Journal Orthopaedi and Traumatology Surabaya

Back Matter

Back Matter — Tue, 30 Apr 2024 00:00:00 +0000

Back Matter

Clinical Characteristic of Patients Underwent Bone Mineral Density Examination in Prof. Dr. R. Soeharso Orthopaedic Hospital in 2022-2023: A Cross-Sectional Study

R. Andhi Prijosedjati, Pamudji Utomo, Leli Sabariyah, Ahmad Fauzi — Tue, 30 Apr 2024 00:00:00 +0000

Background: In Indonesia, osteoporosis affects roughly 23% of men and women aged 50-70 and a staggering 53% of those over 70. Understanding the characteristics of patients undergoing bone mineral density (BMD) examinations is crucial for developing better strategies for prevention, diagnosis, and treatment. This study investigates the characteristics of patients who had BMD examinations at the Prof. Dr. R. Soeharso Orthopaedic Hospital.

Methods: A cross-sectional study was conducted at Prof. Dr. R. Soeharso Orthopaedic Hospital from April 2022 to April 2023, using a total sampling approach and data extracted from digital medical records. The variables included age, gender, body mass index (BMI), BMD T-score from the lumbar spine, hip, and forearm, frequency and location of fragility fracture (FF), osteoporosis frequency, and fracture risk assessment (FRAX) score for major osteoporotic fracture (MOF) and hip fracture. Patients with incomplete data were excluded.

Results: This study involved 168 patients, mainly women (83%) and men (17%). Most (81.5%) were aged 50-74, with osteoporosis affecting 29.2% and severe osteoporosis affecting 60.7%. The spine was the most common site of FF (88.2%). Osteoporosis severity correlated with higher BMI (p<0.05). FRAX scores for MOF and hip fractures were mostly in the low-risk category.

Conclusions: A high prevalence of osteoporosis and severe osteoporosis among women, particularly those in the age of 50 to 74 years, and higher BMI was correlated with greater severity of osteoporosis. FF was found more common among women with the spine as the most frequently affected site.

The Risk Factors of Patients with Cruris Fracture Nonunion in dr. Mohamad Soewandhie Hospital in 2021 - 2022: A Case- Control Study

Regina Clarissa, Bimo Sasono, Ni Njoman Juliasih — Tue, 30 Apr 2024 00:00:00 +0000

Background: The crural region is highly susceptible to injury in Indonesia, with fractures being a common occurrence. However, if not properly treated, these fractures can lead to complications such as nonunion. To investigate the risk factors for nonunion cruris fractures, this study was conducted at Dr. Mohamad Soewandhie Hospital, examining age, gender, working status, education, trauma mechanism, and previous treatment history.

Methods: This case-control study analyzed patient records from 2021-2022 at Dr. Mohamad Soewandhie Hospital, comparing 12 nonunion and 24 union cruris fracture cases. Data on age, gender, work, education, trauma, and treatment history was collected between August and October 2023. Statistical analysis was performed using the Mcnemar and Wilcoxon tests, with a significance level of p < 0.05.

Results: A study of 149 cruris fractures found 12 nonunions, primarily affecting males aged 26-45 or 46-65. Notably, the highest nonunion rate (41.7%) was in the 12-25 age group (p = 0.027). Males were more affected, with 7 nonunion cases (58.3%) (p = 0.041). Working class patients had the highest fracture and nonunion rates (83.3%) (p < 0.001). High school education was most common among nonunion cases (75%) (p = 0.374). High-energy trauma was reported in almost all nonunion cases (91.7%) (p < 0.001). All nonunion patients had a history of ORIF (p = 0.102).

Conclusions: The study revealed that age, gender, work status, and trauma mechanism significantly influenced nonunion cruris fractures at Dr. Mohamad Soewandhie Hospital in 2021-2022. Patient education and past treatment history, however, had no significant impact.

