Serial kasus berbagai metode perawatan dislokasi sendi temporomandibula berdasarkan jenis dislokasinyaCase series of various temporomandibular joint dislocation treatment methods based on the dislocation type

Pendahuluan: Dislokasi sendi temporomandibula (TMJ) merupakan suatu keadaan dimana kondilus keluar dari fosa glenoidalis ke arah superior, posterior atau anterior melewati eminentia artikularis dan seringkali disertai dengan spasme otot-otot pengunyahan. Penanganan yang terlambat dapat menimbulkan komplikasi berupa asimetri wajah dan menggangu pengunyahan. Tujuan penulisan kasus ini adalah menyampaikan serial kasus perawatan dislokasi sendi temporomandibular berdasarkan jenis dislokasinya. Laporan kasus: Empat tipe kasus dislokasi TMJ datang ke IGD dan Poli Bedah Mulut dan Maksilofasial Rumah Sakit Hasan Sadikin Bandung dengan riwayat dislokasi yang berbeda. Pasien berjenis kelamin dua laki-laki dan dua perempuan, berusia 33 hingga 66 tahun dengan faktor predisposisi menguap. Klasifikasi dislokasi yaitu akut dan kronis. Perawatan keempat kasus berupa reduksi manual, menggunakan metode Hippocrates dan wrist pivot, hingga pembedahan dengan miotomi. Simpulan: Keadaan dislokasi yang berbeda memerlukan perawatan yang berbeda. Kasus akut dapat segera dilakukan reduksi manual, sedangkan kasus kronis memerlukan pembedahan. Keterlambatan penanganan yang tepat dapat membuat keadaan menjadi lebih berat sehingga memerlukan penanganan yang lebih kompleks dan biaya yang lebih besar. ABSTRACTIntroduction: Temporomandibular joint (TMJ) dislocation is a condition in which the condyle exits the glenoid fossa superiorly, posteriorly, or anteriorly through the articular eminence and is often accompanied by mastication muscle spasm. Delayed treatment can cause complications in the form of facial asymmetry, thus interfere with mastication. The purpose of the case series was to present a case series of temporomandibular joint dislocations treatment based on the dislocation type. Case reports: Four different patients with four types of TMJ dislocation cases came to the ER and the Oral and Maxillofacial Surgery Clinic of Hasan Sadikin Hospital Bandung, with different dislocation histories. The patients were two males and two females, aged 33 to 66 years, with predisposing factors of yawning. Classifications of dislocations were acute and chronic. The four cases’ treatments were manual reduction, each using the Hippocrates method and wrist pivot, up to surgery with myotomy. Conclusions: Different dislocation conditions require different treatments. Acute cases can be directly reduced manually, while chronic cases require surgery. Delay in proper handling will severe the situation, requiring more complex treatment with higher costs.

Subsurface Deformation Mechanism in Nano-cutting of Gallium Arsenide Using Molecular Dynamics Simulation

During the nano-cutting process, monocrystalline gallium arsenide is faced with various surface/subsurface deformations and damages that significantly influence the product’s performance. In this paper, molecular dynamics simulations of nano-cutting on gallium arsenide are conducted to investigate the surface and subsurface deformation mechanism. Dislocations are found in the machined subsurface. Phase transformation and amorphization are studied by means of coordination numbers. Results reveal the existence of an intermediate phase with a coordination number of five during the cutting process. Models with different cutting speeds are established to investigate the effects on the dislocation. The effect of crystal anisotropy on the dislocation type and density is studied via models with different cutting orientations. In addition, the subsurface stress is also analyzed.

Acromioclavicular Reconstruction Using Semitendinosus Tendon Autograft: A Technical Note and Case Report

Background: Although there are several surgical options for the treatment of acromioclavicular joint (ACJ) dislocation, there is no definite gold standard. Anatomical reconstruction techniques are becoming more popular due to the new understandings of the anatomy and biomechanics of the ACJ. Case Report: A 40-year-old male with left ACJ dislocation (Type 3 Rockwood classification) underwent anatomical reconstruction with a semitendinosus tendon graft harvested from the left knee. Conclusion: Anatomical reconstruction of ACJ by autograft is an effective treatment option.

Dislocations of the acromioclavicular and sternoclavicular joint in children and adolescents: A retrospective clinical study and big data analysis of routine data

Background Dislocations of the sternoclavicular joint (anterior/posterior) and acromioclavicular joint (SCJ and ACJ, respectively) are rare injuries in childhood/adolescence, each having its own special characteristics. In posterior SCJ dislocation, the concomitant injuries in the upper mediastinum are most important complication, while in anterior SCJ dislocation there is a risk of permanent or recurrent instability. Methods In a retrospective analysis from seven pediatric trauma centers under the leadership of the Section of Pediatric Traumatology of the German Trauma Society, children (<18 years) were analyzed with focus on age, gender, trauma mechanism, diagnostics, treatment strategy and follow-up results. Additional epidemiological big data analysis from routine data was done. Results In total 24 cases with an average age of 14.4 years (23 boys, 1 girl) could be evaluated (7x ACJ dislocation type ≥ Rockwood III; 17x SCJ dislocation type Allman III, including 12 posterior). All ACJ dislocations were treated surgically. Postoperative immobilization lasted 3–6 weeks, after which a movement limit of 90 degrees was recommended until implant removal. Patients with SCJ dislocation were posterior dislocations in 75%, and 15 of 17 were treated surgically. One patient had a tendency toward sub-dislocation and another had a relapse. Conservatively treated injuries healed without complications. Compared to adults, SCJ injuries were equally rarely found in children (< 1% of clavicle-associated injuries), while pediatric ACJ dislocations were significantly less frequent (p<0.001). Conclusions In cases of SCJ dislocations, our cohort analysis confirmed both the heterogeneous spectrum of the treatment strategies in addition to the problems/complications based on previous literature. The indication for the operative or conservative approach and for the specific method is not standardized. In order to be able to create evidence-based standards, a prospective, multicenter-study with a sufficiently long follow-up time would be necessary due to the rarity of these injuries in children. The rarity was emphasized by our routine data analysis.