Jurnal Orthopaedi dan Traumatologi Indonesia

Strong Correlation Between Disabilities of Arm, Shoulder and Hand Score and Modified Mayo Wrist Score Affected by Radius Union Scoring System and C-Reactive Protein in Patients with Conservatively Managed Distal Radius Fracture

2024-01-15T14:50:52+00:00

Introduction:
Fractures of the distal radius are the most common fractures in the upper extremity. The conservative management of these fractures often yields favorable outcomes, which can be measured using various scoring systems, and are often associated with controlled inflammatory response. This study aims to determine whether the Modified Mayo Wrist Score (MMWS) can be an alternative to the gold standard Disabilities of Arm, Shoulder and Hand (DASH) score. Additionally, we investigate the effect of the Radius Union Scoring System (RUSS) and the C-Reactive Protein (CRP) inflammatory marker to those scores.

Material & Methods:
Patient samples were consecutively taken from a population of patients with conservatively managed distal radius fractures using a cast. The patients were treated with a cast for 6 weeks, followed by a radiographic evaluation to assess the RUSS score and blood sampling in the 9th week to measure CRP level. In the 12th week, the DASH and MMWS were assessed.

Result:
Correlative analysis showed a strong correlation between MMWS and DASH score, and a predictive correlation between RUSS and CRP level toward MMWS and DASH score.

Conclusion:
The MMWS scoring system correlates with the DASH score, making it a promising scoring system in clinical practice, while a high RUSS score and low 9th-week CRP level can cause better functional outcomes in patients with conservatively managed distal radius fracture.

Returning to Sport After Anterior Cruciate Ligament Reconstruction in Active Non-Athlete Individual: A Literature Review

2024-05-07T03:08:05+00:00

Anterior cruciate ligament (ACL) tears frequently occur as sports injuries, particularly in active young individuals. ACL reconstruction is a standard treatment for active individuals seeking to return to sports. Prehabilitation and post-operative rehabilitation therapy play crucial roles in strengthening the quadriceps and hamstrings before ACL reconstruction, facilitating the healing process, and enabling a return to sports at the pre-injury level. However, determining the appropriate time to resume sports activities after the injury is a complex and multifaceted decision-making process. Many criteria are considered for returning to sport after ACL reconstruction. Most surgeons suggest that individuals return to sports after nine months, with a limb symmetry index greater than >90% symmetry LSI criteria in hop tests and individuals exhibiting greater psychological readiness were more likely to return to sports.

Current Update in Achilles Tendon Rupture Management: Operative or Nonoperative?

2024-04-15T00:59:05+00:00

The Achilles tendon is the most commonly ruptured tendon in the foot and ankle region. The peak incidence of Achilles tendon rupture occurs in the age range of 30-49 years, with a higher prevalence among males. Various risk factors, including aging, obesity, episodic athletic activity, engagement in high-impact sports, antibiotic use, and systemic factors, contribute to the occurrence of Achilles tendon rupture. Beyond the injury mechanism, it is crucial to assess any history of minor or repetitive trauma to the Achilles tendon and identify associated risk factors. Thorough examination and comparison of both the affected and unaffected sides are essential. While the diagnosis of Achilles Tendon Rupture is primarily clinical, radiological imaging can aid in visualizing the tendon gap. Treatment options for Achilles tendon rupture include conservative and surgical approaches. Despite a lower re-rupture rate associated with surgical treatment, recent evidence suggests that conservative treatment provides comparable results. However, return to activity was found to be better in surgical treatment with early rehabilitation

Outcome Comparison Between Percutaneous Vertebroplasty Versus Conservative Treatment in Osteoporotic Vertebral Compression Fracture: A Systematic Review and Meta Analysis

2024-02-22T15:34:17+00:00

Introduction:
Osteoporotic vertebral compression fractures (OVCFs) are common in older adults and cause chronic back discomfort and kyphotic deformity. Percutaneous vertebroplasty (PVP) is preferred over conservative treatment (CT) for pain relief and quality of life improvement. However, there are ongoing debates about PVP's effectiveness and safety, with some suggesting it should only be available to patients who have exhausted other non-invasive options.

