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<![CDATA[RISK FACTORS FOR IMPAIRED BONE DENSITY IN MALE PATIENTS UNDERWENT HEMODIALYSIS DUE TO CHRONIC KIDNEY DISEASE ]]>
<![CDATA[Patritius Kelik Dwi Santo Ismoyo]]>;
<![CDATA[Sugeng Yuwana]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 2 (2018): October 2018 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v7i2.2018.125-131
<![CDATA[Background: Chronic kidney disease (CKD) is associated with impairment of mineral metabolism that, in turn, may result in the derangement of bone density, i.e. osteopenia or osteoporosis. Purpose: The objective of this study is to assess the impairment of bone density in male patients underwent routine hemodialysis due to stage V CKD.Methods: Subjects in this cross sectional study were male patients underwent routine hemodialysis in Hemodialysis Unit Dr. Sardjito General Hospital Yogyakarta in June 2014. Subjects were invited when they were over 18 years old and had undergone hemodialysis for at least 6 months. Bone density of lumbar spine, total hip and femoral neck were assessed using DEXA. We collected information on age and the etiology of the CKD from medical records. Body weight and height were measured using calibrated apparatus. Data were analyzed using OpenEpi.Results: We invited 30 male patients with mean (SD) age of 56.8 (13.8) years. Bone density of lumbar spine and femoral neck were significantly associated with the duration of hemodialysis, i.e. OR (95% CI) of 31.7 (3.8-856.0), p=0.0003 and 12.0 (1.9-111.0), p=0.005, respectively for those underwent hemodialysis of more than 12 months. Obesity was only protective for the bone density of the total hip, OR(95%CI) of 0.1 (0.004-0.9), p=0.03. There was no association between the etiology of the CKD and the decrease in bone density.Conclusion: This study observed significant association between the duration of hemodialysis and bone density.]]>
<![CDATA[ORTHOPAEDIC EMERGENCY CASES AT HASAN SADIKIN HOSPITAL BANDUNG CAUSED BY TRADITIONAL BONE SETTER PRACTICE ]]>
<![CDATA[Hantonius Hantonius]]>;
<![CDATA[Hermawan Nagar Rasyid]]>;
<![CDATA[Gibran Tristan Alpharian]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 1 (2018): April 2018 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v7i1.2018.77-84
<![CDATA[Traditional bone setting is common in developing nations. The practitioners are barely educated and rely so much on experience. Although they are popular in public, traditional bone setter are known in hospital practice for their failures and complications which present to hospitals for remediation.The purpose of the study is to report the orthopaedic emergency cases caused by the practice of traditional bone setter. This was an observational descriptive study, 36 patients with complications after practice of traditional bone setters and subsequently presented to emergency ward in Hasan Sadikin Hospital between 1st January 2015 and 31st August 2017 were evaluated.Among emergecy orthopaedic cases at Hasan Sadikin Hospital caused by bonesetter practice, compartment syndrome and gangrene are the most common complications occured. Twenty patients (56%) with infected wound and compartment syndrome had successful operation., thirteen patients (36%) with gangrene of the extremities had amputations, and three patients (11%) with multiple organ failure died. Twelve percent of amputations in our centre were related to bonesetter practice.The result of this study indicates that traditional bone setters practice may caused patients to develop complications, lose their limbs even lives due to inappropriate treatments.]]>
<![CDATA[ADOLESCENCE TIBIAL TUBERCLE AVULSION FRACTURE: OPTION OF SURGICAL TREATMENT IN WORSENING CONDITION OF PRE-EXISTING OSGOOD-SCHLATTER DISEASE (OSD) ]]>
<![CDATA[Fira Soraya]]>;
<![CDATA[Ritzky Pratomo Affan]]>;
<![CDATA[Bagus Danu Hariyanto]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 2 (2020): October 2020 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v9i2.2020.55-62
