Lesi Pleksus Brakialis Tata laksana Komprehensif

Lesi Pleksus Brakialis adalah cedera anyaman saraf tepi di daerah leher (Cervical) dan bahu yang berakibat pada kelumpuhan otot-otot bahu, siku, pergelangan tangan, dan jari-jari tangan. Anyaman saraf tepi daerah Cervical yang dibentuk oleh akar saraf Cervical dan Thoracal, dapat mengalami kerusakan yang disebabkan oleh peregangan yang berlebihan, kompresi, atau terkena benda tajam dan mengakibatkan terputus atau bahkan tercabut. Kerusakan yang terjadi dapat sebagian maupun total dengan level cedera yang bervariasi, baik yang supraclavicular maupun yang infraclavicular. Kelumpuhan akan terjadi pada daerah bahu dan siku, jika kerusakan anyaman saraf tepi terjadi pada anyaman saraf tepi leher bagian atas. Kelumpuhan akan terjadi pada daerah pergelangan dan jari-jari tangan, jika kerusakan anyaman saraf tepi leher bagian bawah. Kelumpuhan pada seluruh anggota gerak atas, mulai dari bahu, siku, pergelangan tangan, dan jari-jari tangan terjadi jika kerusakan anyaman saraf tepi terjadi pada keseluruhan bagian anyaman tersebut

Mesenchymal Stem Cell dan Aplikasinya Pada Rekayasa Jaringan Tendon

Defek tendon akibat kecelakaan kerja, kecelakaan lalu lintas dan bahkan kecelakaan kriminalitas, hingga kini masih merupakan tantangan besar dibidang bedah tangan. Defek tendon fleksor yang sering dijumpai dalam praktek sehari-hari ada 2 jenis. Defek tendon fleksor yang diakibatkan bukan karena kehilangan jaringan tendon tetapi oleh karena tidak tertangani dengan baik (neglected) tendon fleksor yang terputus. Defek tendon fleksor jenis yang lain adalah defek yang disebabkan oleh karena kehilangan jaringan tendon. Penanganan kedua jenis defek tendon fleksor ini pada prinsipnya memerlukan jaringan pengganti. Pilihan jaringan pengganti tendon adalah tendon autograft, tendon allograft, polimer biodegradabel sintetik, dan bahkan rekayasa tendon (tendon tissue engineering)

Tissue Bank and Tissue Engineering

Abstract Permanent damage on the tissue or organ are still a major problem and chalenge to be solved in the world of medicine. Humankind has tried to solve the problem using technologies available in their respective era since long time ago. We can read from various literature about the efforts already made to replace and consequently heal the damaged tissue or organ. Tissue or organ damage caused by war and many other causes became the main reason of the tissue bank's estabilishment in many parts of the earth. Tissue bank strife to provide safe and high quality products to be used as natural biomaterial for damaged tissue reconstruction in patients. Several processes started from procurement, processing, and finally sterilization has been done to guarantee safe and useful products for the patients in need. In line with the recent technological advancement, especially with the introduction of stem cell usage, tissue and organ reconstruction has entered a new era that will bring greater hope for patients. If the previous methods that used biomaterial only employ dead tissue in the reconstruction procedures, tissue engineering will make the combination between stem cell and biomaterial as scaffold possible, thus enabling the living tissue to be used in reconstruction. This method, albeit still in the process of research, is expected to yield better results

Double Free Functioning Muscle Transfers for Brachial Plexus Injures: A Case Report

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

Comparison of clinical evaluation of post-operation patients of open reduction internal fixation (ORIF) plating proximal humerus using conventional methods and minimally invasive plate osteosynthesis (MIPO) in Surabaya

ABSTRACT There are several kinds of approaches in the installation of implants for proximal humerus therapy. At present, minimally invasive surgery is gaining in popularity; this is supported by increasingly good technological developments to optimal the postoperative outcome is more optimal than conventional methods. This study used an analytic retrospective design with samples of post-ORIF Plating MIPO and posted ORIF due to proximal humeral fracture. Evaluation using the instrument of VAS Score, ASES Score, and measurement of range of motion. Statistical tests showed that there was a significant difference in the VAS score at the first evaluation (p = 0.002); the last review was not significant. In ASES Score, abduction, flexion, and external rotation, there were significant differences during the first and last evaluations. Adduction, extension, and internal rotation have no significance. The method of minimally invasive plate osteosynthesis (MIPO) on proximal humeral operative fracture therapy had a better clinical outcome and operating time than post-ORIF plating with conventional methods. As well, the MIPO method on proximal humeral fracture operative therapy based on radiological features has the same union rates compared to post ORIF plating with conventional methods. The method of minimally invasive plate osteosynthesis (MIPO) in operative therapy of neer 2 and 3 proximal humeral fracture has a better clinical outcome than conventional methods.Keywords: proximal humeral fracture, Minimal Invasive Plate Osteosynthesis (MIPO), Open Reduction Internal Fixation (ORIF)Correspondence to: [email protected]  

Immunogenicity of Bone Graft Using Xenograft Freeze-Dried Cortical Bovine, Allograft Freeze-Dried Cortical New Zealand White Rabbit, Xenograft Hydroxyapatite Bovine, And Xenograft Demineralized Bone Matrix Bovine In Bone Defect Of Femoral Diaphysis White Rabbit Experimental Study In Vivo

