetic factors, and other outcomes.Results: From 130 studies obtained, after a full-text review, four studies were included in the systematic review. The total sample size was around 268 patients with a mean age of 4-14. Male patients were higher than females. There is no significant difference in satisfactory outcomes measured by Flynn’s Criteria.Discussion: Flynn's criteria was found to be different in the result of the studies. Insignificant loss of carrying degree and Baumann's angle between two procedures. Some complications, like nerve injury, infection, and scar, were also seen after surgery.Conclusion: The two approaches have an insignificant difference in their functional outcome. The choice of which procedure to perform relies on the surgeon’s preference and the situation of the fractures.
Do We Need A Bone Block Procedure in Recurrent Anterior Shoulder Instability?: A Case Report Hastomo Agung Wibowo; Dadang Rona Sasetyo; Yusa muhammad Thoriq; Felix Giovanni Hartono
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.16-22

Abstract

Background: Recurrent Anterior Shoulder Instability (RASI) is usually preceded by trauma. The incidence recurrence rate is high in trauma Induced RASI, especially in younger patients. The right diagnosis and management must be ruled out immediately for a better outcome. Case Report: The 28-year-old man complained of right shoulder instability for the past eight years, which worsened in the last year. The patient had a history of trauma. Anterior apprehension and relocation test for the right shoulder showed a positive result. Radiologic imaging showed bony bankart loss (27%) and an on-track hillsach lesion of the humeral head. The Instability Severity Index Score (ISIS) is 7 points. Based on these results, an open surgery bone block-Latarjet procedure was done. The surgery was successfully performed, and there was no sign of recurrent instability and pain after one year.Discussion: The number of recurrent shoulder dislocations is over 75%. Bone loss found in the patient will increase the chance of RASI. No block procedure effectively prevented future recurrence from the bone stop effect, which increases the glenoid cavity, stretching effect, and tensioning effect that prevents excessive humeral translation.Conclusion: In the case of RASI, treatment decisions need to be based on the patient's exact condition. Bone block-Latarjet procedure is indicated in patients with bony bankart loss >25%, on track hillsach lesion, and >6 ISIS. In this research, the patient showed improved functional and clinical outcomes after eight years of chronic shoulder instability.
Growth Factor Comparison in Cortical Demineralized Bone Matrix that Demineralized Using Chloric and Acetic Acid Edward, Mouli; Mahyudin, Ferdiansyah; Basuki, Mohammad Hardian; Suroto, Heri; Perwira, Ferdiansyah Danang
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.1-9

Abstract

Background: Demineralized bone matrix (DBM) is an alternative biomaterial for which specific acid and immersion time are needed to optimize growth factor preservation. The optimal demineralization protocol for preserving growth factors in DBM remains unclear. This study investigated DBM extraction methods using different acids and immersion times to maintain optimal growth factor preservation.Methods: This in vitro experimental laboratory study used a randomized controlled post-test-only group design. We characterized the Insulin-like growth factor-1 (IGF-1), Bone morphogenetic protein-2 (BMP-2), and Transforming growth factor-β (TGF-β) content of 1 gram of New Zealand White Rabbit cortical bone immersed in 0.6 M hydrochloric acid and 0.5 M acetic acid for 3, 6, and 9 days. We then analyzed the differences in growth factor levels in each acid and performed statistical analysis.Results: IGF-1 levels were higher in DBM demineralized with acetic acid than with hydrochloric acid. BMP-2 and TGF-β levels were higher in DBM demineralized using hydrochloric acid. The concentration of growth factors decreased over time in DBM demineralized using acetic acid. The highest growth factor level was obtained after 6 days of immersion in hydrochloric acid.Conclusion: DBM demineralized with acetic acid yielded higher average IGF-1 levels compared to hydrochloric acid. However, BMP-2 and TGF-β levels were higher with hydrochloric acid. Growth factor levels in hydrochloric acid peaked at 6 days and then decreased. These results suggest that avoiding over-demineralization is important for maintaining growth factor levels. Further research is needed to optimize DBM processing.
Persistent Chronic Periprosthetic Joint Infection Treated with Three-Stage Revision Hip Arthroplasty: A Case Report Nurul Ramadian; Jifaldi Afrian Maharaja Dinda Sedar
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.31-35