<![CDATA[Background: Osgood-Schlatter disease (OSD) is the most frequent cause of chronic knee pain in adolescents. Tibial tubercle avulsion fractures are an infrequent injury, approximately between 0.4-2.7% of all epiphyseal injury. Even though the relation between OSD and tibial tubercle avulsion fracture is still controversial, there are cases previously reported with this presentation.Case Report: A 16-years-old boy complained of pain on his left knee, significantly below the patella with ambulation limitation. He had a two-months history of knee pain in the same location and prominence on the area below the patella that was getting more significant over time. The patient was actively involved in volleyball in his school. The radiographic findings show fragmented tubercle fractures on the left tibial, soft tissue swelling in the tubercle's anterior side, and increased density of the infrapatellar fat pad. The patient underwent ORIF with screws. After a one-month post-surgery, the patient felt minimal pain when bending his left knee.Discussion: Male adolescents (12-15 years) and repetitive sprinting and jumping sports are the risk factors for OSD. About 90% of cases show a complete resolution, but some conditions make the OSD worse, such as low compliance at exercise avoidance. Surgery is rarely indicated for OSD, but in the condition of, even though very uncommon, tibial tubercle avulsion fracture, surgery gives a better outcome and resolution.Conclusion: All Osgood-Schlatter disease' patients should temporarily restrict sports activities to prevent tibial tubercle avulsion fractures.]]>
<![CDATA[CLINICAL APPLICATION OF BONE MORPHOGENETIC PROTEIN ON FRACTURE HEALING PROCESS ]]>
<![CDATA[Riko Febrian Kunta Adjie]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 6 No. 2 (2017): October 2017 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v6i2.2017.48-54
<![CDATA[Delayed union or non-union often occurs in bone healing fracture process. The clinical application of Bone Morphogenetic Proteins (BMPs) has helped an increasing number of patients achieve bone regeneration in clinical area lacking simple solutions for difficult bone healing situations. Many researches has proved that BMPs improved fracture healing regeneration. In this review article, introduction and current clinical issues are summarized on efficacy and function of BMPs. Currently, rhBMP-2 and rhBMP-7 have shown clinical significance but other subfamily members of BMPs still lacked of evidence.]]>
<![CDATA[DEGENERATIVE SCOLIOSIS: A CASE REPORT ]]>
<![CDATA[I Ketut Martiana]]>;
<![CDATA[M Mukaddam Alaydrus]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 2 (2019): October 2019 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v8i2.2019.104-110
<![CDATA[Background: Scoliosis in adults is a spinal deformity in adult patients with a Cobb angle of more than 10° in the coronal plane. Degenerative scoliosis is a term used for the presence of spinal coronal deviation in the elderly population due to segment degeneration. This case report presents a quite different management option, namely applying intraoperative vertebral correction to the subject. The operative procedure carried out on the patient has experienced success as indicated by improvement in symptoms and curve progressiveness in patients.Case: A patient suffers degenerative scoliosis at Surabaya RKZ Hospital. Data is taken from medical records, patient clinical records, home visits, and physical examination of patients.Discussion: From the results of the post op clinical examination, it was found that pain complaints improved compared to pre-op complaints. From the results of the post op radiological examination, the position of fixation was good, there was no spondylolisthesis, lumbar dextroscoliosis (+), lumbar spondylosis (+), drain tip as high as Th12-L1.Conclusion: Giving operative management can directly improve the patient's quality of life and reduce symptoms experienced in a shorter time.]]>
<![CDATA[DOUBLE FREE FUNCTIONING MUSCLE TRANSFERS FOR BRACHIAL PLEXUS INJURIES: A CASE REPORT ]]>
<![CDATA[Heri Suroto]]>;
<![CDATA[Teddy Heri Wardhana]]>;
<![CDATA[Farindra Ridhalhi]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 8 No. 1 (2019): April 2019 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v8i1.2019.19-24
