Publications by authors named "Renaldi Prasetia"

20 Publications

  • Page 1 of 1

Ultrasound-Guided Suprascapular Nerve Block at Spinoglenoid Notch and Glenohumeral Joint Hydrodilation.

Arthrosc Tech 2022 Jul 14;11(7):e1233-e1238. Epub 2022 Jun 14.

Department of Orthopaedics-Traumatology, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia.

Hydrodilation of the glenohumeral joint is commonly employed as a nonsurgical intervention for the frozen shoulder. Accuracy and pain during the procedure can be regarded as difficulties in performing this procedure. Ultrasonography (USG) guided injection and suprascapular nerve block can improve the accuracy and can decrease pain during the hydrodilation procedure. We present the step-by-step method for performing USG-guided injections for suprascapular nerve block and hydrodilation.
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http://dx.doi.org/10.1016/j.eats.2022.03.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353275PMC
July 2022

The role of suprascapular nerve block in hydrodilatation for frozen shoulder.

SICOT J 2022 14;8:25. Epub 2022 Jun 14.

Department of Orthopaedics-Traumatology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, 40161 Bandung, Indonesia.

Introduction: Frozen shoulder is a debilitating problem that requires comprehensive diagnosis and management. Patients usually recover, but the possibility of not reobtaining a full range of motion exists. Thus, early shoulder exercises are necessary to achieve their full range of motion. This study aims to understand the effects of suprascapular nerve block (SSNB) augmentation at the spinoglenoid notch in hydrodilatation to treat frozen shoulder to facilitate early shoulder exercises.

Methods: The current study retrospectively observed 31 patients, including 40-60-year-old patients diagnosed and treated with primary frozen shoulder. The participants were divided into groups A (hydrodilatation) and B (hydrodilatation and the augmentation of an SSNB). Shoulder function and pain scores were assessed before, during, and after the intervention (at months 1 and 6).

Results: The result of this study shows that suprascapular nerve block plays a role in decreasing pain in intraintervention (0.69 vs. 5.73; p < 0.05), month 1 of follow-up (3.44 vs. 6.40; p < 0.05), but not significant on month 6 of group A and B after intervention (5.88 vs. 7.20; p > 0.05). Better delta functional scores were noted in the therapy group during month 1 of the follow-up (delta American shoulder and elbow surgeons [ASES]: 19.29 vs. 34.40, p < 0.05; delta disabilities of the arm, shoulder, and hand [DASH]: 17.88 vs. 38.15, p < 0.05). The difference in functional score on month 6 between both groups was not significantly different (delta ASES: 31.97 vs. 30.31, p > 0.05; delta DASH: 36.63 vs. 38.92, p > 0.05).

Discussion: One rationale for using an SSNB augmentation at spinoglenoid notch in hydrodilatation for treating frozen shoulder was to obtain pain relief immediately to facilitate early manual exercise. SSNB has positive effects on short-term evaluation of shoulder pain and function after glenohumeral hydrodilatation, but not in the long term.
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http://dx.doi.org/10.1051/sicotj/2022026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9196022PMC
June 2022

Primary traumatic shoulder dislocation associated with rotator cuff tear in the elderly.

Int J Surg Case Rep 2022 Jun 16;95:107200. Epub 2022 May 16.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.

Introduction And Importance: The shoulder is one of the most unstable joints of the body. Shoulder dislocation accounts for up to 60% of all major joint dislocations. This study reports two cases of primary traumatic shoulder dislocation and shows that in the elderly, primary traumatic shoulder dislocation is associated with a rotator cuff tear (RCT).

Case Presentation: A case report and narrative review included two female patients, aged 63 and 100 years. Presenting symptoms were instability, pain, and restricted shoulder movement. Both were successfully treated by surgery. Arthroscopy was performed in the first patient and open reduction in the second patient.

Clinical Discussion: In the first case, we found synovitis around the rotator interval, long head of the biceps tendinitis, and tears of the subscapularis tendon, supraspinatus tendon, and subacromial bursitis. The anterior labrum was normal. In the second case, complete detachment of the infraspinatus tendon was found. In both cases, rotator cuff repair was performed. Primary traumatic shoulder dislocation in the elderly is often associated with rotator cuff injury. Therefore, a detailed evaluation and management of the rotator cuff injury is essential. Rotator cuff injuries cause loss of dynamic stabilization of the shoulder, leading to recurrent shoulder dislocation and chronic shoulder instability.

