Evaluation and redesign of osteosynthesis plate, prodused in Indonesia

Indonesia is a disaster-prone country with many traffic accidents.. As a result, many people suffer from broken bones and need orthopaedic surgery, including osteosynthesis plates to fix them. The high demand for osteosynthesis plates cannot be fulfilled by import only, because of their high price, import-limitations and distribution-problems. The solution for these problems is clear: manufacturing osteosynthesis plates locally. Several Indonesian “back yard” manufacturers produce these plates, but they are hardly used because their quality is not known and has not been scientifically evaluated. In this study we have evaluated the quality of osteosynthesis plates produced in Indonesia based on biological, biomechanical, and metallurgical phenomena, which revealed that the surface quality of the Indonesian plates is good. However, Indonesian plates were found to be less strong as the standard European plates and showed higher susceptibility to corrosion due to the use of inferior material.. We proposed and studied ways to improve the performance of the Indonesian plates: Better quality control will ensure the use of the proper, corrosion-resistant material and a reproducible geometry, thus consistent strength. Strength can be further increased by creating the final shape by cold work and by applying Surface Mechanical Attrition Treatment (SMAT). A simple machine was designed to apply SMAT. Test results showed that the newly designed Indonesian plates were much stronger, even as strong as the standard plate. This study therefore showed that it is possible to manufacture an osteosynthesis plate in Indonesia with simple means, possessing a quality that is comparable to the standard plate.

Accuration of Fine Needle Aspiration Biopsy in Musculoskeletal Tumour

Fine needle aspiration biopsy (FNAB) has been reported to be the preferable choice of biopsy for musculoskeletal tumour. While FNAB appears to have advantages to core biopsy in the aspect of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. This research was designed to evaluate the diagnostic accuracy of fine needle aspiration in musculoskeletal tumour in Sardjito Hospital from 2010 until 2014. This was a descriptive study from medical record in Sardjito Hospital from 2010 until 2014. The inclusion criteria are musculoskeletal tumours in all age level that has been performed FNAB with subsequent operative treatment and confirmation of histopathology examination in Sardjito Hospital. There were 41 elligible subjects in this study. Concordance diagnosis of FNAB and histopathological examination in all musculoskeletal tumor cases was found to be 86%. In addition, the concordance in soft tissue tumor cases was 94% with the detail as follows: giant cell tumor was 86%, synovial sarcoma was 50% and liposarcoma was 50%. In bone tumours, the accuracy was found to be 60% with the detail as follows: distribute osteosarcoma was 60%, osteochondroma was 50% and chondrosarcoma was 50%. Our data showed that accuracy of FNAB for diagnosis of musculoskeletal tumours was 86% with soft tissue tumour 94%, bone tumour 60% and others 93%. Therefore, Fine needle aspiration biopsy is still important diagnosis tool in musculoskeletal tumours

Accuration of Fine Needle Aspiration Biopsy in Musculoskeletal Tumour

Fine needle aspiration biopsy (FNAB) has been reported to be the preferable choice of biopsy for musculoskeletal tumour. While FNAB appears to have advantages to core biopsy in the aspect of simplicity and cost, the diagnostic accuracy should be the most critical parameter in determining the choice of biopsy. This research was designed to evaluate the diagnostic accuracy of fine needle aspiration in musculoskeletal tumour in Sardjito Hospital from 2010 until 2014. This was a descriptive study from medical record in Sardjito Hospital from 2010 until 2014. The inclusion criteria are musculoskeletal tumours in all age level that has been performed FNAB with subsequent operative treatment and confirmation of histopathology examination in Sardjito Hospital. There were 41 elligible subjects in this study. Concordance diagnosis of FNAB and histopathological examination in all musculoskeletal tumor cases was found to be 86%. In addition, the concordance in soft tissue tumor cases was 94% with the detail as follows: giant cell tumor was 86%, synovial sarcoma was 50% and liposarcoma was 50%. In bone tumours, the accuracy was found to be 60% with the detail as follows: distribute osteosarcoma was 60%, osteochondroma was 50% and chondrosarcoma was 50%. Our data showed that accuracy of FNAB for diagnosis of musculoskeletal tumours was 86% with soft tissue tumour 94%, bone tumour 60% and others 93%. Therefore, Fine needle aspiration biopsy is still important diagnosis tool in musculoskeletal tumours

Treating natural disaster victims is dealing with shortages:An orthopaedics perspective

During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on imported ones. One of the alternatives is utilization of local resources, but only after they have been proven safe to use, and meet the international standards set. Through this paper we would like to urge the international community to include locally produced biomedical products, like osteosynthesis plates in their scientific evaluations and communications. When the quality of local products is proven, the reluctance to use local products also by surgeons from developing countries will disappear and larger scale production can be initiated. This in its turn solves many problems that come after natural disasters and stimulates the national economy in an efficient and effective way

SCAFFOLD DARI BOVINE HYDROXYAPATITE DENGAN POLY VYNIALCHOHOL COATING

In Indonesia, it is about 40% patients with hard tissue defect due to ostheoporosis, cancer or accidents and therest are defect since they have born.For many years, efforts for recovering have been done by transplantation orimplantation methods.Transplantation is more appropriate butit is not sustain because of limited donor, whileimplantation using synthetic materials such as bioceramics scaffoldis expensive due to import and the scaffold iseasier to break which does not match to the medical requirements.The research therefore has been addressed to thisissue. Local bovine hydroxyapatite (bHA)scaffold has been used as thebase material and poly vynilalchohol (PVA)as a coating material.The bHA scaffold was prepared by cutting a fresh bovine bone in the size of 5mmx5mmx5mmand boil it in a distilled water to remove its organic material. It was then heated up at 900 oC for 2 hours infurnace to obtain bovine hydroxyapatite scaffold (bHA). Coating process has been carried out by dip coating of thebHAscaffold in PVA solution

SCAFFOLD BHA/GELATIN DENGAN PELAPIS PVA UNTUK APLIKASI IMPLAN

Hard tissue defect, particularly at the bone structure, is a common problem in Indonesia causing improper function. About 60% of it is caused by defects that occur since birth, and the rest is caused by other factors, such as accidents. To treat these problems, medical doctor usually carry out transplantation or implantation. Implantation is done by filling the bone cavity with biomaterial made from Ca/P-based material, such as hydroxyapatite (HA). In the form of powder, pure HA is difficult to be formed into a certain shape and geometry since this material is brittle and has a high melting point (1400 oc), which is impossible to reach in a surgery environment. Additionally, in the form of macro-porous blocks, they are very weak and easy to break, far from the requirements. In order to form pure HA at room temperature and still fulfill the required strength, other biocompatible materials are needed. In this work, HA, gelatin and PVA were used to form samples. The HA was derived from bovine bone, bioactivity and oteoconductivity. Gelatin was used as a matrix of the composite, whilst Polyvynil Alchohol (PVA) acted as a coating. The HA was derived by calcination of bovine chips at 900 oC for 2 hours, while the gelatin (G) and PVA were supplied by commercial purchase. The ratio of [G/bHA] to distilled water (H2O) was 30%, 40% dan 50% w/v. PVA 0.2% w/w coating was done by dipping the block in liquid nitrogen (N2). Tests were performed by DTS and microstructure analysis was carried out by SEM. The results show that sample with [G/bHA] of 50% w/v gave DTS of 6.219 MPa. This tensile strength matched the strength of human bone from a 62 year old person.