<![CDATA[Free functional muscle transfer for brachial plexus injury is one of the alternatives to repair the upper extremity function, where usually one type of muscle is used, the gracillis. The method of using two donor muscles to restore the motor function is worth considering for a better improvement of the quality. A 36 years old man with a complete left brachial plexus injury from C5-T1 due to motorcycle accident. A double free functional muscle transfer was performed using the gracillis muscle and the adductor longus muscle with the arterial source from the thoraco-acromial artery with the phrenic and accessory nerves. The gracillis muscle is used to flex the fingers while the adductor is used for flexing the elbow. A one year post-operative evaluation showed the patient was already capable of flexing his elbow with the muscle score of 3 and also the fingers with the muscle score of 1. The double free functional muscle transfer procedure is effective in achieving the moving function of both the elbow and the hand.]]>
<![CDATA[THE EFFECT OF PLATELET RICH PLASMA ON MESENCHYMAL STEM CELLs (MSCs) DIFFERENTIATION INTO CHONDROBLAST ]]>
<![CDATA[Dwikora Novembri Utomo]]>;
<![CDATA[I Gde Adi Widiastana]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 6 No. 2 (2017): October 2017 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v6i2.2017.80-85
<![CDATA[The addition of platelet rich plasma to mesenchymal stem cell culture on growth media and chondrogenic media had any effect on stem cell’s proliferation and differentiation into chondroblast has not been determined. This research is to find out the effect of platelet rich plasma on mesenchymal stem cell’s differentiation and proliferation into chondroblast on in vitro media. Randomized control group posttest only design. Blood was taken from the rabbit’s vein to be processed into platelet rich plasma (PRP). Mesenchymal Stem Cell (MSC) was harvested from the bone marrow of the rabbit to be cultured. The MSC’s culture were divided into three groups of modification. The first group was combination of MSC added with Complete Culture Medium (CCM) and Chondrogenic Diferentation Medium (CDM) without PRP as control group. The second group had the same combination as the first group with extra 5% PRP. The third group had the same combination as the first group with extra 10% PRP. The results were evaluated in the following 21 days. The group that received extra 5% PRP had significant increase of chondroblast count compared to the group without PRP addition (p=0,033). The same result also occured on the groups that received extra 10% PRP compared to the group without PRP addition (p=0,028). There were no significant diferences between both the second and the third groupchondroblast count (p=0,203). There was a significant effect of platelet rich plasma on mesenchymal stem cell’s diferentiation and proliferation into chondroblast on invitro media.]]>
<![CDATA[GIANT CELL TUMOR OF THE RIBS: A CASE REPORT ]]>
<![CDATA[I Putu Gede Pradnyadewa Pradana]]>;
<![CDATA[Mouli Edward]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 10 No. 1 (2021): April 2021 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v10i1.2021.32-38
<![CDATA[Background: Giant Cell Tumor (GCT) is a benign tumor but can be malignant and spread to other organs. Common site of GCT develops in long bone, especially in the knee. A lesion that develops in flat bone is considered rare. This case report aims to recognize GCT of bone and its predilection and help improve diagnostics and manage this case to provide better results.Case Report: A seven-year-old female came with complaints of lump and intermittent pain in left-back. The lump is gradually getting more prominent. The pain is localized in the back mid-area, worsen with any touch around the area. On examination, there is deformity and mass on the posterolateral side at the 9th rib level around 3 cm in diameter. There was tenderness on palpation and limited range of motion (ROM). The cytological and radiological finding suggests GCT of bone. The patient had resection surgery of the lesion. The histopathologic results on the operative specimens confirmed the diagnosis of GCT.Discussion: An unusual location of GCT lesions needs to be a concern because they can be underdiagnosed not to receive optimal therapy. Inadequate therapy can increase the incidence of recurrence and malignancy changes. In this case, the patient had resection surgery. Postoperatively, the patient is in good condition with no sign of local recurrence.Conclusion: GCT should be included in the differential diagnosis of rib-originated tumors. Tumor lesions in unusual places other than long bones and occurs on the immature patient should be particular concern and confirmed diagnosis.]]>
