Jurnal Orthopaedi dan Traumatologi Indonesia

A Tuberculous Osteomyelitis Late Finding Affected The Fifth Metatarsal

2023-06-17T07:18:03+00:00

Many studies have reported osteoarticular involvement of tuberculosis, but few cases of tuberculous osteomyelitis of the foot have been reported. We describe a case of tuberculous osteomyelitis affecting the fifth metatarsal bone in a 56- 56-
year-old diabetic male patient and review the literature describing clinical manifestations, imaging aspects, and management of skeletal tuberculosis. A 56-year-old male patient presented with severe pain and swelling in his left leg for the past 6 months. He had no history of trauma. He had fever over his two months, had no cough, had lost weight, and had light sweats at night. His pain and swelling did not subside despite oral medication. The patient was diabetic. The patient also had radiating pain from his lower back to his left leg and numbness all over his lower back.

Tuberculosis is a widespread problem in Indonesia. It can affect any part of the body. However, the feet are rarely affected. Tuberculosis is on the rise and it is important to recognize the less common symptoms of this disease to allow early diagnosis and successful treatment. In urban areas where TB prevalence is high, there may be no TB exposure or 'typical' symptoms and signs. Radiological features are non-specific, so indicators of high suspicion are required. Patients with suspected risk factors or tuberculosis should have a biopsy to make the diagnosis and start treatment.

Management of Polytrauma Patient in a Limited Setting : A Case report

2023-09-08T08:18:03+00:00

Polytrauma patients with multiple fractures present a significant challenge in limited resources settings. The application of damage control orthopedics (DCO) principles, including temporary stabilization, staged definitive fixation, and multidisciplinary collaboration, resulted in favorable outcomes for the patient. This case report describes the successful management of a polytrauma patient who sustained multiple injuries, including unstable pelvic fracture and fractures of the femur, radius, shoulder dislocation, and distal radio-ulnar joint dislocation. This report emphasizes the importance of timely intervention and resource optimization in limited settings.

Open Reduction and Internal Fixation with Tension-Band Wiring and Cerclage for 8 Years Neglected Patellar Fracture: A Case Report

2023-09-14T04:33:59+00:00

Introduction: Fractures of the patella are serious injuries commonly caused by direct trauma of the anterior knee surface. Various techniques such as tension band wiring (TBW) and cerclage wiring have been proposed.
Case: A 55-year-old woman who had a neglected left patellar fracture for 8 years. Radiographic evaluation revealed complete fracture of the left patellar bone with displacement and visible callus, fusion of the superior patellar fragment with the epi-metaphysis of the right femur with soft tissue swelling, malunion impression, left patellar subluxation anteriorly and grade III osteoarthritis. An open reduction internal fixation using tension band wire and cerclage was performed and postoperative evaluation revealed acceptable alignment of the patella and implant. Total Bostman knee was 28 points to analysis knee function.
Discussion: TBW is one of treatment methods for patella fracture fixation by counteracting muscle traction, maintaining the reduction and transforming the tensile forces between the quadriceps muscle and the anterior tibia tuberosity to
compress the patella articular cortex during knee flexion. It also stabilizes the fracture and enhances bone healing by closing the fracture gap and maintaining the interfragmentary contact. Cerclage wire is passed through the quadriceps and patellar tendon. Knee immobilization is unnecessary and the functional outcome is always adequate.
Conclusion: TBW with cerclage is favorable to stabilize a neglected transverse patella fracture. It is associated with satisfying clinical outcome and less complications. The placing of the tension band close to the patella decreases the
rate of major loss of reduction and implant failure.

An Update of Tuberculosis Spondylitis and The Holistic Management by Subroto Sapardan Total Treatment: Literature Review Study

2023-06-17T07:18:53+00:00

Tuberculosis spondylitis or Pott disease is a pathological condition that is caused by infection of Mycobacterium tuberculosis and manifests a combination of osteomyelitis and arthritis that usually involves more than one vertebrae. It has recently shown a significant resurgence in developed nations secondary to global migration. Concurrent with this phenomenon, multidrug-resistant bacterial strains of tuberculosis have been increasing in developing nations over the past decades. This reality causes TB spondylitis to be a serious disease with several diagnostic and treatment challenges. One of the treatment methods for tuberculosis spondylitis that has been established in Indonesia is the Subroto Sapardan Total Treatment Protocol, by emphasizing holistic from basic to advanced treatment, this protocol is effective in treating the spondylitis.

The Pathomechanics, Clinical Assessment and Management of Hallux Valgus: A Literature Review

2023-07-22T14:10:24+00:00

Hallux valgus, the most common forefoot deformity, can restrict movement and cause pain. There are several internal and external variables that contribute to the development and advancement of the hallux valgus. Several conservative and surgical treatment methods must be determined depending on the severity of the bunion, as well as any concomitant foot and ankle diseases. Only when the condition is still in its early stages can conservative management stop the progression of hallux valgus. Surgical treatment of hallux valgus is technically difficult and carries a high risk of recurrence and complications.

Doctor, will my sleep improve after the rotator cuff surgery?

2024-01-08T09:44:12+00:00

A rotator cuff tear (RCT) is one of the most common causes of disability and shoulder pain, especially in older individuals due to age-related degeneration. It is not uncommon for patients to experience sleep disturbances due to aggravated pain at night. However, only around 15% of people may have an asymptomatic RCT.¹

Sleep disturbance is a common finding in patients with RCT. A systematic review showed that only 11% of symptomatic rotator cuff patients were without sleep disturbances.²The quality of sleep has become an important component of our health that requires attention in patients with a rotator cuff tear.
Unfortunately, in the field of orthopedics, sleep disturbances were considered trivial and underappreciated, perhaps due to many related conditions
that may contribute to sleep disturbances.

Total Knee Replacement in Valgus Knee

2023-09-22T03:41:52+00:00

Total knee replacement (TKR) in valgus knee patients presents unique challenges and requires careful consideration of various factors to ensure optimal outcomes. Valgus knee deformity can be associated with various underlying conditions,
including autoimmune diseases like rheumatoid arthritis. Nearly 10% of patients undergoing total knee replacement have valgus knee deformity, which is associated with poorer functional outcomes than varus knees. When planning TKR
procedures for patients with valgus knee deformity, it is crucial to identify the underlying reason, as the surgical strategy and implant selection may vary according to the individual etiology and patient factor. Proper alignment and stability of the knee joint need precise bone cuts, soft tissue balance, and implant design. Soft tissue balance ensures optimal joint function and range of motion. A comprehensive pre-operative planning process that takes into account these factors
is essential for achieving the best possible outcomes and patient satisfaction in TKR for valgus knee patients. Different surgical approaches, such as the medial parapatellar and lateral parapatellar approaches, offer distinct advantages and
disadvantages in treating valgus knee patients, and the choice of approach should be based on the surgeon's expertise and the patient's specific anatomy and deformity. For a successful output, the coronal, sagittal, and rotational alignment
must be in proper proportion. Therefore, before performing a total knee replacement on a valgus knee, it is necessary to have a thorough understanding of the problem and the treatment options available.