Changes in Pediatric Fracture Cases during the Coronavirus Disease 2019 Pandemic: Data from a National Referral Orthopedic Hospital in Indonesia

AIM: This study aims to compare the impact of coronavirus disease 2019 (COVID-19) on pediatric fracture services in a national referral orthopedic hospital in Indonesia to understand the service provisions that may be required during the pandemic. METHODS: The study compared the population group during 1 year of the COVID-19 pandemic in Indonesia to the same period 1 year before. This cross-sectional study was performed in Prof. Dr. R Soeharso Orthopedic Hospital, Surakarta, Indonesia, from March 2019 to February 2021. The subjects were pediatric fracture patients aged 0–18 years. Patients recorded on other orthopedic service support installations such as radiology, laboratory, or physiotherapy and diagnosed with any other orthopedic sub-specialty were excluded. RESULTS: A total of 1787 patients were recorded in this study, with the mean of pediatric fracture patients during the pre-COVID-19 period was 90.75 (standard deviation [SD]: 28.5) and during the COVID-19 period was 58.16 (SD: 19.17) monthly. In the 1st year of the pandemic, there was a significant reduction in clinical visits compared to the same period in 2019 (p < 0.005). CONCLUSION: There were significant differences in pediatric fracture cases clinic visits and patients’ length of stay in the COVID-19 period than before the COVID-19 occurred.

Management of resistant congenital clubfeet by the new operative procedure (Hussain's procedure): An experience of a fellowship program

Background and Objectives: Pakistan Society for Rehabilitation of the Disabled Orthopedic Hospital is renowned for the correction of orthopedic deformities including foot and ankle deformities. Consultant orthopedic surgeon Afzal Hussain, pioneers the treatment of orthopedic deformities and has developed a new operative technique for congenital clubfoot. This research was planned to report the success of Hussain's Procedure in detecting and managing the anomalous structures. Material and Methods: This research was mixed retrospective and prospective research carried out during fellowship of first author in which, operative procedure of the resistant congenital clubfoot associated with anomalous structures viz. anomalous muscles and tarsal coalitions, were performed with the new operative procedure by Dr. Hussain, were assisted by the first author and a minimum of 5 years of follow up of the cases was done by the senior author (Afzal Hussain). Cumming’s modification of Laavag and Ponseti score was applied for the calculation of the results at the follow-ups. Results: During the fellowship, 10 cases of clubfeet with muscle anomalies were managed. Similarly 7 clubfeet with tarsal coalitions were managed. There was full correction of the clubfoot deformity. The cases were followed up by the senior author (Afzal Hussain) for at least 5 years. During the minimum of 5 years followup post completion of treatment, Cumming’s modification of Laavag and Ponseti scores of the operated clubfeet were found to be excellent. Conclusion: The resistance to management of congenital clubfoot by casting may be because of anomalous structures. New operative procedure by Consultant Afzal Hussain names as Hussain's Procedure was helpful in detecting and managing the anomalous structures.

Managing the Neglected and the Residual Clubfeet with the New Operative Procedure (Hussain’s Procedure) – An Experience of Six-Month Fellowship

Background: Pakistan Society for Rehabilitation of the Disabled Orthopedic Hospital is renowned for the correction of orthopedic deformities including foot and ankle deformities. Dr. Afzal Hussain, a consultant orthopedic surgeon in the hospital, pioneers in treatment of foot and ankle deformities and he has developed a new operative procedure for congenital clubfoot. Working with the surgeon for 6 months during the fellowship, management of the neglected and the residual congenital clubfeet with the new operative procedure and their follow-ups were assisted by the first author. Materials and Methods: Operative procedure of the neglected and the residual congenital clubfeet, which were performed with the new operative procedure by Dr. Hussain, were assisted by the first author and a minimum of 5 years follow up was done by the senior author (Afzal Hussain). Cumming’s modification of Laavag and Ponseti score was applied for the calculation of the results at the follow-ups. Results: During the follow-ups of 11 cases of neglected congenital clubfeet and 9 cases of residual clubfeet (operated earlier with posteromedial release) which had been operated by the new operative procedure, Cumming’s modification of Laavag and Ponseti scores of the operated clubfeet were calculated and the results were found to be excellent. Conclusion: Early results of the new operative procedure by Dr. Afzal Hussain for congenital clubfoot in the neglected and the residual congenital clubfeet were found to be excellent.