Abstract

Background: Periprosthetic Joint Infection (PJI) is a dreadful complication of primary Total Hip Arthroplasty (THA). Following revision THA, up to 17% of revision THA can be complicated with PJI. Three-stage revision should only be done if simple debridement fails to treat PJI. Here we present a rare case of persistent PJI, treated with three-stage revision and bone grafting.Case Report: A thirty-seven-year-old female patient came with a chief complaint of hip pain four months ago. Four years ago, the patient had a right column femur fracture and was treated with THA. One year afterward, the implant was infected, and the hip was debrided. One year later, the infection symptom recurred, and three-stage revision hip arthroplasty was planned with one year delay for each stage: removal of the implant, replacement of spacer, and reimplantation. The acetabular bone was augmented using autograft from the iliac wing during reimplantation. After reimplantation, the pain subsides, and the patient can walk normally again.Discussion: Previous studies have found various risk factors that might contribute to the failure of two-stage revision arthroplasty. The infecting bacteria is one of the major risk factors, and therefore appropriate antibiotic is important. Augmentation of bone graft can also supplement acetabular bone loss during failed THA as it helps as a scaffold for bone healing.Conclusion: Three-stage revision hip arthroplasty after PJI using bone graft for augmentation is possible with a good result.
Medical Rehabilitation Impact Towards Dynamic Balance in Lateral Ankle Sprain Patients Moses Rizky Haryanto; Jonathan Salim; Nana Novia Jayadi; Mirna Phandu
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 1 (2023): April 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i1.2023.10-15

Abstract

Background: Lateral ankle sprain (LAS) is one of the most prevalent and recurring injuries occurring during physical activities, especially sports. The resulting morbidity forces individuals to limit or change their physical activities. Medical rehabilitation can prevent recurrent injuries by restoring dynamic balance deficits. Previous studies have shown contradictory results. We investigated the effect of medical rehabilitation on dynamic balance in patients with LAS.Methods: This was a numerical, analytical study with a prospective cohort design. Two groups, consisting of 13 LAS subjects each, were purposively chosen. Only the former participated in the three sessions of the rehabilitation program. The modified star excursion balance test was performed initially and three weeks later. Normalized composite scores were recorded in Microsoft Excel and statistically analyzed using SPSS 24 with a 5% significance level.Results: LAS was commonly found in males (57.69%), with an average age of 20.62 ± 6.24 years old, on the dominant foot side (57.69%). Both groups were matched for age (p = 0.292), sex (p = 0.247), and dominant injured foot (p = 0.193). The rehabilitation group presented a greater increase in normalized composite score than the control (∆ = 3.10 ± 4.71 vs. 2.04 ± 7.05, p = 0.654).Conclusion: Dynamic balance increased more in the rehabilitation group than in the control group, but the difference was insignificant. Medical rehabilitation should not be mandatory but optional for patients with LAS with limited resource access. Nevertheless, rehabilitation should be continued for other important aspects of treatment.
Examining The Impact of The COVID-19 Pandemic On Pediatric Orthopedic Cases: A Systematic Review and Meta-Analysis Ahmadin Yusuf Rizal Susatyo; Nizar Al Rhaazi; Farhan Haidar Fazlur Rahman; Ismail Hadisoebroto Dilogo
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.59-65

Abstract

Background: This study examines the adverse effects of COVID-19 pandemic on pediatric orthopedics globally, including decreased patient admissions. The adverse effects of pandemic on pediatric orthopedic patients and surgeries have not been determined. This study aims to conduct a comprehensive systematic review and meta-analysis to investigate the specific impact of COVID-19 pandemic on pediatric orthopedic admissions and surgical cases.Methods: A thorough examination of published literature was performed by searching databases such as PubMed, ScienceDirect, and Cochrane Library, using PRISMA guidelines, and limiting the search to articles published up to January 2022. The primary focus of this review was to inspect the ratio of admission and surgical cases, expressed as a risk ratio (RR) with a 95% confidence level. The study also evaluated any variation among outcomes using the I2 test and examined potential bias using the Egger test. The study findings were calculated using Review Manager 5.4.Results: Fifteen studies were reviewed, revealing a 70% decrease in pediatric orthopedic admissions during the pandemic but no significant difference in admissions between the pandemic and pre-pandemic eras (RR 1.08, 95% CI 0.76-1.54, p=0.66). Furthermore, in the perspective of the pediatric orthopedic surgical case, the pooled analysis also did not show any significant difference between both periods (RR 1.05, 95% CI 0.95 to 1.17, p=0.35). Egger's test result showed no evidence of small-study effects (p = 0.22).Conclusion: This study found that the number of children admitted for orthopedic surgeries and other orthopedic treatments was not greatly impacted during the COVID-19 pandemic.
Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis Andy Lesmana; Hapsari Retno Dewanti; Lenty BR Perangin Angin; Muhamad Irvan Muzakky; Stefi Geovani Valentin Hayon; Mentari Maratus Sholihah; Muhammad Ifham Hanif
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.77-82