Conclusion: The associated pathology of the primary traumatic shoulder dislocation in elderly are rotator cuff tear. The management of the rotator cuff tear in primary traumatic shoulder dislocation can prevent further shoulder instability events.
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http://dx.doi.org/10.1016/j.ijscr.2022.107200DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121268PMC
June 2022

Soft tissue reconstruction on the very late presenting neglected acromioclavicular dislocation Rockwood type IV. A case report.

Int J Surg Case Rep 2022 Jun 6;95:107171. Epub 2022 May 6.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.

Introduction And Importance: Acromioclavicular (AC) joint dislocation Rockwood type IV is a rare condition characterized by the posterior displacement of the distal clavicle and soft tissue damage. The rate of soft tissue healing markedly decreases as time from injury increases. In this case report, we had a very late presenting neglected AC joint dislocation Rockwood type IV successfully treated by AC and coracoclavicular (CC) reconstruction.

Case Presentation: A 24-year-old female presented with pain around her right shoulder since a motorcycle accident four years prior to current presentation. She was diagnosed with a posterior AC joint dislocation and suggested undergoing surgery, but she refused and chose to seek an alternative treatment. The patient felt pain chronically and could not elevate her shoulder, and she decided to come to our hospital. We performed a physical and radiograph examination that showed an AC joint dislocation Rockwood type IV. The management, suggested to the patient, was AC and CC soft tissue reconstruction.

Clinical Discussion: The advantages of using this procedure were to restore effective anatomy and avoid bone-to-bone contact between the clavicle and acromion. The disadvantages were increased cost and needed to be evaluated for long-term results. We considered the idea of maintaining AC joint reduction by biologic soft tissue healing of the graft and augmentation fixation to replace the CC ligaments. We could not rely on biological soft tissues healing themselves due to the chronicity.

Conclusion: AC and CC reconstruction can be an option of treatment in neglected AC joint dislocation Rockwood type IV with excellent clinical and radiographic results.
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http://dx.doi.org/10.1016/j.ijscr.2022.107171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9108874PMC
June 2022

Traumatic Inferior Glenohumeral Dislocation Associated With Rotator Cuff Avulsion Fracture: Arthroscopic-Assisted Fixation: A Technical Note.

Arthrosc Tech 2021 Dec 9;10(12):e2667-e2673. Epub 2021 Nov 9.

Department of Orthopaedics-Traumatology, Faculty of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia.

Traumatic inferior glenohumeral dislocation with rotator cuff avulsion fracture rarely occurs and may cause chronic pain and diminished shoulder function. Several treatment options are available for this injury, such as open reduction internal fixation and arthroscopic-assisted reduction internal fixation. This technique describes a step-by-step technique to manage traumatic inferior glenohumeral dislocation with rotator cuff avulsion fracture using the simultaneous closed reduction procedure for traumatic inferior glenohumeral dislocation and the arthroscopic procedure with suture bridge technique for the treatment of rotator cuff avulsion fracture.
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http://dx.doi.org/10.1016/j.eats.2021.08.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719107PMC
December 2021

High-Grade Bursal Side Rotator-Cuff Repair: A Surgical Outcome Review.

Orthop Res Rev 2021 11;13:179-186. Epub 2021 Oct 11.

Department of Anatomy, Physiology and Biology Cell, Universitas Padjadjaran, Bandung, Indonesia.

Purpose: We aimed to evaluate surgical outcomes of high-grade bursal rotator cuff-tear repairs.

Methods: This systematic review was performed in May 2020 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using PubMed. Inclusion criteria were English-language studies reporting the results of pain improvement, functional outcome scores, and radiographic examinations after repair of bursal side partial rotator-cuff tears at any time point in patients of any age and with all levels of evidence. Exclusion criteria were articles not in English, in vitro or animal studies, epidemiological studies, and such article types as technical notes or narrative reviews.

Results: Of 58 articles, five were included in this study, of which three and two had level III and IV evidence, respectively, four were comparative studies, and one was a case series. Visual analogue scales were used in four of the five studies, all showing improvement in pain assessment from 5.87 preoperatively to 1.02 postoperatively. All five studies showed significant improvement on each functional outcome score at the final follow-up. The retear rate for all studies was 10.97% (27 of 246).

