Relationship between TLR-2 level and clinical or radiological severity on patients with tuberculosis spondylitis in Dr. Wahidin Sudirohusodo hospital Makassar.

Spinal tuberculosis or TB spondylitis is one of the most common types of extra pulmonary tuberculosis, which is about 15% of all cases. It causes severe morbidity, neurological deficits, and severe deformities in the patients. The growth of Mycobacterium tuberculosis in culture specimens obtained from infected tissue is the single gold standard diagnostic test for spinal TB. Toll-like receptor (TLR) is one of the important receptors in the first-line defence system against microbes. TLR-2 and TLR-4 are known to be associated with tuberculosis infection. Based on this background, the researchers were interested in examining the relationship between TLR-2 levels and the clinical and radiological severity of TB spondylitis patients. A cross-sectional study was conducted with patients diagnosed with tuberculosis spondylitis at Dr Wahidin Sudirohusodo Makassar. Patients diagnosed with TB spondylitis confirmed by blood tests, GeneExpert, and magnetic resonance imaging without prior treatment were included. Data analysis were conducted by using descriptive analysis and one-way ANOVA for bivariate analysis. The mean value of TLR2 levels in TB spondylitis patients was 9.1 g/dL. TLR2 levels in paraesthesia were significantly higher than normal (P < .05). Similar trend were analyzed on the motor neurologic status with TLR2 levels in paraparesis were significantly higher than those in normal (P < .05). There is a significant relationship between the TLR2 levels in TB spondylitis and their impaired motor and sensory function. Spinal destruction has been shown to provide significant relationship with TLR2 value in spondylitis TB.

Functional outcome of campanacci grade 3 giant cell tumours of distal radius after resection and reconstruction with ulnar translocation technique: a case series.

Reconstruction after en-bloc resection can be challenging in cases of Campanacci grade 3 giant cell tumour of the bone (GCTB) of the distal radius. Here, the authors examined the outcomes of patients with Campanacci grade 3 GCTBs of the distal radius who underwent wrist arthrodesis and reconstruction with ulnar translocation. Material and methods: This case series was a retrospective single-centre study. Clinical assessments regarding the functional status and complications were follow-up. The functional results were evaluated using the Musculoskeletal Tumor Society (MSTS) and Disability of Arm, Shoulder, and Hand (DASH) Score. Paired t-tests were used to compare the MSTS and DASH scores separately before and after the operation. Statistical differences were considered significant at P less than 0.05. Results: Seven patients were included in this study. The mean follow-up period was 14.43±8.08 months. The average length of tumour resection was 9.78±2.88 cm. The average range of motion of the involved forearm was 82.66° of supination and 81.54° of pronation. The average MSTS score was 11.71±2.21 before and 25.14±2.41 after the operation (P<0.05). The average DASH score on admission was 40.14±14.66, which decreased to 9.02±4.23 after the operation (P<0.05). Of the seven cases, one case had a recurrence, and one patient had radioulnar synostosis. Conclusion: Wrist arthrodesis combined with ulnar translocation can be considered a simple and effective reconstruction method with preservation of function after en-bloc resection of Campanacci grade 3 GCTB of the distal radius. It provides good functional outcomes with low complication rates.

Functional outcome of modified Jones procedure in patient with non-union Humerus and high radial nerve palsy: A case report.

Background: Middle to distal humeral fractures can cause high radial nerve palsy. A tendon transfer surgery can be performed to treat irreversible and longstanding radial nerve palsy in order to improve the lost hand function. Case report: A 39-year-old right-handed female office worker presented with deformity in her left arm and drop hand. She had a motorcycle accident a year before and was treated by a traditional bonesetter. The extension movements in her left wrist and fingers were restricted. We performed an ORIF with bone graft at her left nonunion humerus and also tendon transfer procedure to treat the high radial nerve palsy. We use the modified Jones procedure to attach the palmaris longus to the extensor pollicis longus. After that, we attached the flexor carpi radialis to extensor digitorum communis and extensor carpi radialis brevis with the Pulvertaft technique. After five months of follow up, the patient finally can extend her wrist and thumb. Conclusion: Modified Jones procedure is a viable option to treat high radial nerve palsy with great functional outcomes after 5 months of follow up.