Characteristics of Nonunion Fractures in Patients with Antebrachial Fractures at dr. Mohamad Soewandhie General Hospital Surabaya 2021-2022: A Retrospective Study

Tasya Monica, Bimo Sasono, Cempaka Harsa Sekarputri — Tue, 30 Apr 2024 00:00:00 +0000

Background: Nonunion, a complication of fracture healing, can lead to patient morbidity. Contributing factors include age, gender, fracture type, multiple fractures, infection, prolonged nonsteroidal anti-inflammatory drug (NSAID) use, smoking, nutritional status, and history of chronic disease. This study aims to determine the prevalence and characteristics of nonunion antebrachial fractures at dr. Mohamad Soewandhie General Hospital Surabaya.

Methods: This retrospective descriptive study involved 111 patients. Data was gathered from medical records treated at dr. Mohamad Soewandhie General Hospital Surabaya for antebrachial fracture during 2021-2022. The study protocol obtained approvals from two local ethical committees. Data included demographics, fracture characteristics, fracture type, multiple fractures, infection, NSAID use, hypertension and diabetes history, smoking habits, and nutritional status by BMI calculation.

Results: This study found a 24.3% prevalence of antebrachial nonunion fractures at dr. Mohamad Soewandhie General Hospital Surabaya in 2021-2022, mostly in males (66.7%) aged 17-25 years (22.2%). Nonunion in antebrachial fractures is marked by high rates in closed (92.6%) and single fractures (92.6%). Notably, infections (22.2%), smoking (7.4%), and hypertension history (7.4%) are common contributors. Despite ideal BMI in many cases (44.4%), nonunion still occurred.

Conclusions: The study conducted at Dr. Mohamad Soewandhie General Hospital in Surabaya revealed a high prevalence of antebrachial nonunion fractures at 24.3%, particularly among young males. It was found that closed, single fractures were the most common type, with infections, smoking, and a history of hypertension being significant contributing factors. Interestingly, even individuals with an ideal BMI were still at risk for nonunion.

Front Matter

Front Matter — Tue, 30 Apr 2024 00:00:00 +0000

Front Matter

Bioanthropological and Biomechanical Perspectives on Skeletal Senescence Variation: A Literature Review

Sayf Muhammad Alaydrus, Muhamad Andri Jauhari — Tue, 30 Apr 2024 00:00:00 +0000

Background: Senescence is the deterioration of the body's biological and physiological function throughout later life. Senescent populations are more prone to diseases, though other than osteoporosis, skeletal senescence is a less discussed topic in Indonesia. Furthermore, a global and national increase in the aging population showed that they will be a major group in society, thus raising the urgency to review this matter. This study aims to comprehend the physiological and biomechanical mechanisms of skeletal senescence, as well as senescent variations in a certain sex or population affinity.

Literature Review: Age-related skeletal cellular death and imbalance contribute to bone damage in elders. Senescence also affects skeletal biomechanics, expressed in increased bone porosity and brittleness. Stresses in aged bone risk straining above its elastic limit and causing fractures due to its inability to tolerate stresses. The loss of sex hormones is related to skeletal senescence, especially in females, though the effects of testosterone on skeletal senescence are underresearched. Dietary change, estrogen replacement therapy, and calcitonin consumption are effective measures in reducing the effects of osteoporosis. Variations were found in the bone aging process in different populations, especially regarding bone mineral density loss in white, African-American, Asian, and Hispanic populations.

Summary: Specific population-based healthcare services in geriatrics and gerontology are highly suggested to ensure inclusive healthcare for every aged individual. Due to the minimum data about bone aging in Indonesia (other than osteoporosis), the authors encourage data procurement on local populations to create more suitable medical guidelines for elders in Indonesia.

Thumb Arthrodesis in The Arthritis Cases: A Scoping Review

Ghifar Akbar, Viskasari Pintoko Kalanjati, Teddy Heri Wardhana — Tue, 30 Apr 2024 00:00:00 +0000

Backgrounds: Osteoarthritis in the thumb is a common condition affecting men and women, especially postmenopausal women, causing pain, swelling, and reduced hand function. Arthrodesis is a treatment option for thumb arthritis, increasingly accessible in medical practice, though coverage remains limited. This article aims to review recent case reports on thumb arthrodesis in older people over the last three years, depicting the method's use and outcomes.

