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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
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
Acute compartment syndrome of the forearm after trans-radial approach to percutaneous coronary intervention: a case report Istan Irmansyah Irsan; Satria Pandu Persada Isma; Alifian Alifian; Muhammad Alwy Sugiarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 2 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005502202308

Abstract

Percutaneous coronary intervention (PCI) through transradial pathway is associated with lower risk of severe vascular problems comparing to transfemoral. It is reported that the acute compartment syndrome (ACS) in forearm is significant lower comparing to leg. A 47 y.o. male with ACS following a transradial approach of PCI due to inferior myocardial infarction was reported. The patient experienced pain and swelling in his right forearm for 7 hr after the procedure and was later brought to hospital and treated with emergency of fasciotomy. The patient showed good post-fasciotomy recovery on the first 2 wk and showed good DASH score after 4 wk. Quick diagnosis with prompt treatment makes a better outcome for the patient. Consequently, a high level of awareness to make the diagnosis as quickly and accurately management as possible could prevent morbidity caused by late and unrecognized management compartment syndrome eventually could make a better clinical outcome.
A Case Report of Radiation Therapy as Definitive Treatment for Desmoid Tumor in a Young Girl Rafiq Sulistyo Nugroho; Irma Darinafitri; Eviana Norahmawati; Istan Irmansyah Irsan; Satria Pandu Persada Isma
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.977

Abstract

Introduction: Desmoid tumor is a benign growth that can exhibit aggressiveness and various patterns, resulting in a wide range of management methods. These methods include observation to active interventions, such as surgery, radiation, and systemic therapy. Therefore, this case report aimed to present the role of radiation therapy for desmoid tumors in a young girl who refused limb amputation to preserve the organ.Case Presentation: This study presented the case of a 13-year-old girl with a vast and painful desmoid tumor in the left upper arm. Magnetic resonance imaging (MRI) on the left shoulder showed an 8 x 9 x 17 cm solid soft tissue mass on the left deltoid muscle with the necrotic component that expands to adjacent cutaneous and subcutaneous tissue. In this case, the left humerus attaches to the deep brachial artery and vein. Previous pathological studies with immunohistochemicals showed desmoid fibromatosis. A multidisciplinary team discussion led to the selection of, radiotherapy for treatment because of tumor localization and proximity to the critical structure. Radiation was also selected as the definitive therapy of choice with the aim of local control and organ preservation. Furthermore, the radiation dose was 56 Gy in 2 Gy per fraction over six weeks. After six months of follow-up, the patient reported pain relief, improved range of motion, and reduced tumor size.Conclusion: Radiotherapy reduced desmoid tumor size and improved symptoms without compromising organ function in young girls.