Conclusion: High-grade bursal side partial-thickness rotator cuff-tear repair gave satisfactory results in terms of pain scores, range of motion, and functional outcomes. The retear rate was still considerably high (10.9%), necessitating better understanding of the basic science, such as molecular mechanisms during adaptation, to improve the surgical technique.
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http://dx.doi.org/10.2147/ORR.S323092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8524261PMC
October 2021

Open Reduction on very late-presenting unreduced posterior elbow dislocation: Still promising treatment option.

Int J Surg Case Rep 2021 Jul 2;84:106056. Epub 2021 Jun 2.

Department of Orthopaedics and Traumatology - Faculty of Medicine - University Padjadjaran - Indonesia.

Background: Neglected dislocation of the elbow is associated with instability, pain, and limitation of elbow function. In developing countries, neglected dislocations of the elbow are quite common, and most patients initially go to local bonesetters, which only aggravates the problem.

Presentation Of Case: Two patients with a history of unreduced posterior elbow dislocation for more than 1 year and were treated by a traditional bonesetter were included in this case study. The first case was a 65-year-old female with a history of injury around her right elbow around 12 months before admission. The patient underwent open reduction with triceps lengthening and immobilization with plaster of paris for 3 weeks. The second case was a 53-year-old male with a history of injury caused by a fall on an outstretched hand around 18 months before admission. The patient underwent arthrolysis followed by triceps lengthening, internal fixation with transarticular k-wire, and immobilization with elbow slab for 3 weeks.

Discussion: To optimize treatment goals and patient function, various surgical approaches have been described for treating chronic elbow dislocations. The benefit of the VY triceps lengthening is to simplify the reduction procedure, especially in the elbow dislocations with greater chronicity. The downside of the VY lengthening is possible triceps weakness, delayed physiotherapy, and increased postsurgical pain. On the basis of this study, open reduction should remain a treatment option for patients regardless of age and chronicity of injury.

Conclusion: Operative treatment of late-presenting, unreduced elbow dislocation is effective in restoring the joint to a painless, stable, and functional limb.
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http://dx.doi.org/10.1016/j.ijscr.2021.106056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203810PMC
July 2021

A decade of evolution in Indonesian orthopedic publication: A bibliographic report.

J Clin Orthop Trauma 2021 Apr 12;15:110-116. Epub 2020 Oct 12.

Department of Orthopaedic & Traumatology, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

During the past decade, there was an increasing interest in orthopedic research in Indonesia. Therefore we aimed to investigate the profile of Indonesian orthopedic trend publication from 2010 to 2019. Systematic research was conducted to identify all orthopedic articles authored by Indonesian orthopedic surgeons. Article details (number of authors, authors' affiliation, publishing journal), type of author's affiliation, affiliate collaboration, study field, type, and level of evidence (LOE) were recorded and evaluated. Publishing journal metric and author h-index were also recorded. Descriptive statistics were used to summarize the data. Two hundred and twenty articles were included in our study. Clinical studies were the most common article type, followed by case reports and basic science. Among clinical articles, therapeutic studies were found significantly more frequent. On the other hand, economic studies were not found in this study period. The most popular field was oncology, followed by knee and spine. The average number of authors per article was 5.23 with a total of 205 individuals who had contributed during this decade. University hospital was the most common affiliation found and single-center study was the most common affiliate collaboration. The most common level of evidence was level V (case reports). Eighty-seven specific publishing journals were identified. More than 42% of the articles were published in journals with SJR between 0.25 and 0.50. The average author h-index was 3.56 (0-7). Although there was an increasing trend and quantity of publications among Indonesian authors, most articles had level 5 evidence (case reports) and the quality of publishing journals was mostly Q3 with a low-moderate SJR. Improvement of the article's quality and institutional collaboration will be needed for future contribution in global orthopedic society.
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http://dx.doi.org/10.1016/j.jcot.2020.10.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919978PMC
April 2021

Modified Eden-Lange procedure for iatrogenic lateral scapular winging.

Int J Surg Case Rep 2020 28;77:129-132. Epub 2020 Oct 28.

Department of Orthopaedics- Traumatology, Faculty of Medicine, University Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia.

