ABSTRACT
Background: Loss of limbs occurs due to different causes and has increased in many countries. This has large economic, physical and social impacts. This study investigates the demographics of patients undergoing amputation at Saiful Anwar Hospital Malang.Methods: This retrospective study was done from January 2014 to December 2018. The patient demographics included age, sex, organ amputation, etiology and amputation level. A total of 479 patients were studied in the study.Results: The average amputation value was 95.8 per year and varied from 72 to 134. The average age of the subjects was 44 years. Of all patients, 311 were male (64.93) and 168 women (35.07), 236 of amputations (49.27%) were major and 243 (50.73%) were minor.Conclusions: The main cause of amputation is trauma and most often is the amputation of the lower extremity. In trauma patients, the average age is 29 years. This result shows the same characteristic in the cause of amputation as in many other developing countries based on some studies. Trauma is the most common cause of amputation in Malang.
ABSTRACT
Aneurysmal fibrous histiocytoma is rare clinicopathological variant of Cutaneous Fibrous Histiocytoma. The clinical manifestation of Aneurysmal Fibrous Histiocytoma is often confusing to distinguish from other skin lesions. Most of the cases showed rapid increase in size or a history of recurrence, however histologically all are almost similar. Rarity of aneurysmal fibrous histiocytoma and high numbers of recurrence rate poses a big diagnostic challenge. Late treatment will result in a decrease until loss of function of the affected region. In this article, author reported the case of aneurysmal fibrous histiocytoma of the hand in 7 years old girl with restricted at 2nd-3rd metacarpophalangeal joints. The patient had undergone a series of investigations until finally a wide excision was carried out. Excision tissue was performed CD 68 and CD 34 immunocytochemical smear to establish the diagnosis. It was not simple to make diagnosis aneurysmal fibrous histiocytoma. While it is benign, the lesion can appear malignant, and one should consider an excisional biopsy to rule out malignant conditions. The diagnosis had to be confirmed by histopathological and performed immunocytochemical smear. It was often necessary to take aggressive actions with wide excision and reconstruction.
ABSTRACT
The free vascularized fibular graft has been successfully applied as a reconstruction option in patient with large secondary skeletal defects result from excision of pathologic tissue after neurofibroma surgical excision. It provides a strong cortical strut for reconstruction of defects, so that the free vascularized fibular graft is ideal for ulna reconstruction. A 22-year-old male with lump in his right forearm for 3 months previously which become bigger and more painful. There was also sings of ulnar nerve disfunction. From the CPC result, we diagnosed forearm neurofibroma. We performed wide excision and reconstruction using free vascularized fibular graft. On the last follow up, the active and passive ranges of motion (ROM) of 4th and 5th metacarpal was measured with the help of a goniometer. The ulnar neurological state was tested by manual testing and graded on the Medical research council (MRC) scale. Four weeks after surgery, the operation wound at the right forearm and right lower leg was good and no infection signs. The graft viability was good with compromised vascularity. The post-operative passive and active ROM of the 4th and 5th metacarpal able did full extend. The post-operative sensoris level of the ulnar area improved from pre-operative sensoris level.Post-operative follow-up, in the early period (up to 6 weeks) we monitor the graft viability. Our case reported good result in the operation wound, the graft viability, the passive and active ROM of the 4th and 5th metacarpal and the sensoris level of the ulnar area.