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Andri M.T. Lubis
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Medicine & Pharmacology

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Child abuse, a case report Lubis, Andri M.T.; Hadi, Syaiful A.
Medical Journal of Indonesia Vol 13, No 1 (2004): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (196.673 KB) | DOI: 10.13181/mji.v13i1.124

Abstract

Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65) Keywords: child, abuse
The use of ceftriaxone impregnated beads in the management of chronic osteomyelitis Lubis, Andri M.T.; Tobing, S. D.L.; Siregar, Paruhum U.
Medical Journal of Indonesia Vol 14, No 3 (2005): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (371.86 KB) | DOI: 10.13181/mji.v14i3.195

Abstract

Up to now, orthopaedic management of chronic osteomyelitis is still problematic. Debridement and antibiotic administration is still a widely practiced management. However, oral or parenteral antibiotics often cannot reach the infection site well. Some experts have developed a system to administer local antibiotic in the form of antibiotic beads. Antibiotic beads on the market are still very expensive. Therefore, we made efforts to make our own antibiotic beads by using ceftriaxone as the antibiotic. Ceftriaxone impregnated beads were made by mixing 2 grams of Ceftriaxone powder with 40 grams of polymethyl methacrylate (PMMA) bone cement sterilely. The size of the beads was 3 x 5 mm. Thirty male rabbits that were induced to get osteomyelitis by inoculating Staphylococcus aureus to their left radius bones were used. In the fourth week, clinical, radiological, histological examination and bacterial culture were performed to prove the presence of osteomyelitis. Then, the samples were divided into 3 groups of ten. The first group only underwent debridement. The second group underwent debridement followed by intravenous ceftriaxone administration. The third group underwent debridement followed by intravenous ceftriaxone and ceftriaxone-impregnated beads administration. After four weeks, clinical, radiological, histological examination and bacterial culture were repeated. In the first group, the incidence rate of osteomyelitis at the end of the fourth week of therapy was 60% (success rate 40%). In the second group, after four weeks of therapy the incidence rate of osteomyelitis after treatment was 20% (success rate 80%), whereas that of the third group was 0% (success rate 100%). In conclusion, the efficacy of combination of systemic antibiotic therapy and ceftriaxone impregnated beads in the therapy of chronic osteomyelitis is better than systemic antibiotic therapy. (Med J Indones 2005; 14: 157-62)Keywords: debridement, polymethyl methacrylate
The effects of intra-articular tranexamic acid given intraoperatively and intravenous tranexamic acid given preoperatively on post surgical bleeding and transfusion rate post total knee arthroplasty Triyudanto, Aryo N.; Lubis, Andri M.T.
Medical Journal of Indonesia Vol 25, No 4 (2016): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.086 KB) | DOI: 10.13181/mji.v25i4.1502

Abstract

Background: Despite the advances in the design and fixation of implants in total knee replacement (TKR). the amount of postoperative bleeding is still an important issue that has not been resolved. This study aimed to measure the effectiveness of various tranexamic acid administration.Methods: This was a randomized controlled trial study, held from August 2014 to February 2016 at Cipto Mangunkusumo Hospital, Jakarta. Twenty two patients having TKR were divided into three groups: the control group, the tranexamic acid intra-articular-intraoperative group, and the intravenous preoperative group. Intraoperative bleeding, haemoglobin (Hb) level on preoperative to five-day-post-surgery, total drain production, total blood tranfusion needed and the drain removal timing were recorded and compared. Numerical data were analyzed by using parametric and non-parametric test, depended on the normality of the data.Results: The amount of blood transfusion needed in both the intra-articular group (200±SD 100 mL) and the intravenous group (238±SD 53 mL) were significantly different compared to those in the control group (1,016±SD 308.2 mL) (p=0.001). Meanwhile, there was no significant difference between the amount of blood transfusion needed in the intra-articular group and the intravenous group. Total drain production in the intra-articular group (328±SD 193 mL) and intravenous group (391±SD 185 mL) was significantly different compared to the control group (652±SD 150 mL) (p=0.003). No significant difference between the levels of both preoperative and postoperative haemoglobin, the amount of intraoperative bleeding, and the duration of drain usage.Conclusion: Intravenous and intra-articular tranexamic acid effectively decreased transfusion volume and drain production in patients undergoing TKR.
Modified exorotation graft tension for tibial fixation in anterior cruciate ligament reconstruction: a randomized controlled trial Pontoh, Ludwig A.P.; Dilogo, Ismail H.; Bardosono, Saptawati; Lubis, Andri M.T.; Harahap, Alida R.; Pandelaki, Jacub; Hidayat, Mohammad
Medical Journal of Indonesia Vol 27, No 3 (2018): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (893.664 KB) | DOI: 10.13181/mji.v27i3.1765