Introduction: Lateral winging scapula is rare and generated by the trapezius paralysis. It is most likely iatrogenic from procedures involving the posterior cervical triangle. The modified Eden-Lange procedures one of the options by restoring the major actions of a flaccid trapezius. This case report aims to evaluate the outcomes.

Case Report: A 34-year-old female came with right lateral scapular winging after radical neck tumor dissection and miss diagnosed by another hospital and underwent shoulder surgery. We performed a physical examination and showed lateral winging scapula. The best management therapy for this patient used modified Eden-Lange procedure.

Discussion: Conservative treatments for Lateral scapular winging caused by spinal accessory nerve injury might be successful in early 20 months. However, our patient was injured 26 months before surgery which made Eden-Lange Procedures was the best choice for the patient. Modifications to this procedure allowed her to achieve excellent results.

Conclusion: Correction of the lateral scapular winging by modified Eden-Lange procedure combined with physical therapy for patient's trapezius palsy to gain adequate stability for daily activities.
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http://dx.doi.org/10.1016/j.ijscr.2020.10.068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649588PMC
October 2020

Autologous tendon graft for non-union distal clavicle fracture in a patient with chronic kidney disease.

Int J Surg Case Rep 2020 28;77:116-121. Epub 2020 Oct 28.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

Background: Fracture of distal-end accounts for 20% of all clavicle fracture. In the situation of impaired bone healing environment such as chronic kidney disease (CKD), nonunion rates after surgery might increase. In the case where bone healing is unexpected, biological healing with tendon graft could be an alternative method to maintain bone reduction.

Presentation Of Case: A 62-year old male with a history of end-stage CKD presented to the hospital with pain, wound, and deformity on the right shoulder. The patient have had surgery in the past 4 months and resulted in a non-union fracture of the distal third right clavicle. The patient underwent implant removal and continued with coracoclavicular ligament reconstruction with autologous tendon grafts of semitendinosus tendon and mini-plate augmentation.

Discussion: The Distal clavicle has a high rate of delayed and nonunion even without the presence of comorbidity. A compromised bone quality frequently leads to failed osteosynthesis in patients with end-stage renal failure. In the advanced stages of kidney disease, problems with a renal clearance of phosphate and low 1ɑ-hydroxylase levels resulting in increased serum phosphate levels and low serum calcium levels. Given these circumstances, we considered the idea to maintain fracture reduction by biologic soft tissue healing of the graft to replace the coracoclavicular ligaments as we can not rely on normal bone strength and healing capacity.

Conclusion: In the situation where bone healing is unexpected, biological healing with tendon graft may be necessary. The use of autologous tendon graft and mini-plate suture augmentation could help to maintain bone reduction in such environment.
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http://dx.doi.org/10.1016/j.ijscr.2020.10.106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649590PMC
October 2020

Necrosis in the flexor hallucis longus muscle after subclinical leg compartment syndrome and tibial fracture: A case report.

Int J Surg Case Rep 2020 17;72:490-493. Epub 2020 Jun 17.

Department of Orthopaedics and Traumatology, Universitas Padjadjaran Medical School/Hasan Sadikin Hospital, Jalan Pasteur 38, Bandung, 40161, Indonesia. Electronic address:

Introduction: Compartment syndrome is a condition in which an increased pressure within one compartment results in decreased blood flow, preventing nutrition and blood supply from reaching nerve and muscle cells. Ongoing physiological cascades can progress to local and systemic manifestations. This article presents a case of subclinical compartment syndrome resulting in muscle necrosis and contracture. More specifically, this article highlights the presentation of a complicated and neglected case of subclinical compartment syndrome with a subsequent fixed equinus deformity and its management.

Presentation Of Case: A 15-year-old high school student sustained a proximal tibia fracture during a motor vehicle accident. The compartment was not recognized until a period of follow-up. The patient later presented to our clinic with ankle equinus deformity. Further exploration found the contracture and necrosis of flexor hallucis longus (FHL) muscle. We excised the necrotic wound and performed an ankle fusion.

Discussion: The patient had developed subclinical localized deep posterior compartment syndrome in the distal portion of the FHL muscle. As only a small portion of the muscle was involved, there was no retraction of the main muscle belly; however, the necrotic part can become fibrotic and adhere to the surrounding tissues. While subclinical compartment syndrome is not uncommon, the finding of isolated FHL muscle necrosis is rare. Thus, the management is still debatable.

