1.The Outcome of Complex Pelvic Fracture after Internal Fixation Surgery
Ismail HD ; Lubis MF ; Djaja YP
Malaysian Orthopaedic Journal 2016;10(1):16-21
Introduction: Complex pelvic fracture, which has a very
high mortality and even higher morbidity, needs internal
fixation surgery as an integral part for its management. It was
necessary to conduct a study regarding outcome of complex
pelvic fractures after internal fixation surgery.
Material & Method: Twenty-six patients with complex
pelvic fractures that had been treated with internal fixation
surgery during 2011-2014 were enrolled. These patients had
an open pelvic fractures or Tile type B or C pelvic fracture
who had undergone internal fixation surgery with at least 6
months follow-up. Evaluation of the morbidity and
functional scoring was performed using Majeed and
Hannover Score.
Results and Discussions: Average of age was 31 years old
and follow up time was 25 months. There were 7 patients
with open pelvic fracture and 19 with closed fracture.
Excellent Majeed Score were found on 78.6% cases in Tile
B fractures and 50% in Tile C. Good Hannover Score was
found in 64.3% Tile B cases and 80% Tile C cases. Fracture
type was statistically insignificant with acquired sexual
dysfunction (p>0.05), but significant with the chronic pain
(p=0,.017). We also found that urogenital injury is associated
with sexual dysfunction (p=0.005).
Conclusions: The outcome of complex pelvic fracture after
internal fixation surgery was excellent. More than 90%
patients got an excellent and good result on Majeed Score,
and also very good and good result on Hannover Score.
Fractures, Bone
2.Minimal Invasive Plate Osteosynthesis (MIPO) Technique Using Anterolateral Approach for Treating Closed Proximal Humerus Fracture
Ismail HD ; Boedijono DR ; Hidayat H ; Simbardjo DS
Malaysian Orthopaedic Journal 2012;6(1):18-24
Proximal humerus fracture is the second most common
fracture of the upper extremity and presents several unique
problems such as anatomical complexity, high risk of
avascular necrosis, minimal bone stock for purchase,
significant morbidity, and lack of a universally accepted
treatment. Recent treatments for proximal humerus fractures
include use of minimally invasive plate osteosynthysis
(MIPO). The aim of this cross-sectional study was to
evaluate the outcomes of our less invasive technique using a modified anterolateral approach for treatment of proximal
humerus fractures. Ten such operative procedures were
performed in patients of varying age and with varied
mechanism of injury from 2002-2011. All cases were
conducted in an acute setting. There were no cases of
infection and the functional outcome scores were good. This
approach represents an alternative treatment for closed
proximal humerus fracture but more extensive studies are
needed.
3.Outcome of Cloverleaf Locking Plate Fixation for Femoral Neck Fractures in Young Adults
Ismail HD ; Phedy ; Oktavian Irawadi Purba ; Bambang Gunawan ; Djoko Simbardjo
Malaysian Orthopaedic Journal 2012;6(1):30-34
Femoral neck fractures in young adults remain a major
problem in orthopaedics. Although treatments using
cannulated screws and sliding hip screws are widely
accepted, they pose significant clinical challenges. In the
present study, we evaluated the outcome of treatment using
cloverleaf locking plate fixation (augmented with the
addition of addition of nonvascularised autologous bone
grafts for neglected fracture). Fourteen patients were
investigated in this cross-sectional study. Union times and
Harris hip scores were analysed by independent T-test based
on displacement (displaced vs. nondisplaced) and type (acute vs. neglected) of fracture. No difference in union time was found between acute and neglected groups and between nondisplaced and displaced fractures. Harris hip scores were similar between acute and neglected groups and between non- and displaced group. Cloverleaf locking plate fixation is a viable alternative method for stable fixation of femoral neck fractures in young adults.