Telaah Pustaka Carpal Tunnel Syndrome

Carpal Tunnel Syndrome  adalah salah satu kelainan pada bidang Orthopaedi, dimana terjadi penekanan  pada  Nervus Medianus oleh ligamentum transverase carpal. Nervus ini memberikan persyarafan pada jari jempol, jari telunjuk, jari tengah dan sebagian jari manis. Ketika tendon membengkak atau ligamen menebal maka volume didalam terowongan tersebut akan mengecil dan menyebabkan Nervus Medianus  akan terjepit. Artikel ini akan menjelaskan tentang gejala yang dialami, cara mendiagnosa, terapi yang dilakukan dan terapi lanjutannya serta  apa saja komplikasinya. (QM 2017;01:60-64

Femur Pathological Fracture Caused by Metastatic Bone Disease Derived from Foot Squamous Cell Carcinoma

Background : Bone is an organ and the most common site that prone to metastatic cancer and cause serious morbidity. Besides, metastatic cancer to bone will limit skeletal function so that decrease quality of life and even death that most of them caused by its complication.Objective : Reporting a rare case about Squamous Cell Carcinoma that cause femur pathological fracture caused by Metastatic Bone Disease.Material and Method : Case report in women patients 55 years old with femur close fracture one-third middle caused by Metastatic Bone Disease in RSUD Soetomo Surabaya, period May 2015-March 2016.Data is taken retrospectively from medical record through interview, physical examination, radiological examination, and laboratory.Result and Discussion : Patients are treated in hospital because of femur close fracture one-third middle caused by Metastatic Bone Disease.  Based on physical and radiological examination, it is decided being done by skin traction first. The next plan is surgery. Patients are treated with interlocking nail left femur. Evaluation after surgery is done with medical rehabilitation, that is ROM exercise. Until now, 9 months after surgery, patients still control routinely to be done chemotherapy and there is improvement in patient’s condition.Conclusion : Metastatic process in bone often cause pathological fracture. Bone Metastatic is common from Breast, Lung, Prostate and Kideney Cancer. There was no publication before about Bone Metastatic Disease come from Squamous Cell Cancer. Mirel’s score is used as guiding in fixation prior to the next treatment. Decision of surgery is considered through patient’s objective and subjective appraisal that can be calculated in Abdurrahman score system

Pendekatan Sistematis Diagnosis, Terapi dan Follow-Up Tumor Muskuloskeletal (Multidisplinary Approach)

Insiden tumor muskuloskeletal rendah, sedangkan terapinya bisa sangat berat bagi pasien dan keluarganya, seperti tindakan amputasi tungkai. Dengan penanganan yang sempurna sekalipun, umur harapan hidup beberapa penderitanya tidak mencapai angka yang tinggi. Oleh sebab itu, di bidang tumor muskuloskeletal, mutlak dibutuhkan standar pelayanan yang tinggi mulai dari skrining, diagnosis, penatalaksanaan dan evaluasi pasca terapi. Salah satu standar pelayanan yang tinggi di bidang diagnosis adalah prinsip multidisiplin dalam penegakan diagnosis. Paling tidak dokter-dokter spesialis orthopedi, patologi dan radiologi bersama-sama membahas informasi dari masing-masing bidang untuk disatukan menjadi diagnosis yang tepat

Hemangioma Pedis and Tuberculoma Pedis Sinistra in Children

HISTORY: The girl 15 years old, had main complaint, there was a mass in her pedis since she got 2 years old, look red, no pain although in walk, size equal with the skin. The mass got bigger and pain in walk. The mass get bleedy after had crushed by stone, after that bleedy always happen when there was a contact, although soft touch. Patient had history contact with tuberculosis patient. INTERESTING POINTS FOR DISCUSSION: Tuberculoma is a mass that happened because infected bacil mycobacterium tuberculosis, hemangioma is a soft tissue mass that formed by vascular. hemangioma commonly happened in children about 4-10% in children’s tumor. It happened in a girl 3-5 more times than in a boy. Both of them are rare happen in the same time, especially in pedis. From this case, we  can found both type in the same patient. SOLUTION AND RATIONALE: For this case of soft tissue tumor,we use open biopsy. After we found the result , the best treatment for hemangioma and tuberculoma of the pedis for this case is below knee amputation. FINAL OUTCOME: For this case, the best treatment is amputation, and after amputation, the patient never complain about pain anymore, she feel satisfied and overall her quality of life is improving

Analysis of prognostic factors in soft tissue sarcoma: Cancer registry from a single tertiary hospital in Indonesia. A retrospective cohort study

Background Soft tissue sarcoma is one cause of mortality in adult malignancies. This tumor is rare, persistent, and highly-recurrent. Many patients are came in late stage. It is important to identify a prognostic tool that is reliable, easily obtainable, and widely applicable. The aim of this study is to investigate and analyze the prognostic value of clinicopathological and biomarker factors in patients with soft tissue sarcoma. Methods This retrospective study extracts data from the musculoskeletal tumor registry from January 2012 to December 2018 in a single tertiary hospital. Eighty patients with diagnosis of soft tissue sarcoma were included. Preoperative modified Glasgow Prognostic Score, Neutrophils/Lymphocytes Ratio, Hemoglobin, serum lactate dehydrogenase data were analyzed along with demographic, clinical, radiological and histopathological data. The relationship between variables on overall survival, distant metastasis, and local recurrence were evaluated using univariate and multivariate Cox regression. Results On univariate analysis, there was significant relationship between hemoglobin, Neutrophils/Lymphocytes Ratio and modified Glasgow Prognostic Score with overall survival (p = 0.031, HR = 1.99; p = 0.04, HR = 1.129; and p = 0.044, HR = 3.89). A significant relationship was found between age and soft tissue sarcoma stage with distant metastasis (p = 0.046, HR = 1.95; and p = 0.00, HR = 3.22). In addition, we also found significant relationship between surgical margin with local recurrence (p = 0.018, OR = 3.44). However, on multivariate analysis the independent prognostic factor for overall survival was only modified Glasgow Prognostic Score (HR = 2.138; p = 0.011). Stage IIIA (HR = 5.32; p = 0.005) and IIIB (HR = 13.48; p = 0.00) were independent prognostic for distant metastasis. Surgical margin was independently associated with local recurrence (HR = 14.84; p = 0.001). Conclusion Modified Glasgow Prognostic Score can be used as prognostic tool of overall survival in soft tissue sarcoma patients. Moreover, stage of STS and surgical margin can be used as a prognostic factor for distant metastasis and local recurrence of soft tissue sarcoma respectively

Implantation of bovine hydroxyapatite and secretome with different oxygen concentration may improve massive bone defect regeneration: An experimental study on animal model Show less

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