Conclusion: This article emphasized that neglecting compartment syndrome may result in undesired complications, which emphasizes the importance of an early diagnosis and treatment.
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http://dx.doi.org/10.1016/j.ijscr.2020.06.059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322238PMC
June 2020

Clinical features and repair integrity after knotless - In situ suture bridge technique in high-grade bursal side rotator cuff tears.

J Orthop 2020 Jul-Aug;20:352-358. Epub 2020 Jul 8.

Department of Orthopaedics Surgery, Faculty of Medicine, Thammasat University, Thailand.

Introduction: The purpose of study is to describe outcome of the knotless-in-situ suture-bridge repair technique, combining concept of articular-preservation, medial-row knotless, and full-layer repair on the high-grade bursal-side rotator cuff tear (PBS-RCT).

Methods: The repair-technique, on 27 shoulders with PBS-RCT, were retrospectively evaluated. Range of Motion (RoM), visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score were evaluated. Minimal 6-months Post-operative MRI were evaluated for repair-integrity.

Result: RoM evaluation, VAS, and ASES Score were improved significantly ( < 0.01). Post-operative MRI showed intact repaired tendon in 25-patients (96.2%).

Conclusion: Arthroscopic knotless-in-situ suture-bridge repair technique in PBS- RCT showed good functional-outcome and repair-integrity at minimum 2-years after surgery.
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http://dx.doi.org/10.1016/j.jor.2020.06.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352058PMC
July 2020

Accuracy comparisons of intra-articular knee injection between the new modified anterolateral Approach and superolateral approach in patients with symptomatic knee osteoarthritis without effusion.

Asia Pac J Sports Med Arthrosc Rehabil Technol 2019 Jul 26;17:1-4. Epub 2019 Mar 26.

Department of Orthopedics and Traumatology Universitas Padjadjaran, Dr. Hasan Sadikin Teaching Hospital, Bandung, Indonesia.

Background: Intra-articular knee injection with steroid or various other agents have been used to control the local inflammation and relieve pain in the osteoarthritis knee. To achieve the maximal potential therapeutic worth and decrease the complications from the inaccurate knee injection, these medications should be delivered directly into the intra-articular space. Injection technique is one of the most important factors for accuracy of knee injection. Therefore, this study was aimed to propose the new modified anterolateral injection technique for higher accuracy of knee injection in symptomatic osteoarthritis knee without effusion.

Material And Methods: Patients with symptomatic osteoarthritis without effusion were included prospectively from May 2014 to May 2015 and randomized into 2 groups for knee injection: Modified anterolateral (MAL), Standard superolateral (SL). Knee injection was performed by one experienced orthopaedic. Accuracy of injection was test by mini air-arthrography technique. The pain from injection were evaluated by visual analog scale (VAS).

Result: 132 knees were included, 66 knees were modified anterolateral group same as superolateral group. The modified anterolateral injection was significantly yield the higher accuracy rate than the standard superolateral injection (89% vs 58%, P < 0.05). The pain visual analog scale was not significantly different between the modified anterolateral and standard superolateral injection technique (2.61 vs 2.65, P = 0.917) No adverse events were occurred.

Conclusion: The new modified anterolateral injection yields the higher pooled accuracy rate. From the accuracy and the advantage of the new modified anterolateral injection, this is the preferred injection technique for the symptomatic osteoarthritis without knee effusion.
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http://dx.doi.org/10.1016/j.asmart.2019.02.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438910PMC
July 2019

Preoperative planning of medial opening wedge high tibial osteotomy using 3D computer-aided design weight-bearing simulated guidance: Technique and preliminary result.

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019831455

6 National Metal and Materials Technology Center, Pathumthani, Thailand.

Background: High tibial osteotomy (HTO) is an established treatment for uni-compartmental osteoarthritis with varus deformity in relatively active young patients with good knee mobility. The most important factor for success and low complications of HTO is the precise correction of osteotomy. The objective of this study was to evaluate the accuracy of pre-operative planning of open-wedge HTO using t3D computer-aided design (CAD) weight-bearing simulated guidance technique for the succession of surgery.

Materials And Methods: Nineteen patients who met the inclusion criteria were recruited between July 2013 and June 2014. 3D CAD weight-bearing simulated guidance technique was obtained from standard anterior-posterior, lateral of hip-to-ankle full leg standing radiographs, and computed tomography (CT) scan provided the weight-bearing corrective axis of preoperative planning and predictive corrective mechanical axis value. Post-operative mechanical axis value was obtained after surgery.

