Brachial plexus injury is known to be one of the most serious upper limb injuries, causes paralysis of the upper limbs and changes in activity of daily living, with the consequence disruption of activity of daily living, socio-economic problems, depression, and hopelessness. Management must be done properly. The evaluation and examination consist of detailed anamnesis on chronological events, complete physical examination, imaging studies, and electrophysiology study. Management can be done nonsurgically and surgically. Knowledge of the history of injury, timing of surgery, priority in restoring function, and managing patient expectations are important concepts in treating patient with brachial plexus injury. Timing is a very important thing. The results of these interventions vary depending on several parameters. Recognizing the basic principles of managing brachial plexus injuries is indispensable for all clinicians who treat these injuries.
The difficult situation of the coronavirus disease (COVID)-19 pandemic may affect to hip and knee arthroplasty service. Retrospective study was performed to patients who received elective total hip/total knee arthroplasty (THA/TKA) from January to September 2020 at Prof. Dr. R. Soeharso Orthopaedic Hospital, Surakarta, Indonesia. There were a total of 64 THA and 227 TKA from January to September of 2020. There was an extreme decrease in the number of TKA surgery during April, May, and June in 2020. The effect of coronavirus disease-19 pandemic to the decrease of arthroplasty service was mainly in the first 3 months period.
ABSTRACT
Background: Platelet Rich Fibrin (PRF) is a growth factor concentration functioning as an initiator of wound healing and bone regeneration, and it is mainly reported in dentistry rehabilitation and rejuvenation.
Objective: summarize and analyze the evidence based on the effect of PRF on the bone osteogenesis
Methods: A comprehensive search was conducted on the bibliographic databases or Medical Subject Headings in the PubMed. The search was conducted among articles that were published between 2010 and 2021. Required article information was extracted from each article by abstract and full paper availability that focuses on the Platelet-Rich Fibrin (PRF) And Osteogenesis. We recruited studies with the design was employed clinical trials with in vitro and in vivo approaches. The only study that provided osteogenesis outcome proceeded to the quantitative analysis.
Results: Regarding literature search and screening processes, it yielded 24 studies for qualitative assessment and eleven studies for quantitative analysis. Most of the studies performed a combination of PRF with other materials such as Mg ring, BMSCs, Gold nanoparticles, and PDLSCs. It showed that PRF combined with other materials enhanced the osteogenic ability. The assessment of PRF only showed the various result in multiple outcome markers. For the ALP, the mean difference is 1.40 [1.14-1.67] p-value 0.001. It indicates there is a significant effect of PRF application with the increase of ALP. For the RUNX2, there is a significant effect of PRF application with the increase of RUNX2 1.10 [0.93, 1.26]. For OCN, the mean difference of PRF in OCN is 0.77 [0.43, 1.12] p=0.001. It showed a significant effect of PRF application with the increase of OCN. There is also a significant effect of PRF application for TRAP with the declining number of TRAP is -1.59 [-2.96, -0.22] p=0.001.
Conclusion: PRF combined with other materials showed more promising results rather than PRF only. Moreover, in the assessment of PRF only, it was found that PRF has a significant effect in accelerating bone osteogenesis.
Keywords:
PRF, Platelet-Rich Fibrin, Osteogenesis
Background: Giant cell tumor (GCT) of bone arising from aphalanx of finger is extremely rare. Although, the occurrence of GCT in the hands is a rare, it has been reported that GCT of the small bones (small-bone GCT) carries a higher risk of local recurrence and metastasis than conventional GCT. Subjects and Method: We report two cases of GCT arising from a phalanx of a hand finger. First patient was treated with wide excision of the tumor and fusion with fibular bone graft with the help of a K-wire. Second patient was treated by excision of tumour (Curretage) with allograft bonegraft for bone defect. Results: At their most recent follow-ups (4 months, respectively), both were recurrence free and had returned to their previous occupational and recreational activities.
Conclusion:The effectiveness of these methods in the treatment and prevention of recurrence is still under discussion and there is no gold standard for treating GCT.
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