Ankle sprains are commonly seen injuries among athletic and young population, and it is necessary to stabilize the patient ankle as soon as possible. Authors report the cost-effective option of using a modified Brostrom technique with one suture anchor in a limited resource setting. Case a 24- year-old male came to the orthopaedic clinic with chief complaint of left ankle pain for the past 2 weeks after jumping and landing in a twisted position. Patient also complained of unstable ankle after the fall. On physical examination, the ankle showed tenderness and instability when anterior drawer test was performed. The patient was diagnosed with lateral ankle instability. This case report describes a modification to the original Brostrom procedure using one suture anchor to anatomically reconstruct the lateral ankle ligaments in treating high demand patient who have lateral ankle instability. After six months follow up, the patient has shown significant improvement on his left ankle. Despite of all the modifications of Brostrom procedure, the use of more suture anchors or sophisticated technique such as arthroscopy might result in increasing cost. Reasonably good outcome can still be achieved with modified Brostrom procedure that utilizes minimal incision, simple steps, and single suture anchor. Due to its cost-effectiveness, authors believe that modified Brostrom technique with one suture anchor is an effective and practical treatment option for lateral ankle instability. Brostrom technique using suture anchors as shown here can provide similarly good outcomes compared with other more complex techniques.
Background: Burns are a skin injury or injury caused by thermal that causes morbidity or mortality in patients, due to either heat or radiation, electrical and chemical reactions. In burns can occur bacterial growth that will cause an infection, both gram-positive bacteria and gram-negative bacteria. Necessary antibiotics in the treatment of infection by bacteria on burns. The incidence of burns is increasing from year to year, but data in Indonesia that discuss about the number of infections in burns and the use of antibiotics is still small. Aim: The study aims to determine the pattern of germs and antibiotic sensitivity test in patient burn unit at Sanglah Denpasar Hospital period January 2016-January 2017. Method: This research is a descriptive descriptive cross sectional study conducted at Sanglah Denpasar General Hospital (RSUP). Data obtained in the form of secondary data of medical record of patient period January 2016-January 2017. Data were analyzed by using SPSS program. Result: The results showed that from 63 patients, found 51.0% gram positive and 49.0% gram negative. In the positive gram found 8 species of bacteria with the most bacteria that is Staphylococcus aureus 15.87% and Strep β Haemolyticus 15.87% and gram negative found 3 types of bacteria with the highest number Pseudomonas aeruginosa 30.16%. Conclusion: Antibiotics with the highest resistance were found Amoxicillin 85.7%, Amoxicillin / Sulbactam 81.2% and Ampicillin 87.5% while the highest sensitivity antibotics were Amikacin 82.3%, Meropenem 75.0% and Linezolid 85.7% both on gram negative and gram positive.
Resumo Objetivos O objetivo deste estudo é revisar e analisar sistematicamente o desfecho funcional do procedimento de tenodese extra-articular lateral (TEL) em complemento à reconstrução do ligamento cruzado anterior (RLCA) em de estudos com alto nível de evidências. Métodos Realizamos a pesquisa bibliográfica para estudos clínicos comparando o método TEL como complemento à RCLA com a RLCA isolada. Os resultados principais foram a pontuação no Comitê Internacional de Documentação de Joelho (IKDC, na sigla em inglês), pontuação de Lysholm, e falhas no enxerto. Variáveis contínuas foram relatadas, como médias e intervalos de confiança (ICs) de 95%. Resultados Seis estudos clínicos com 1,049 pacientes foram incluídos na metanálise. O período de seguimento foi de, em média, 24 meses (intervalo de 6–63 meses). A adição do procedimento TEL à reconstrução do LCA resultou em melhor resultado funcional com base no escore IKDC (p < 0,05). A falha do enxerto foi menor no grupo RLCA mais TEL (16 dos 342 pacientes) em comparação com o grupo apenas RLCA (46 dos 341 pacientes) (p < 0,05). Conclusão Há evidências de alto nível de que o procedimento TEL como complemento à RLCA é preferível em termos de resultado funcional e falha do enxerto.
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