<![CDATA[THE ROLE OF PLATELET-RICH FIBRIN FACILITATES THE HEALING OF GASTROCNEMIUS MUSCLE DEFECT: A PRELIMINARY STUDY ON ANIMAL MODEL ]]>
<![CDATA[Dwikora Novembri Utomo]]>;
<![CDATA[Kukuh Dwiputra Hernugrahanto]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 7 No. 1 (2018): April 2018 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v7i1.2018.31-41
<![CDATA[Background: Scar formation has been a classical issue in the healing of skeletal muscle defect which will results in decrease of strength and function. Platelet-rich plasma (PRP) has been studied to enhance the healing of muscle defect. The disadvantages of it include the risk of immunologic reaction, time-consuming preparation, and lack of scaffold element. Platelet-rich fibrin (PRF) is a new generation of platelet concentrate that provides good source of growth factors and scaffold element necessary for the healing. This study is to provide a fondation of PRF preparation and implantation for the healing of experimental defect of gastrocnemius muscle in an animal model.Purpose: The goal is to provide a fondation of PRF preparation and implantation for the healing of experimental defect of gastrocnemius muscle in an animal model.Methods: Animal Care and Use Committee, Airlangga University approved the study. Twenty New Zealand white rabbits were divided into two groups. In control group, a defect was created in the right gastrocnemius and no implantation was done. In study group, similar defect was created with implantation of PRF. Two and four weeks after surgery, the defect was examined immunohistochemically for the expression of Pax7 protein.Results: The implanted group showed higher IRS score in two and four weeks compared to the control group.Conclusion: The use of PRF facilitates the healing of muscle injury. This study will be used as a fondation for further study on PRF.]]>
<![CDATA[CONGENITAL PSEUDOARTHROSIS TIBIA IN CHILD WITH NEUROFIBROMATOSIS TYPE 1 TREATED WITH THE COMBINED VASCULARIZED FIBULAR GRAFT AND ELASTIC STABLE INTRAMEDULLARY NAIL (ESIN) ]]>
<![CDATA[Sulis Bayusentono]]>;
<![CDATA[Trixie Brevi Putri]]>
<![CDATA[ Journal Orthopaedi and Traumatology Surabaya Vol. 9 No. 1 (2020): April 2020 ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/joints.v9i1.2020.22-28
<![CDATA[Background: CPT is a disorder characterized by nonunion tibial fracture that occurs spontaneously or after trivial trauma. Therapy usually includes surgical management and aims to gain lifetime bony union, avoid leg length discrepancy, and to prevent mechanical axis deviation, surrounding soft tissue lesion, joint stiffness, and pathological fracture. CPT remains to be a challenging orthopedic issue due to the difficulty to gain and to maintain the union and functional limb. The combined VFG and ESIN is one of our preferred method in Surabaya. Case: A 13-year-old boy complained about crooked right lower leg since 1-year old, and fractured at 11 years old. In January 2014, the patient underwent ORIF ESIN combined with free VFG. The patient got bony union 24 months after the ORIF ESIN and VFG surgery. RUST modified scoring system showed a score out of 3, which signified that there was a radiographically significant union at the site of tibial pseudoarthrosis. Discussion: The combined VFG and ESIN is to maintain bony union and stability. Intramedullary fixation offers a good tibial alignment and prevents refracture. Hypertrophy and the vitality of VFG support the bony union. The level of success rate in both primary and secondary union is a benefit shown after VFG therapy. Conclusion: Combination of VFG after complete resection of tibial pseudoarthrosis and ESIN in this case report showed a success in achieving and maintaining the bony union, thus this therapy became one of the preferences as a suitable standard therapy that we use in our hospital institution.]]>