An overview of the quality of life of Knee osteoarthritis patients at the Surakarta Orthopedic Hospital

ABSTRACT Background: Osteoarthritis is a chronic degenerative disease of the joints. Functional limitations experienced by people with knee osteoarthritis are related to changes in quality of life. Knee Osteoarthritis needs to be assessed as a whole which includes several domains of quality of life, namely the domains of pain, stiffness and physical function. This study was conducted to determine the correlation between pain intensity and quality of life in patients with knee osteoarthritis. Methods: a quantitative study using an analytic observational method with a cross-sectional approach. Population of 70 patients, a sample of 33 patients. The research was conducted in October 2020 at the Orthopedic Hospital in Surakarta City, Central Java, Indonesia. Data were collected by direct interviews to assess pain intensity based on the Numeric Rating Scale (NRS) and assess quality of life based on the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Normality test using Sapiro Wilk because the data is normaly distributed. Hipotesis test using Pearson correlation. Results: Age range of patients with knee osteoarthritis mostly occurred at the age of 56-60 years, women had a greater frequency of experiencing knee osteoarthritis with a frequency of 78.8%, the most incidence of knee osteoarthritis was experienced by patients with normal BMI, namely 54.5%, The results of the Pearson correlation test showed a significance value of Sig. (2-tailed) is 0.000149 <0.05, which means that there is a significant correlation between the variables between pain and quality of life. Has a positive relationship and strong relationship strength (r = 0.613). Conclusion: There is a significant correlation between pain intensity and quality of life in patients with osteoarthritis

Effect of Coronavirus Disease-19 Pandemic to the Volume of Total Hip and Knee Arthroplasty Surgical Service: Experience from a Single Tertiary Orthopedic Hospital in Indonesia

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.

Effect of Arm Position on Visualization of Target Zone for Posterior Glenohumeral Joint Injection

Objectives: Glenohumeral injections can be performed using a variety of approaches. We hypothesize that the position of the ipsilateral arm affects the target zone for posterior approach of glenohumeral joints. Material and Methods: We performed ultrasound on three volunteers with arm with in neutral and varying degrees of flexion and extension. Results: We found that target zone is increased on flexion and decreased with arm in extension. Conclusion: Considering patient comfort, target zone, and operator ergonomics, we conclude that the posterior glenohumeral US-guided injections should be performed with patient lying on the contralateral side with the ipsilateral arm in neutral, and hand rested on the thigh (Birmingham Royal Orthopedic Hospital (BROH) position).

Employee participation and organizational efficiency & effectiveness in Ntional Orthopedic Hospital, Lagos Sate

The study examined the impact of employee participation on the efficiency and effectiveness in National Orthopedic Hospital, Lagos State. Demographic data from National Orthopedic Hospital, Lagos State were analyzed using simple percentages and frequency counts. Three hypotheses postulated for the study were statistically tested using the Multiple Linear Regression. Research results show that that employee consultation and Joint decision making have positive and significant influences on effectiveness and efficiency of National Orthopedic Hospital in Lagos State, while employee delegation was found to have a negative and significant effect influence on effectiveness and efficiency of National Orthopedic Hospital, Lagos State. To improve organizational efficiency and effectiveness National Orthopedic Hospital, Lagos State, we recommend that management of the public hospital state should adopt a participatory approach in decision making to encourage employees' affirmative commitment to organizational goals and objectives, which will breed a harmonious working environment devoid of bitterness and hostility. Keywords: Effectiveness, Efficiency, Employee Participation, Hospital, Organisation.