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

Evaluasi Komplikasi Plate Exposure Pasca Reseksi Amelobl Astoma Mandibula Dengan Rekonstruksi Pelat Titanium Di Rsup Dr. Sardjito YOGYAKARTA

Resection of the jaw is a primary option of treatment in mandibular ameloblastoma with bone damage. Mandibular resection will cause mandibular stability disturbance due toloss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunctioning. To restore its stability, installment of mandibular reconstruction plate on the remaining mandibular by using screws. However, it is not uncommon that plate exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plates to the mandibular bone. A 3D stereolithography modelcan help provide the best assesment on the bone defect, plan the making of the more easily pre-operative curved plates and provide more accurate faster surgery time. Objective: To evaluate plate exposure after mandibular resection with titanium reconstruction plates in Dr. SardjitoHospital. Case report: A case was reported on mandibular reconstruction after resection of ameloblastoma with titanium plate performed in Dr. Sardjito Hospital that experienced intra-oral plate exposure and oro-cutaneous fistula on the left mandible. The clinical evaluation showed the curved titanium plate did not adapt well with the remaining mandibular bone; therefore, the titanium plate was removed without replacing it with a new plate. Inappropriate adaptationof curved titanium plate is one of the main causes of plate exposure. The use of a 3D stereolithography model is very helpful for the success of mandibular reconstruction

Interleukin-1 genetic polymorphisms in knee osteoarthritis: What do we know? A meta-analysis and systematic review

Purpose Interleukin-1 is the main proinflammatory cytokine in osteoarthritis (OA). Several single-nucleotide polymorphisms (SNPs) within the IL-1 gene cluster (IL-1 beta, IL-1R1, and IL-1RN) have been determined, but their associations with knee OA remain poorly understood. The present study aimed to identify the associations between IL-1 SNPs and knee osteoarthritis. Methods This meta-analysis and systematic review included all comparative studies published in the MEDLINE/PubMed, Embase, Google Scholar, and Cochrane Library databases. We performed a systematic search to identify relevant studies on the evaluation of the correlation between the IL-1 gene and knee OA published up to February 2020 that met the eligibility criteria. Nine studies on a total of 2256 knees with OA and 3527 healthy knees met the eligibility criteria. Results associated with IL-1A, IL-1B, IL-1R1, and IL-1RN SNPs were extracted and compared between knees with OA and healthy knees. Methodological quality was assessed using the Newcastle-Ottawa scale (NOS). All studies with fair or good quality were included. Results The meta-analysis showed that the risk of knee OA is decreased by the IL-1RN*1 and IL-1RN*1/*1 genotypes and increased by the IL-1RN*2 and I-L1RN*1/*2 genotypes. The systematic review revealed only two studies associating the IL-1RN allele, none associating the IL-1B polymorphism, and only one study associating IL-1A and IL-1R1 polymorphisms with knee OA. Conclusions Several IL-1RN alleles and genotypes play a role in knee OA but other genetic variations in the IL-1 region were still conflicting in its association with knee OA.Orthopaedics, Trauma Surgery and Rehabilitatio

Sensitiveness of the Constant-Murley’s Shoulder and Quick DASH as an Outcome Measure for Midshaft Clavicle Fracture

BACKGROUND: Quick DASH and Constant-Murley’s Shoulder are two valid measuring tools for health status and are useful for patients with a wide variety of upper-extremity complaints; it is sufficiently sensitive to reveal even small changes in function. Objective: To evaluate the sensitivity of Quick DASH and Constant-Murley’s Shoulder as an outcome measurement for midshaft clavicle fracture. METHOD: The study population consisted of 64 patients with a diagnosis of midshaft clavicle fracture based on clinical and radiological criteria. Study design was that of a classic prospective cohort study with measurements at 3 and 6 months following the injury. Evaluation was based on effect size (ES) and standardized response means (SRM). RESULT: Both Quick DASH and Constant-Murley’s Shoulder showed high sensitivity (ES: 0.711; SRM: 1.46 and ES: 0.628; SRM: 1.45, respectively). CONCLUSION: Quick DASH was more sensitive than Constant-Murley’s Shoulder in detecting clinical changes on midshaft clavicle fractures at 3 and 6 month following treatment

Spinal cord injury without radiological abnormality (SCIWORA) manifested as self-limited brown-SEQUARD syndrome

Introduction: Combination between SCIWORA and Brown-Sequard syndrome in a patient is a rare condition. In SCIWORA, there is usually a delay in neurologic deficits which can potentially lead to misdiagnosis. Therefore, the clinician should have a good understanding of the course of the disease to make a good diagnosis and treatment. Case report: Reporting a case of female 20 years old with chief complaint of severe neck pain and delayed limbs weakness. The mechanism of injury was fall with the head hit the ground in left lateral flexion position. The physical examination showed zero motor power of the right limbs and contralateral pain and temperature deficit 1 h after the injury. We diagnosed the patient with incomplete spinal cord injury at C4 level with associated Brown-Sequard syndrome. We gave soft collar neck for immobilization, medication with NSAID for analgetic and Methylprednisolon. We found dramatic improvement in 10 h after the injury with motor improvement from 0 to 5 and normal sensory function. The patient then was discharged with good functional outcome and with no sequelae. Conclusion: Incomplete cervical spinal cord injury without radiological abnormality that manifested as Brown-Sequard syndrome is a rare case and potentially confusing condition. Better understanding of the course of the disease may help the clinician to make a right diagnosis and plan for management. Keywords: SCIWORA, Brown-Sequard syndrome, Spinal cord injur