ORTHOPAEDICS ASSESSMENT:

ONCOLOGY DIVISION

dr. Reza Devianto Hambali

dr. Arief Abidin
dr. A.S. Marsahala Lumbantobing

Consultants :
Prof. Dr. dr. Darmadji Ismono, Sp.B., Sp.OT(K).
dr. M. Naseh Sajadi Budi Irawan, Sp.OT(K).
dr. Herry Herman, Sp.OT., Ph.D.
dr. Bangkit Primayudha, Sp.OT.
POSTOPERATIVE ASSESSMENT
Mrs. R., 31 y.o.
 MRS. R, 31 Y.O.
History Taking:
Chief complain: pain and swelling at left wrist
1 years prior hospital admission, the patient complained of
pain and swelling at left wrist
• Lump with the size of a marble, but grew bigger as an
tennis ball in 2 months
• Patient feels pain in her left wrist
• There is no decrease sensibility on the fingers
• History of fever was denied.
• History of lumps elsewhere was denied.
• History of night pain was denied
• 9 months before came to Hasan Sadikin Hospital,
patient seek medical treatment in Rajawali Hospital, got
X ray and biopsy examination

Past Medical History:

• There is no past medical history

Physical Examination
At left wrist
L: Lump +, size 10x10x8 cm, shiny skin +, scar post biopsy +, venectation -, fungating wound -, deformity -, bruising –
F: Tenderness +, warmth +, solid mass +, immobile, smooth surface, distal neurovascular within normal limit
M: Limited rom
X RAY (SEPTEMBER 2021)
X Ray (September 2021)
PA (DESEMBER 2020)
Microscopic Finding (Illustration)

WebPathology: VISUAL SURVEY OF SURGICAL PATHOLOGY; 2021

 WORKING DIAGNOSIS:

GIANT CELL TUMOR AT LEFT DISTAL RADIUS

CAMPANACCI GRADE III

PERFORMED :

LIMB SALVAGE WITH WIDE RESECTION + BONE

CEMENT INSERTION + ORIF K-WIRE
DESIGN INCISION
INTRAOPERATIVE
INTRAOPERATIVE
INTRAOPERATIVE
INTRAOPERATIVE
PREOPERATIVE ASSESSMENT
Ms. S., 22 y.o.
 MS. S, 23.Y.O (2021)
History Taking:
Chief complain: lump and pain at left knee
12 months prior hospital admission, the patient complained of
pain that came suddenly at her left knee after she falls from
motorcycle
• After 4 months there was lump with the size of a egg, but
grew bigger as an tennis ball now
• History of fever was denied.
• History of lumps elsewhere was denied.
• History of night pain was denied
• 5 months before came to Hasan Sadikin Hospital, patient
seek medical treatment in Islamic Hospital Arafah in Jambi
and got X ray, and biopsy examination

Past Medical History:

• There is no past medical history

Physical Examination
At left knee
L : lump (+) 7x4x3 cm, venektasi (-), fungating wound (-), deformity (-), bruising (-), Scar + post biopsy
F : Tenderness (+), warmth -, solid mass, immobile, smooth surface, distal neurovaskular normal compared to other side. CRT < 2”
M : ROM knee joint limited due to lump
X RAY (AUGUST 2021)
X RAY (AUGUST 2021)
MRI (September 2021)
MRI (September 2021)
MRI (September 2021)
MRI (September 2021)
MRI (September 2021)
MRI (September 2021)
PA (Mei 2021)
Microscopic Finding (Illustration)

WebPathology: VISUAL SURVEY OF SURGICAL PATHOLOGY; 2021

 WORKING DIAGNOSIS :

GCT AT LEFT PROXIMAL TIBIA CAMPANACCI

GRADE II

MANAGEMENT :

LIMB SALVAGE : WIDE EXCISION +

MEGAPROTHESIS PROXIMAL TIBIA
THANK YOU