Methods: After filtering per PRISMA-Sc guidelines on PubMed and the Journal of Hand Surgery (2020-2023), with additional manual filtering, four articles were found and analyzed using the JBI Critical Appraisal Checklist for Case Reports before inclusion.

Result: Four case reports related to pollex arthrodesis in the last three years were published in PubMed. These include rare cases of bilateral thumb psoriatic arthritis, a novel surgical approach for nonunion after arthrodesis, and successful fusion using a vascularized bone graft. The limited number of articles may be attributed to the research cycle, shifting focus, and alternative treatments. With increased healthcare access and osteoarthritis prevalence, more people will seek treatment, potentially leading to increased arthrodesis procedures. Opportunities for new research include evaluating surgical techniques, biomaterials, and growth factors to enhance bone healing. Long-term follow-up studies remain crucial for identifying risk factors and improving patient outcomes in thumb arthrodesis.

Conclusion: Despite limited research published in the last three years, arthrodesis remains a relevant treatment option for pollex conditions, with rising demand due to increasing osteoarthritis prevalence and healthcare access. Further research on surgical innovations and long-term outcomes is crucial.

Medial Plantar Artery Flap for Soft Tissue Coverage of Heel Defect: A Case Report

Ramadhani Hengki Wijaya, Achmad Fachrizal — Tue, 30 Apr 2024 00:00:00 +0000

Background: Numerous flap options exist for providing soft tissue coverage for defects on the heel region. This study presents a case where a bone-exposed wound on the left heel region was successfully reconstructed using a medial plantar artery flap.

Case Report: A 16-year-old girl presented with a necrotic wound on the left heel region with calcaneus, malleolus, and talus fractures following trans-ankle external fixation on her left leg. After debridement and necrotomy, the wound revealed exposed calcaneus and implant. A medial plantar artery flap was dissected, preserving its vascularization. The flap was then carefully transferred to the wounded area and sutured appropriately. A skin graft harvested from the ipsilateral femoral region was used to cover the donor site.

Discussion: This case demonstrates the efficacy of the medial plantar artery flap as a local flap option for heel defect coverage. It is a relatively easy-to-perform procedure that provides a strong and thin skin flap. Moreover, it offers a favorable cosmetic outcome for the patient, as the surgical scar can be be relatively easy to hide with footwear. However, limitations of the medial plantar artery flap include its size and depth constraints, as well as loss of vascularization from a medial plantar artery on the plantar region.

Conclusion: The medial plantar artery flap is a feasible option as a local flap for the heel region. It is relatively easy to perform, provides a strong thin skin flap, and can results in a preferable cosmetic outcome.

The Application of Posterior Plate in Tibial Plateau Fracture: A Case Report

Muhammad Zaim Chilmi, Firas Febrian — Tue, 30 Apr 2024 00:00:00 +0000

Backgrounds: Tibial plateau fracture is the most frequent type of fracture caused by motor-vehicle collision. This injury may or may not be associated with soft tissue injury, such as the knee's ligaments. Posterior tibial plateau fractures are a rare subtype that requires surgical intervention. This case report describes the outcome of posterior plating in treating a posterior tibial plateau fracture.

Case report: A 41-year-old female patient came to the emergency room (ER) after being involved in a traffic collision. The patient underwent a thorough medical examination, which revealed the tibial eminence avulsion associated with the fracture of the head of the fibula. Surgical treatment was performed using a posterior approach through an inverted L-shaped incision.

Discussion: Tibial plateau fractures are serious injuries that often require surgery. However, the decision to operate depends on several factors, including the morphology of the fracture, the patient's profile, the condition of the soft tissues, and the expected recovery of the articular surface and the axis of the limb.

Conclusion: A surgical technique using a posterior approach through an inverted L-shaped incision with a small medial T-plate, lateral bone graft, and roof K-wire fixation demonstrates positive outcomes for treating closed posterior tibial plateau fractures and avulsion fractures of the tibial eminence.