MyMedR

Displaying all 2 publications

Abstract:

Sort:

Total Elbow Arthroplasty as the Treatment of Choice for a Young Man with Neglected Terrible Triad of the Elbow Joint and Schizophrenia: A Case Report

Savio SD, Artha K, Wiguna I

Malays Orthop J, 2024 Nov;18(3):66-70.
PMID: 39691565 DOI: 10.5704/MOJ.2411.009

In young patients, the use of total elbow arthroplasty (TEA) is rarely preferred due to its high rate of mechanical failure. Poor compliance and psychological problems encountered may lead to increased difficulty in management. A 38-year-old male complained stiffness and pain on his left elbow. History of trauma was present 10 months ago, when he fell down from a tree of 6m high. Immediate closed reduction and immobilisation with backslab was performed, but he was lost to follow-up due to Schizophrenia. In physical examination, we found varus and recurvatum deformity with inability to flex the elbow beyond 30° and perform pronation. Plain radiograph and CT scan confirmed the terrible triad of elbow with callus formation. Total elbow arthroplasty with soft tissue release was then performed, resulting in satisfactory range of motion at one year follow-up. The management of neglected terrible triad of the elbow is challenging not only due to the bony problems, but also contracted muscles and fibrotic joint. TEA previously has been described in cases of inflammatory arthritis and degenerative arthritis, less in post-traumatic conditions especially in young patients. Though there is still scarcity in literatures discussing the burden of psychiatric problems in arthroplasty patients, but the existing literatures proved the correlation between psychiatric comorbidity with higher rate of post-operative adverse events. Total elbow arthroplasty can be considered as a surgical treatment for a young patient with neglected fracture dislocation of elbow with satisfactory result; however close post-operative monitoring and routine physiotherapy exercise should always be performed.
Fulltext The Efficacy of Bisphosphonate in the Treatment of Giant Cell Tumour of the Bone: A Systematic Review and Meta-Analysis

Deslivia MF, Savio SD, Wiratnaya I, Astawa P, Sandiwidayat KS, Bimantara NG

Malays Orthop J, 2023 Mar;17(1):98-110.
PMID: 37064619 DOI: 10.5704/MOJ.2303.012

INTRODUCTION: Anti-osteoclastic mechanism of Bisphosphonate (BP) is crucial to treat Giant Cell Tumour of the Bone (GCTB), however no established guidelines of its use have been published. This systematic review and meta-analysis is the first to summarise recent clinical studies on the subject.
MATERIALS AND METHODS: A systematic search was performed based on PRISMA guidelines for clinical trials of BP administration in GCTB. Baseline data including BP regimen, dose and timing was summarised. The primary outcomes assessed were recurrence rate, metastases, survival rate, functional outcome, clinical outcome, radiological outcome, and adverse effect.
RESULTS: We identified 8 articles from 2008-2020. Most studies administer 4mg of Zoledronic acid post-operatively, with five studies mentioning pre-operative administration and six studies describing post-operative administration. There was a total of 181 GCTB cases analysed in this study. The BP group presented lower recurrence rate than control group (three studies; Odds Ratio [OR] 0.15; 95% Confidence Interval [CI], 0.05 - 0.43; p<0.05; heterogeneity, I2=0%). As for survival rate, BP group is comparable to control group (two studies; OR 1.67; 95% CI, 0.06 - 48.46; p=0.77; heterogeneity, I2=65%).
CONCLUSION: Bisphosphonate therapy offers satisfactory recurrence rate, functional outcome, clinical outcome, radiological outcome, survival rate and metastases rate in patients with GCTB, with minimal adverse effects. Pre- and post-operative administration of bisphosphonates in combination might be the most beneficial in minimalising the recurrence rate.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links