Methods:
A systematic review was conducted following the principles outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A thorough literature search was conducted to get a complete, peer-reviewed manuscript in English that compares the outcomes of vertebroplasty versus conservative therapy in osteoporotic compression fractures. We conducted a comprehensive search on PubMed, Google Scholar, and Cochrane Library. This systematic study aims to compare the therapeutic efficacy of vertebroplasty versus conservative therapy.

Results:
The electronic investigation identified 236 entries from various databases, screening them for eligibility, assessing duplicates, and eliminating duplicates, resulting in 9 studies for qualitative and quantitative synthesis. The heterogeneity across studies was examined throughout the I2 statistic described as follows: low, 25% to 50%; moderate 50% to 75%; or high>75%. There is no significant difference found in 1 week and 3 months of pain relief in these two groups in pain relief (mean difference 0.73 (-0.52, 1.96); 95% CI, P = 0,25); (mean difference -0.76 (-2.02, 0.49); 95% CI, =0.23). we found no statistically significant difference between those two groups favoring the PVP group in terms of quality-of-life outcome (mean difference -0.76 (-2.02, 0.49); 95% CI, P < 0.23); (mean difference 1.75 (-0.87, 4.38); 95% CI, P < 0.19). PVP has no association with new adjacent vertebral fractures. (M-H, Fixed, 95% CI
-0.07 (-0.17, 0.03); I2 = 0%, P = 0.16).

Conclusion:
Comparatively, percutaneous vertebroplasty was determined to be more effective in alleviating pain and enhancing quality of life, without posing an elevated risk of nearby vertebral fracture as compared to the CT group. Therefore, it is necessary to conduct a more extensive investigation to determine which patients with osteoporotic vertebral compression fractures (OVCFs) are most likely to experience a positive outcome following percutaneous vertebroplasty (PVP) with little risk of sequelae.

The Relationship between Morphometry of The Proximal Femur Bone and The Type of Proximal Femur Bone Fracture in The Elderly Female Population at RSUP H. Adam Malik Medan from 2017 to 2022

2024-04-15T00:56:15+00:00

Background:
Fractures of the pelvic bone are frequently encountered in elderly patients and are often associated with increased mortality rates. At the moment, identifying osteoporosis as a risk factor for proximal femur fractures is the primary focus. The morphometry of the proximal femur can also be utilized to predict the risk factors for proximal femur fractures. This study was conducted to assess the relationship between proximal femur bone morphometry and proximal femur fractures in elderly women at H. Adam Malik General Teaching Hospital, Medan.

Material & Methods:
This study is an observational analytical research aimed at investigating the relationship between the morphometry of the proximal femur bone and the type of proximal femur bone fracture in an elderly female population. The study will adhere to predetermined inclusion and exclusion criteria. The morphometric variables measured in this study are hip axis length (HAL), femoral head diameter (FHD), femoral neck length (FNL), femoral neck diameter (FND), horizontal offset (HO), and femoral neck shaft angle (FNSA).

Result:
This study collected 90 samples, with 15 of them not meeting the inclusion and exclusion criteria, resulting in a final sample size of 75. Out of 75 research samples, the Hip Axis Length (HAL) has an Eta test value of 0.264. The Femoral Head Diameter (FHD) has an Eta test value of 0.162. The Femoral Neck Diameter (FND) has an Eta test value of 0.276. The Femoral Neck Length (FNL) has an Eta test value of 0.277. The Horizontal Offset (HO) has an Eta test value of 0.277. The Femoral Neck Shaft Angle (FNSA) has an Eta test value of 0.488.

Conclusion:
This study reports a weak correlation between the morphometry of hip axis length, femoral neck diameter, femoral neck length, femoral neck diameter, and horizontal offset of the proximal femur with proximal femur fractures. Furthermore, a moderate correlation was found between the morphometry of the femoral neck-shaft angle of the proximal femur and the type of proximal femur fracture.