Abstract

Background: Musculoskeletal extrapulmonary tuberculosis is accounting for only 10-15% of all cases. Current attention has been focused on hand tuberculosis due to its increasing prevalence. This study describes an unusual case of extrapulmonary tuberculosis that manifested as a soft tissue tumor of the hand.Case Report: A 17-year-old male presented with a painful swollen part of the 3rd finger of the left hand. The mass was irregular and suppurative, with discoloration and foul smell. Laboratory results showed anemia and increased erythrocyte sedimentation rate. The computed tomography scan showed an isodense soft tissue (size 2.19 cm x 1.59 cm x 4.21cm) across the distal to the proximal part of 3rd phalanx bone to the metacarpal region with a decrease of phalanx bone density with no sign of bone destruction or any periosteal reaction. The histopathology study revealed a chronic granulomatous structure surrounded by epitheloid cells, datia Langhans cells, and caseating necrosis. The acid-fast staining confirmed the presence of bacilliform bacteria.Discussion: Extrapulmonary tuberculosis typically results from secondary hematogenous dissemination and reactivation of the main foci. There are no specific tests to diagnose musculoskeletal tuberculosis preoperatively, leading to delayed diagnosis. Histopathological examination and culture are needed to confirm the diagnosis.Conclusions: Slow progression and multiple differential diagnoses frequently result in a delayed diagnosis, which leads to complications. Initial radical excision and anti-tuberculosis multidrug therapy provide excellent functional outcomes and recurrence prevention.
HRQoL Evaluation of Pediatric Osteogenesis Imperfecta with Zoledronic Acid Therapy Martanto, Tri Wahyu; Rahman, Hamzah Rafly; Kurniawati, Patricia Maria
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.49-58

Abstract

Background: Zoledronic acid, a bisphosphonate, increases bone mineral density (BMD), which can reduce clinical manifestations in osteogenesis imperfecta. This study investigates the impact of zoledronic acid therapy on the quality of life of pediatric patients with osteogenesis imperfecta.Methods: A retrospective analytical study was conducted on 16 pediatric patients with osteogenesis imperfecta who received intravenous zoledronic acid. Quality of life was assessed before and after therapy using the PedsQL 4.0 questionnaire. A paired t-test was used to analyze changes in each domain of the PedsQL 4.0. The results were expressed as an adjusted odds ratio with a 95% confidence interval. A p <0.05 was considered statistically significant.Results: A significant increase was found in the children’s self-reported social performance (+12.083, p = 0.023) and proxy-reported physical performance, social performance, and total score (+14.844, p = 0.006; +10.625, p = 0.010; +10.364, p = 0.006, respectively). An insignificant increase was found in child-reported physical performance, school performance, and total score (+8.833, p = 0.148; +5.000, p = 0.359; +7.065, p = 0.115, respectively), and proxy-reported emotional and school performance (+2.500, p = 0.669; +6.250, p = 0.167, respectively). An insignificant decrease was found in child-reported emotional performance (-2.500, p = 0.669).Conclusion: After receiving bisphosphonate therapy, pediatric patients with osteogenesis imperfecta experienced an increased quality of life. Physical and social aspects showed the greatest improvement. Emotional well-being showed the lowest increase in the child's perception, with a decrease in parent perception after therapy.
Characteristics of Low Back Pain Patients at The West Aceh Health Center for The Period January 2022 - June 2023 Adico Notareza Aulia; Safrizal Rahman; Laila Apriani Hasanah Harahap
Journal Orthopaedi and Traumatology Surabaya Vol. 12 No. 2 (2023): October 2023
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v12i2.2023.43-48

Abstract

Background: Around the world, 80% of adults experience low back pain (LBP). LBP frequently results in disability in sufferers, which affects many facets of life. We conducted this study to ascertain the prevalence of low back pain cases in the general clinic of health centers in West Aceh Regency due to the rising incidence of LBP in the world.Methods: To identify the characteristics of LBP (Low Back Pain) patients in the general clinic of health centers in West Aceh Regency from January to June 2023, we utilized a descriptive study approach with a cross-sectional design. Purposive and non-probability sampling were used in this study's sampling procedures.Results: From January 2022 to June 2023, 21.600 patients were registered for care at the general clinic of the health centers in the West Aceh area. 230 LBP patients were diagnosed during that time, or 10,6 cases per every 1000 clinic visits.Conclusion: The results showed that LBP patients who came to the General Clinic of the West Aceh Health Center from January 2022 to June 2023 were mostly in the age group 50-60 years. Namely, 112 samples (48.7%), female gender 140 people (60.9%) and male 90 people (39.1%), and the type of work patients who experience the most LBP are housewives, as many as 61 people from the total sample.

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