Background: Congenital Scoliosis (CS) defined as vertebral lateral deviation which forms during the intrauterine embryonic phase, carrying incidence between 0,5-1 per 1000 births. Mortality rate increases in untreated case, especially due to pulmonary problem (40%).Contents: CS can range from hemivertebrae (HV) which may be single or multiple, vertebral bar with or without HV, block vertebrae, wedge shaped or butterfly vertebrae. The risk factors for progression include: type of defect, site of defect, and the patient’s age. Plain radiographs remain standard diagnosis. MRI evaluation should be considered. The goal of managing CS is to obtain a balanced trunk and spine while maintaining as much normal spinal growth as possible and preventing neural deficit. Non-operative management is including observation, brace, and traction. The operative procedures are broadly divided into (a) those preventing further deformity: in situ fusion, convex hemiepiphysiodesis, and HV excision, (b) those that correct the present deformity: hemiepiphyseodesis & hemiarthrodesis, single & dual growing rods, HV excision, and reconstructive osteotomy.Conclusion: The treatment of CS remains one of the more challenging aspects of pediatric orthopaedic surgery. Operative treatment should be reserved for patients whom non-operative management didn’t meet the criteria or failed.
Ankle osteoarthritis patients are young and lack of available long last treatment. Ankle arthrodesis remains the gold standard and is the procedure of choice for younger patients who are heavy laborers. These case series evaluate and report five patients undergone ankle arthrodesis at RSUD Dr. Soetomo Surabaya on 2012-2016. The data were collected from patient files, radiographs, and a recent physical examination. The outcome has been assessed with SF-36 score and clinical scoring system Ankle-Hind foot American Foot and Ankle Society. Three male patients and two female patients underwent ankle arthrodesis with cannulated screw, caused by neglected severe ankle dislocation. One patient had open dislocation. Based on SF-36 scoring, the five patients had average score 76,7 with highest and lowest score were 95,9 and 56,7. Based on clinical score ankle-hind foot American Ankle and Foot Society, the average score was 68(51 – 88). The scoring result includes general health, physic, emotional, and social. And clinical scoring ankle-hind foot American Foot and Ankle Society evaluation includes pain, function, and alignment. It shows that there was patient that gains an almost perfect result. Patient with the lowest score also had knee osteoarthritis contralateral from the operated ankle. Early weight bearing on ankle arthrodesis with cannulated screw was the major factor caused unsatisfactory result of this patient. Ankle arthrodesis with cannulated screw has satisfactory result eventhough remain complain on one patient. Nevertheless, ankle arthrodesis with cannulated screw still has an important role in the treatment of choice on ankle reconstruction.Keywords : Ankle arthrodesis, cannulated screw, ankle joint fusion
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