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Irsan, Istan Irmansyah
Universitas Of Brawijaya
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Peroneal Nerve Function and Knee Stability after Resection Giant Cell Tumour of Proximal Fibula, A Serial Case Mustaqim, Warih Anggoro; Isma, Satria Pandu Persada; Irsan, Istan Irmansyah
Berkala Kedokteran Vol 14, No 1 (2018)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/jbk.v14i1.4588

Abstract

Abstract: Giant-cell  Tumour (GCT ) is a benign Tumour, locally aggressive neoplasm which is composed of sheets of neoplastic oviod mononuclear cells uniformly distributed large, osteoclast like giant cell. Incidence GCT of proximal fibula is rare. Peroneal nerve function and stability of knee joint must be considered at the proximal fibula GCT. In 2017 we found three cases of GCT of the proximal fibula in the outpatient clinic Saiful Anwar General Hospital. All three of these patients had a confirmed GCT of proximal fibula  which planned for Tumour resection, peroneal nerve presevation and LCL ligament reconstruction. This is study of three patients with  GCT of proximal fibula was confirm with Clinical Pathological Confrence (CPC). All of patient had presented of lump,  slowly growing pain in lateral side of knee, limping when they walk and numbness in dorsal side of foot. One patient cannot dorsoflexion of ankle. We evaluated a peroneal nerve function and stability of knee after operation and one year after resection of tumour. All patient had occurred peroneal nerve lesion with no instability of knee post operatively. Two patient had complaint with numbness in dorsal side of foot and weakness ankle dorsoflexion and after one year both of patient had improved ankle dorsoflexion but still numbness in dorsal side of foot. One patient  still complaining numbness in dorsal side of foot and weakness ankle dorsoflexion post operation and one year after operation. There is no LCL ligament instability  in all of patient post operation and one year after operation. The peroneal nerve function and LCL ligament stability must consider when facing benign tumours in proximal fibula such as giant cell tumour proximal fibula. These resections result in an unavoidable loss of knee stability because of resecting the lateral collateral ligament (LCL) insertion site on the fibular head. Based on the literature, the incidence rate of postoperative peroneal nerve palsy ranges from 3% to 57%. Giant cell tumour in proximal fibula is rare and require wide excision with intraarticular resection of the proximal tibiofibular join. We must consider about peroneal nerve function and LCL ligament stability during resection of GCT proximal fibula. Keywords: Giant Cell Tumour Proximal Fibula, Peroneal Nerve function, LCL Ligament stability
Musculoskeletal Tumor Profile in Saiful Anwar General Hospital Malang from January 2011-December 2017 Satria Pandu Persada Isma; Istan Irmansyah Irsan; Brian Dhananjaya
Berkala Kedokteran Vol 14, No 2 (2018)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (429.062 KB) | DOI: 10.20527/jbk.v14i2.5336

Abstract

Abstract: Primary tumours of musculoskeletal tissues are relatively uncommomn, they represent only 1% of all malignancies in all ages groups, but the incidence is arising each year. Many medical research and experiments were developed to found appropriate methods of treatment for tumor patients. Mortality rates of malignant musculoskeletal tumor patients still higher than benign cases. The aim of this study was to describe the incidence, age and sex distribution, location and histology of benign and malignant musculoskeletal tumors diagnosed and/or treated at a tertiary referral Orthopaedic Department serving the East Java. This was a retrospective analysis of prospectively collected data of medical records of all patients diagnosed and/or treated for any type of musculoskeletal tumor at Orthopaedic and Traumatology Department of Saiful Anwar Hospital, in the period from January 2011 to December 2017. This study resulted there were 531 cases of musculoskeletal tumor, within the characteristic: the peak of incidence occurs in the patient older than 60; the highest case was Osteosarcoma (92 cases); and breast metastases (40 cases) distributed highest mortality rates for metastastic bone tumor patients. Result of this study was people at age 60 and older have higher risk for Muskulokeletal Tumor, and Osteosarcoma was the most frequent case.  Keywords: Musculoskeletal tumor, data based system, incidence, East Java
The Effect of CaCl2 Added PRP (Platelet Rich Plasma) to the Healing Time, Tensile Strength and Adhesion Degree of the Ruptured Tendinopathic Achilles Tendon of Rats (Rattus norvegicus) Istan Irmansyah Irsan; R. Muhammad David Jayanegara
Berkala Kedokteran Vol 15, No 1 (2019)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (369.489 KB) | DOI: 10.20527/jbk.v15i1.6123

