Problems and treatment surrounding joints, bones and hips are a unity and also a polemic for society, especially for those who live in a number of big cities. The reason is that it is rare to find a hospital that specifically handles bone, joint and hip problems competently by involving a number of cross-disciplinary disciplines.
Siloam Hospitals Mampang Successfully Handled Two of the Most Difficult Cases of Bone and Hip Joint Problems
For example, treatment of Polytrauma and Multiple Fractures involving the joints in particular; Pelvic Acetabulum. Or handling Total Hip Replacement, namely the replacement of the pelvic bones which commonly occurs when humans are in the elderly phase.
As a center of excellence for Orthopedic services, Siloam Hospitals Mampang sees the joint and hip polemic for residents of the capital as a challenge and opportunity.
"Because it is still few or even rare, there is a hospital that involves multidisciplinary treatment for a number of bone and joint cases in a comprehensive manner, and generally the people of the capital head to us at Siloam Hospitals Mampang as a referral center and superior treatment regarding Orthopedics," said Dr.dr. Wahyuni Dian Purwati, Sp.EM, Director of Siloam Hospitals Mampang at the Media Gathering event in South Jakarta on Thursday 14, March 2024.
And these are the two of the most difficult cases that were successfully handled.
A case that requires multidisciplinary treatment with a high level of difficulty
One of the leading orthopaedic experts in Indonesia, Prof. Dr. dr. Ismail Hadisoebroto Dilogo SpOT(K) Pelvic, Hip and Knee., explained that Polytrauma is trauma that occurs in several parts of the body, accompanied by a decrease in physiological function which can result in multiple organ dysfunction and even death in the patient.
"Multiple Fractures are a condition where there is loss of continuity of bone tissue in more than one fracture line, which is usually caused by direct or indirect pressure on the bone surface with high force," said Prof. Dr. Dr. Ismail Hadisoebroto Dilogo who practices permanently at Siloam Hospitals Mampang.
According to Ismail Hadisoebroto, someone who experiences one of these conditions is already at risk of being fatal. So, what if you experience both conditions at the same time?
"Of course, multidisciplinary collaboration is needed from Emergency, SpBS, Anesthesia, SpPD, Medical Rehab doctors, with special expertise from SpOT doctors," explained Prof. Ismail.
Prof. Dr. dr. Ismail Hadisoebroto Dilogo SpOT(K) Pelvic, Hip and Knee. with his team dr. M Triadi Wijaya SpOT(K) and dr. Riky SpOT are orthopaedic surgeons from Siloam Mampang Prapatan Hospital who handled this case. The multidisciplinary collaboration in this case was successfully carried out so that the patient was handled well and now the patient can return to his daily activities. .
This case is a case with a high level of difficulty because this patient was diagnosed with Polytrauma (Mild Head Injury, Interhemispheric SDH + Tentorial) and Multiple Fractures (Pelvic Ring Fracture type A2, Right acetabulum Fracture transverse-posterior wall type, Left Anterior Wall type Acetabular Fracture, Complete Linear Fracture of Bilateral Ramus Pubic and Inferior Pubic, Complete Transverse Fracture of the Left Surgical Neck Humerus, Comminuted fracture and dislocation of left distal humerus, complete transverse fracture of the left olecranon) with almost all fractures located in the articular (joint), which is much more difficult to treat than fractures in the diaphysis (long bone shaft). The outcome of articular surgery is usually worse than fractures located in the diaphysis.
The procedure carried out by Prof. Dr. dr. Ismail and his team are ORIF (Open Reduction Internal Fixation) and Percutaneus Screwing.
ORIF is a type of operation with internal fixation which is performed when the fracture cannot be reduced closed. Meanwhile, Percutaneous Screwing is a minimally invasive operation to fix broken bones, one of which is for Acetabular Fractures because of the complex anatomy of the pelvis.
"After the procedure is completed, patients are advised to routinely undergo physiotherapy during the healing period so that the results of the operation can be achieved perfectly," said Prof. Dr. dr. Ismail explained.
Handling the Most Difficult Cases of Shortened and Fused Hip Joints with Surgical Techniques
Primary difficult Total Hip Replacement (THR) is an operation carried out on patients who have comorbidities with bone or soft tissue disorders.
Even though the procedure carried out is the same as a total hip joint replacement or what we usually know as THR, post-TB Coxitis patients with joints that have fused and shortened by 3cm are cases with a high level of difficulty.
"And this requires a planned, comprehensive approach from an experienced consultant subspecialist orthopaedic surgeon so that you no longer walk with a limp, your legs are the same length, free of pain, the range of motion of the hip joints is restored, you can return to praying in a perfect sitting position and there are no complications after surgery.", said Prof. Dr. dr. Ismail Hadisoebroto Dilogo SpOT(K) who is a pelvic consultant subspecialist orthopaedic surgeon, hip and knee adult reconstruction from Siloam Mampang Prapatan Hospital.
Explained again by Prof. Ismail Hadisoebroto, THR is a surgery to replace a damaged hip joint, namely the damaged bone and cartilage will be replaced, the head of the femur will be replaced with metal or ceramic, and the damaged cartilage surface of the socket is removed and replaced with a metal socket.
This case was handled with a comprehensive approach, reconstructive orthopaedics, internal medicine, anaesthesia, neurosurgery and medical rehabilitation and based on teamwork under the main dpjp Prof. Dr. Dr. Ismail Hadisoebroto Dilogo SpOT(K) who is a pelvic consultant subspecialist orthopaedic surgeon, hip and knee adult reconstruction from Siloam Mampang Prapatan Hospital.