Bone defect remains a big challenge for orthopedic surgeon. Bone grafting nowadays become the second common transplantation after blood transfusion. Autogenous bone graft is the gold standard in treatment of bone defect, but it’s source limitation and donor site morbidity makes some surgeon were looking for allograft or xenograft. There are some issues with allo- and xenograft about difficulty in corporation and rejection reaction. This study explores the immunogenicity of allograft and xenograft. Keyword :  freeze-dried xenograft, freeze-dried allograft, hydroxyapatite xenograft, demineralized bone matrix xenograft

Strategi pengembangan usaha peternakan babi Di Kabupaten Malang

The research  conducted at PT. Farm Delta Peniwen Makmur which is located in Peniwen Village, Kepanjen District, Malang Regency for a month in July – August 2020. The research objectives are 1. To find out the strategy for developing pig farming business at PT. Farm Delta Peniwen Makmur Kepanjen Malang, 2. To find out what factors influence the development of pig farming at PT. Farm Delta Peniwen Makmur Kepanjen Malang 3. To find out the position of the business when viewed from the pig farming strategy at PT. Farm Delta Peniwen Makmur Kepanjen. Primary data is obtained from interviews with respondents, while secondary data is obtained from reports from companies and related agencies, literature owned by companies, and writings related to the topics discussed. The sampling method used total sampling, namely owners, managers, and employees of PT. Delta Peniwen Makmur in Kepanjen, Malang. The interview process uses a list of questions in the form of a questionnaire. The data analysis method uses SWOT analysis, namely analyzing the IFE matrix, EFE matrix, IE matrix and SWOT matrix. The conclusion that can be drawn from the results of the analysis is that in the SWOT matrix, the WT strategy is the most dominant in quadrant IV, which is 1.4 with the results of the IFAS and EFAS calculations on the Cartesian diagram (–0.249 ;–0.164). The company seeks to minimize weaknesses and avoid threats by improving product quality, human resources, production quantities, owners can be responsible for all decisions, carry out innovative promotions, provide maximum service at affordable prices, maintain good relations with distributors or customers regarding complaints that arise. exist, and companies can seek market opportunities in different areas. Suggestions that can be quoted from the conclusion are that companies can further maximize existing strengths and opportunities such as maintaining good relationships with employees, agents and customers, expanding marketing areas by conducting digital promotions, improving production quality, providing affordable prices along with price discounts, and no less important being able to establish relationships with competitors to grow the economy of the surrounding community. Keywords: Development Strategy, Livestock Business, Pig Farmin

Double Free Functioning Muscle Transfers for Brachial Plexus Injuries: a Case Report

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

Constant Murley Score on Patients Post Supraspinatus Reconstruction with Membrane Amnion Composite and Fat Tissue Allogenic Mesenchymal Stem Cell Augmentation

Background: Rotator cuff tears are the most common cases in nontrauma upper extremities in group patient more than 50 years old. Incidence on rotator cuff can't show the real population. New Approaches healing rotator cuff syndrome is tendon regeneration like mesenchymal stem cell injection and growth factor or tissue engineering that has been developed.Methods: Retrospective comparation study of 15 postsupraspinatus reparation patients who has been treated for more than 4 months at the Dr. Soetomo general hospital. Patients is divided into group undergone supraspinatus reparation and patient supraspinatus reparation with augmented by membrane amnion composite and mesenchymal stem cell. Its' functional results were evaluated using constant murley score.Results: Pain score average on supraspinatus reparation patients which augmented by membrane amnion and mesenchymal stem cell and those without augmentation is 15 and 13.7 (p=0.036). Daily activity score average on patients with and without augmentation are 20 and 17 (p=0.037). Flexion score average on patients with and without augmentation are 10 and 8.6 (p=0.114). External rotation score average on patients with and without augmentation are 9.6 and 7.2 (p=0.004). Internal rotation score average on patients with and without augmentation are 9.2 and 7.2 (p=0.012).Conclusion: The constant murley score pain score, ADL score, external rotation score, and internal rotation score in the group with the addition of amniotic membrane and mesenchymal stem cells were significantly better than the group with supraspinatus repair only, but not significantly on the flexion score and lateral elevation score components

Biodegradable vs nonbiodegradable suture anchors for rotator cuff repair: a systematic review and meta-analysis

Purpose: The use of non-biodegradable suture anchors (NBSA) in arthroscopic rotator cuff repair (RCR) has increased significantly. However, several complications such as migration, chondral damage, revision, and imaging difficulties have been reported. Meanwhile, the effectiveness of biodegradable suture anchors (BSA) in overcoming such complications and achieving functional outcomes requires further study. Thus, we aim to compare the clinical outcomes and complications of RCR using BSA and NBSA using direct comparison studies. Methods: Two independent reviewers conducted systematic searches in PubMed, Embase, Cochrane Library, and Web of Science from conception to September 2022. Using the RoB 2 and ROBINS-I tools, we assessed the included studies for bias. We applied GRADE to appraise our evidence. Our PROSPERO registration number is CRD42022354347. Results: Six studies (two randomized controlled trials, one retrospective cohort, and three case–control studies) involving 423 patients were included (211 patients received BSA and 212 patients received NBSA). BSA was comparable to NBSA in forward flexion, abduction, external rotation, Constant–Murley score, and perianchor cyst formation (P = 0.97, 0.81, 0.56, 0.29, and 0.56, respectively). Retear rates were slightly higher while tendon healing was reduced in BSA compared to NBSA, but the differences were not significant (P = 0.35 and 0.35, respectively). Conclusion: BSA and NBSA appear to yield similar shoulder functions and complications in rotator cuff repairs