Abstract

Abstract: Achilles tendinopathy produce morbidity, long-lasting disability in athletes and non-athletes and remain a challenge for clinician. Tendinopathy may lead to reduced tensile strength and a predisposition to rupture.The aim of our study was to evaluate the effects of activated and non-activated PRP on the healing process of ruptured tendinopathic achilles tendon in rat. Tendinopathy achilles condition induced by injecting collagenase bacterial type-1 locally. Right achilles tendon in 48 rats ruptured by transecting it transversely and repaired it by using a Kessler technique. Further, the wound immobilized with PRP and injecting activated PRP (5% CaCl2 added) in  one group, non-activated PRP on the other group and saline on control group. Tendons from each group were collected at the 1st and 2nd week postoperatively also assessed for biomechanical test. Tendons were also evaluated histologically by using hematoxylin-eosin to know adhesion degree based on Tang criteria. The significant differences was found between intervention group and control (p<0.05) at the 1st week but there was not any significant differences at the 2nd week in tensile strength test (p>0.05). Adhesion degree of the intervention group also reduce better rather than the control at the 1st and 2nd week (p<0.05). PRP have a positive effect on healing tendons by improving healing time, mechanical strength and decreasing adhesion degree. Keywords: achilles tendinopathy, PRP, healing time, tensile strength, adhesion
Profile of Musculoskeletal Tumor in Saiful Anwar General Hospital Malang from January 2011 until December 2018 Istan Irmansyah Irsan; Satria Pandu Persada Isma; Abdul Aziz; Muhammad Hilman Bimadi; I Gusti Ngurah Arga Aldrian Oktafandi
Berkala Kedokteran Vol 16, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.542 KB) | DOI: 10.20527/jbk.v16i2.9218

Abstract

Abstract: Musculoskeletal tumors are relatively rare, with 0.2%-0.5% of all malignant tumors in all ages. The geographic distribution of musculoskeletal tumors varies significantly around the world. This study aims to describe the musculoskeletal tumor profile in Saiful Anwar General Hospital. All data were obtained from the department of orthopaedic and traumatology database, Saiful Anwar general hospital. Thus, patients who were diagnosed with either bone tumor or soft tissue tumor between January 2011 to December 2018 were selected for the present study. The clinical-pathological conference (CPC) was carried out to ensure the validity of all the registered data. A total of 577 patients with tumors from January 2011 to December 2018 was obtained. Out of all the cases, 439 (76%) cases are bone tumors, and the remaining 138 (24%) cases are soft tissue tumors. The most frequent locations of the musculoskeletal tumors are the long bones of the thigh and lower leg. This study shows an increasing trend in musculoskeletal tumors incidence, despite decreasing numbers in several years. This result goes along with a rising trend in malignancy cases with a higher amount compared to the benign one. Moreover, MBD and osteosarcoma were found to be the most common tumor and primary bone tumors, respectively. However, the fact that there is some data loss in the study limited the study for a more accurate result.   Keywords: Musculoskeletal tumor; Bone tumor; Osteosarcoma; Malang; East Java
Peroneal Nerve Function and Knee Stability after Resection Giant Cell Tumour of Proximal Fibula, A Serial Case Warih Anggoro Mustaqim; Satria Pandu Persada Isma; Istan Irmansyah Irsan
Berkala Kedokteran Vol 14, No 1 (2018)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (541.41 KB) | DOI: 10.20527/jbk.v14i1.4588

Abstract

Abstract: Giant-cell  Tumour (GCT ) is a benign Tumour, locally aggressive neoplasm which is composed of sheets of neoplastic oviod mononuclear cells uniformly distributed large, osteoclast like giant cell. Incidence GCT of proximal fibula is rare. Peroneal nerve function and stability of knee joint must be considered at the proximal fibula GCT. In 2017 we found three cases of GCT of the proximal fibula in the outpatient clinic Saiful Anwar General Hospital. All three of these patients had a confirmed GCT of proximal fibula  which planned for Tumour resection, peroneal nerve presevation and LCL ligament reconstruction. This is study of three patients with  GCT of proximal fibula was confirm with Clinical Pathological Confrence (CPC). All of patient had presented of lump,  slowly growing pain in lateral side of knee, limping when they walk and numbness in dorsal side of foot. One patient cannot dorsoflexion of ankle. We evaluated a peroneal nerve function and stability of knee after operation and one year after resection of tumour. All patient had occurred peroneal nerve lesion with no instability of knee post operatively. Two patient had complaint with numbness in dorsal side of foot and weakness ankle dorsoflexion and after one year both of patient had improved ankle dorsoflexion but still numbness in dorsal side of foot. One patient  still complaining numbness in dorsal side of foot and weakness ankle dorsoflexion post operation and one year after operation. There is no LCL ligament instability  in all of patient post operation and one year after operation. The peroneal nerve function and LCL ligament stability must consider when facing benign tumours in proximal fibula such as giant cell tumour proximal fibula. These resections result in an unavoidable loss of knee stability because of resecting the lateral collateral ligament (LCL) insertion site on the fibular head. Based on the literature, the incidence rate of postoperative peroneal nerve palsy ranges from 3% to 57%. Giant cell tumour in proximal fibula is rare and require wide excision with intraarticular resection of the proximal tibiofibular join. We must consider about peroneal nerve function and LCL ligament stability during resection of GCT proximal fibula. Keywords: Giant Cell Tumour Proximal Fibula, Peroneal Nerve function, LCL Ligament stability
Co-Authors Abdul Aziz Brian Dhananjaya I Gusti Ngurah Arga Aldrian Oktafandi Muhammad Hilman Bimadi R. Muhammad David Jayanegara Satria Pandu Persada Isma Warih Anggoro Mustaqim Warih Anggoro Mustaqim, Warih Anggoro