Results: This comparative study between the predictive corrective, using 3D CAD weight-bearing simulated guidance technique, and post-operative mechanical axis value, analysed with t-test statistical analysis, showed the insignificant difference ( p > 0.05).

Conclusion: We conclude that the 3D CAD weight-bearing simulated guidance technique has good accuracy as preoperative planning of open-wedge HTO for succession surgery.
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http://dx.doi.org/10.1177/2309499019831455DOI Listing
April 2020

Fixation of femoral attachment: anterior cruciate ligament avulsion fracture with arthroscopy suture loop technique.

BMJ Case Rep 2018 Jul 23;2018. Epub 2018 Jul 23.

Orthopaedic- Traumatology, Thammasat University Hospital, Pathumtani, Thailand.

Anterior cruciate ligament (ACL) avulsion fracture is rare and mostly occur in tibial attachment. Avulsion fracture of femoral attachment of ACL was uncommon and mostly reported in skeletally immature patient. This article aims to report an interesting case of femoral attachment-ACL avulsion fracture in skeletally mature patient with arthroscopic suture loop fixation.A 32-year-old man, with no significant medical-surgical history, sustained a right non-contact pivoting knee injury during soccer competition. Plain radiographs of knee joint demonstrated intra-articular bone fragment in the intercondylar notch space. The MRI confirmed femoral attachment-ACL avulsion fracture. Then, we planned to perform fixation of femoral attachment-ACL avulsion fracture with arthroscopy suture loop technique. At 5 months after surgery, patient had no pain and swelling knee. The physical examination demonstrated negative Lachman test, anterior drawer test, pivot shift test and patient can return to preinjury daily activity and sport activities.
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http://dx.doi.org/10.1136/bcr-2018-224904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6058150PMC
July 2018

Posterior root medial meniscus reconstruction: an option in chronic posterior root meniscal injury management.

BMJ Case Rep 2018 Jun 20;2018. Epub 2018 Jun 20.

Department of Orthopedics- Traumatology, Thammasat University Hospital, Pathumtani, Thailand.

Posterior root medial meniscus (PRMM) tears have shown to be biomechanically equivalent to complete meniscectomy. Drawbacks from PRMM tears repair are unsatisfactory healing rates. In this case report, we outlined a PRMM reconstruction with gracilis graft healing outcome in chronic PRMM tear case, based on clinical and MRI evaluation. A 60-year-old man reported a chief complaint of increasing pain on the right knee joint in the last 1 year after a deep-flexion injury. On MRI investigation, we confirmed the chronic PRMM tear as Osteoarthritis Kellgren-Lawrence grade II. Then, we planned to perform a PRMM reconstruction with gracilis graft per arthroscopy. At the 6-month MRI evaluation, we found healing of the attached PRMM on its footprints, with intact graft transition from the meniscus to the tibial bone tunnel.
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http://dx.doi.org/10.1136/bcr-2017-223068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020895PMC
June 2018

Arthroscopic direct meniscal extrusion reduction: surgical tips to reduce persistent meniscal extrusion in meniscal root repair.

Eur J Orthop Surg Traumatol 2018 May 14;28(4):727-734. Epub 2018 Feb 14.

Department of Orthopaedics Surgery, Faculty of Medicine, Thammasat University Hospital, Pathumtani, Thailand.

Meniscal extrusion (ME) is defined as extension of the meniscal margin by at least 3 mm beyond the tibial margin. The main purpose of meniscal root repair is to restore the anatomy and function of the meniscus. Therefore, the reduction in the ME is one of the important objective outcomes. Nevertheless, the reduced meniscal extrusion was obtained in limited patients after meniscal root repair. This technical note described the arthroscopic direct meniscal extrusion reduction as surgical tips to reduce persistent meniscal extrusion in posterior meniscal root repair.
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http://dx.doi.org/10.1007/s00590-018-2138-6DOI Listing
May 2018

Both Posterior Root Lateral-Medial Meniscus Tears With Anterior Cruciate Ligament Rupture: The Step-by-Step Systematic Arthroscopic Repair Technique.

Arthrosc Tech 2017 Oct 23;6(5):e1937-e1943. Epub 2017 Oct 23.

