Chronic osteomyelitis is an inflammatory process in the bone followed by bone destruction caused by microorganism infection. The annual incidence of osteomyelitis is approximately 21.8 cases per 100,000 person-years in the general population. Implanting antibiotic-loaded carriers directly at the site of infection becomes a promising treatment approach. PerOssal® is an osteoconductive synthetic bone substitute for restoring and filling bone defects. PerOssal® pellets contain 51.1% nanocrystalline hydroxyapatite and 48.5% calcium sulfate. It has a role as bone material to fill bone defects caused by dead bone in chronic osteomyelitis. The porosity of PerOssal® allows a high initial antibiotic release, then decreases to ensure a local concentration of the antibiotic. PerOssal® did not show any in vitro cytotoxicity and fatal adverse event as bone material. PerOssal® is a promising antibiotic-loaded carrier for the management of chronic osteomyelitis. It demonstrates good biocompatibility with initial high antibiotic release without in vitro cytotoxicity and fatal adverse event.

Background: Osteomyelitis has its challenges in its management. Not only because it requires time and cost in treatment, but also a collaboration between doctors, the patient and the environment of family and significant person to the patient himself to achieve optimal management. Case Description: This report was conducted to find the therapy results in a patient with a diagnosis of chronic osteomyelitis, which has suffered the patient for 15 years. This study used a case reports study. Therapy given to the 29 years old male patient with a diagnosis of chronic osteomyelitis of the right femur Cierny Mader IVA was debridement and incision, as well as giving empirical antibiotics according to culture results. The result of the treatment was satisfactory. Conclusion: The patient’s condition improved, and no complaints were reported. The patient can do activities with an assistive device.   Latar Belakang: Osteomielitis memiliki tantangan tersendiri dalam penatalaksanaanya, selain karena membutuhkan waktu dan biaya dalam pengobatan, dibutuhkan kerjasama antara dokter, pasien dan lingkungan baik itu keluarga ataupun orang terdekat pasien itu sendiri agar dapat mencapai penatalaksanaan yang optimal. Deskripsi Kasus: Laporan ini bertujuan untuk mengetahui hasil pemberian terapi pada pasien dengan diagnosa osteomielitis kronis yang sudah diderita oleh pasien sejak 15 tahun yang lalu. Penelitian ini menggunakan metode laporan kasus. Terapi yang diberikan kepada pasien laki-laki 29 tahun dengan diagnosa osteomielitis kronis femur kanan cierny mader IVA berupa debridemen dan insisi, disertai pemberian antibiotik empirik sesuai hasil kultur. Hasil dari pemberian terapi tersebut cukup memuaskan. Kesimpulan: Pasien mengalami perbaikan kondisi dan tidak didapatkan keluhan serta pasien dapat beraktifitas dengan alat bantu

Introduction: The Covid-19 pandemic has been a profound phenomenon affecting the entire world, primarily healthcare systems. Since the first Covid-19 case in Indonesia around March 2020, the healthcare systems and public regulations have been constantly readjusted. In our centre, the pandemic has also had major effects on the orthopaedic and trauma services. This study aims to evaluate the impact of Covid-19 on orthopaedic surgery in Wangaya General Hospital. Method: A cross-sectional study is done retrospectively through medical records among patients underwent orthopaedic surgery from March 2019 to 2021. Pre-Covid control group (March 2019-2020) is compared to Covid case group (March 2020-2021). The parameter of study includes: patient’s demographics, orthopaedic diagnosis, anatomical location, orthopaedic surgery, and type of surgery. T test and chi square test is used for data analysis. Result: Out of the total 916 cases, the number of orthopaedic surgeries is decreased by 42,61% (582 vs. 334 cases; 48,5±10,11 vs. 27,83±4,89 cases/month) on the first year of pandemic. The number of emergency surgeries has escalated significantly with inverted proportion to elective surgeries, such as arthroplasties, implant and benign tumor removal. Polytrauma, lacerations and tendon rupture case has been increased considerably requiring immediate surgical treatment. Conclusion: In response to the pandemic, the objective is to restore high quality healthcare systems by reconstructing newly updated strategies for patient management plan and public regulations during the ongoing Covid-19 pandemic.

Background: Chronic osteomyelitis is still an important problem in the orthopedic field, especially in developing countries. Cat's claws contain many harmful microorganisms and can cause significant morbidity ranging from infection of skin tissue, muscle, and even deeper to bone tissue (osteomyelitis). The aim of this study was to report that injuries caused by cat-scratches and not receiving proper treatment can develop into chronic osteomyelitis. Case presentation: A 14-year-old boy came to the orthopedic polyclinic of Wangaya General Hospital with complaints of a left leg wound that had not healed since 2 years ago after got cat-scratches. The wound was oozing pus, tenderness, and the ankle area was found to be difficult to move because the patient's leg felt stiff. On physical, laboratory, and radiographic examination were found to be suggestive of chronic osteomyelitis. Conclusion: In general, cat scratch injuries are simple and harmless wounds, but if left untreated can lead to infection and morbidity in the future. Persistent symptoms and unrelieved wound conditions should be important indications for patients and practitioners of the possibility of infection that extends to soft tissue or bone tissue. A good understanding of acute wound management is very important in preventing serious infections.   Latar belakang: Osteomielitis kronik masih merupakan masalah penting di bidang ortopedi terutama di negara berkembang. Pada cakaran kuku kucing mengandung banyak mikroorganisme berbahaya dan dapat menyebabkan morbiditas yang signifikan mulai dari infeksi jaringan kulit, otot, bahkan lebih dalam sampai mengenai jaringan tulang (osteomielitis). Tujuan dari penelitian ini adalah untuk melaporkan cidera yang disebabkan oleh cakaran kucing dan tidak mendapatkan pengobatan dengan baik dapat berkembang menjadi osteomielitis kronis. Laporan kasus: Seorang anak laki-laki berusia 14 tahun datang ke poliklinik ortopedi RSUD Wangaya dengan keluhan luka kaki kiri yang tidak kunjung sembuh sejak 2 tahun yang lalu, luka mengeluarkan nanah, nyeri tekan, serta pada daerah ankle ditemukan sulit untuk digerakkan yang dikarenakan kaki pasien terasa kaku. Pada pemeriksaan fisik dan laboratorium ditemukan mengarah pada osteomielitis kronis.  Simpulan: Pada umumnya cidera cakaran kucing hanya luka sederhana dan tidak berbahaya, tetapi jika diabaikan dapat menyebabkan infeksi dan morbiditas dikemudian hari. Gejala yang menetap dan kondisi luka yang tidak membaik harus menjadi indikasi penting bagi penderita dan praktisi terhadap kemungkinan infeksi yang meluas ke jaringan lunak ataupun jaringan tulang. Pemahaman yang baik tentang penanganan luka akut menjadi sangat penting dalam mencegah terjadinya infeksi yang serius.