Abstract

Background: The inability of anterior cruciate ligament reconstruction (ACLR) surgery to reduce tibial internal rotation causes many problems. A large tibial internal rotation will result in a patellofemoral pain syndrome. This study aimed to introduce a new technique of modified exorotation graft tension at tibial fixation to minimize endorotation, reduce tibial internal rotation, and prevent patellofemoral pain syndrome.Methods: This study was a randomized double-blind controlled clinical trial. ACL rupture patients underwent ACLR surgery between December 2014 and Februrary 2015. They were randomized to standard endorotation group or modified exorotation group. Hamstring autograft was used and fixed with an EndoButton® and bioabsorbable interference screw. Tibial tubercle to trochlear grove (TTTG) was used to evaluate rotation, whereas cartilage oligomeric matrix protein (COMP) was employed to analyze cartilage breakdown. The functional outcome was measured using the Kujala score to assess patellofemoral joint function. Evaluations were conducted before the surgery and at 6 months postoperation.Results: A total of 29 subjects were recruited. Sixteen subjects were allocated into the standard endorotation group, and 13 were assigned to the modified exorotation group. The exorotation group demonstrated better results than the endorotation group in all three parameters: TTTG (p=0.028), COMP (p<0.001), and Kujala score (p=0.015).Conclusion: A new technique of modified exorotation direction of graft tension for ACL reconstructive surgery at tibial fixation showed a significant reduction in tibial internal rotation and cartilage breakdown. The proposed method could significantly improve the functional outcome of those with total ACL rupture.
Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage Putro, Rizky N.H.; Priyamurti, Heka; Lubis, Andri M.T.
Medical Journal of Indonesia Vol 22, No 2 (2013): May
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (468.511 KB) | DOI: 10.13181/mji.v22i2.530

Abstract

Background: Osteoarthritis (OA) is the most common knee degenerative disease, the number of OA patients increases along with the increase of life expectancy. Distraction arthroplasty is a less invasive alternatif for OA management by releaving mechanical stress while maintaining intermitten joint fluid pressure changes, thus halting the OA destructive cycle and inducing repair. This study aims to evaluate the anatomical and histopathological changes after distraction arthroplasty on osteoarthritic animal models.Methods: The study was performed on 32 goat stiffle joint (16 goats) with mechanically induced OA by lateral meniscectomy. During the study 6 goats were decreased. Distraction arthroplasty was performed using external fixation on 10 knees for 4 weeks, and the contralateral knees left untreated. The knees were anatomically and histopathologically examined using International Cartilage Repair Society (ICRS) staging and Osteoarthritis Research Society International (OARSI) scoring. The differences of the anatomical and histopathological changes are tested for significance using the Wilcoxon test.Results: There was anatomical and histopathological worsening of the OA on treated knees. The anatomical difference assessed using ICRS stage gave median values of 1.5 and 2.5 respectively (p < 0.002). The histopathological difference assessed using OARSI scoring was significant (6 vs 10; p < 0.002).Conclusion: Distraction arthroplasty in OA goat models in this study, worsens the OA instead of inducing repair. Further studies are required to find out a convincing biological basis of distraction arthroplasty as an alternative treatment for OA. (Med J Indones. 2013;22:64-9)Keywords: Animal model, distraction arthroplasty, osteoarthritis
Co-Authors Aldo F Marsetyo, Aldo F Bambang Setyohadi Carles Siagian, Carles Erick Wonggokusuma, Erick Harahap, Alida R. Heka Priyamurti Ismail H. Dilogo Mohammad Hidayat Pandelaki, Jacub Paruhum U. Siregar Pontoh, Ludwig A.P. Rizky N.H. Putro S. D.L. Tobing Saptawati Bardosono Syaiful A. Hadi Triyudanto, Aryo N.