Department of Orthopaedics Surgery, Faculty of Medicine, Thammasat University, Thailand.

The occurrence of posterior root tear of both the lateral and medial menisci, combined with anterior cruciate ligament rupture, is rare. Problems may be encountered such as the difficulty to access the medial meniscal root tear, the confusing circumstances about which structure to repair first, and the possibility of the tunnel for each repair to become taut inside the tibial bone. We present the arthroscopy technique step by step to overcome the difficulties in an efficient and time-preserving manner.
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http://dx.doi.org/10.1016/j.eats.2017.07.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5799590PMC
October 2017

The role of teriparatide in tuberosity healing after reverse shoulder arthroplasty in complex proximal humeral fragility fracture.

J Orthop Surg (Hong Kong) 2018 Jan-Apr;26(1):2309499017754104

1 Faculty of Medicine, Department of Orthopaedic Surgery, Thammasat University, Rangsit, Thailand.

Introduction: Tuberosity healing is known to be one of the factors that increase functional outcome in Reverse Total Shoulder Arthroplasty (rTSA). In fragility fractures, tuberosity healing is difficult to be achieved. The fragment stability and bone-forming agent application become strategies to overcome this problem. The purpose of this study was to evaluate the benefit of teriparatide application to promote tuberosity union in rTSA on four-part proximal humeral fractures to achieve better functional outcome.

Methods: A retrospective study of a prospectively collected shoulder arthroplasty medical record was performed. Eleven patients were included in this analysis and consisted of two groups, teriparatide and no-teriparatide groups. Patients were evaluated on the range of motions and clinical outcome using the American Shoulder Elbow Surgeon (ASES) Shoulder Score and X-ray to determine tuberosity union. The group differences were analyzed by t-test or Mann-Whitney U test with SPSS version 20.0 for Windows.

Results: The statistical analysis revealed no significant differences in mean age in both the groups. There were significant differences between teriparatide and no-teriparatide groups in external rotation (29.5° vs. 7.5°; p = 0.004), external rotation in 90° abduction (55° vs. 12.5°; p < 0.020), forward flexion (120° vs. 105°; p = 0.002) range of motions, and ASES (84.5 vs. 74.6; p = 0.019). We found clinical difference between teriparatide and no-teriparatide groups in time to achieve the initial callus (33 ± 18.3 days vs. 150 ± 42.4 days) and tuberosity consolidation (165.8 ± 70.3 days vs. 315 ± 106.1 days).

Conclusions: Teriparatide administration supports tuberosity repair results in a high tuberosity healing rate with restoration of external rotation after rTSA in acute complex proximal humeral fractures.
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http://dx.doi.org/10.1177/2309499017754104DOI Listing
September 2019

Bipolar fracture dislocation of clavicle: A report of osteosynthesis and early soft tissue reconstruction.

Int J Surg Case Rep 2017 27;41:194-199. Epub 2017 Oct 27.

Department of Orthopedics and Traumatology Universitas Padjadjaran, Dr. Hasan Sadikin Teaching Hospital, Bandung, Indonesia.

Introduction: Bipolar dislocation of the clavicle, also called bifocal or pan-articular dislocation or floating clavicle, is an uncommon traumatic injury. The injury of this case is also concomitant with distal third clavicle and coracoid fracture. This article aimed to report the experience of performing osteosynthesis and early soft tissue reconstruction on these injuries.

Case Report: We reported a case of bipolar clavicle fracture-dislocation in concomitant with coracoid fracture in a man, aged 32 years old, successfully treated 24days after accident by fixation of both fractures and early simultaneous reconstruction of sternoclavicular- acromioclavicular-coracoclavicular joints.

Discussion: These injuries are rare and capable of causing many complications if they are treated improperly. It is compulsory to carefully assess any fractured clavicle along its whole length, both clinically and radiologically. Various options, from non-operative to operative, have been reported to manage such of these cases. Early bony fixation and soft tissue reconstruction can correct the alignment of clavicle and recover the function of sterno-clavicular and acromio-clavicular- joints promptly.

Conclusion: Fracture osteosynthesis and early soft tissue reconstruction can be regarded as an option treatment for bipolar fracture-dislocation of the clavicle to facilitate prompt treatment and early rehabilitation.
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http://dx.doi.org/10.1016/j.ijscr.2017.10.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683890PMC
October 2017
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