Introduction Osteochondroma (solitary) and multiple hereditary exostoses (plural) are defined as a cartilage-capped bony projection arising on the external surface of bone containing a marrow cavity that is continuous with that of the underlying bone. These tumors grow slowly and develop to cause symptoms such as limited range of motion, joint pain, lumps, and deformities. The use of ulnar distraction osteogenesis has gained popularity in treating deformity in forearm osteochondroma. Problems that arise including bone angulation and persistent radial head dislocation. Case presentation We describe eight cases of forearm osteochondroma that came to the Prof. Dr. R. Soeharso Orthopedic Hospital, Surakarta, Indonesia. We found two variations in the classification of Masada in these 8 patients, Masada type I and IIB. The main complaint was a bent arm. We decided to do surgery in the form of tumor resection and reconstruction of the deformity by using ulnar gradual lengthening and osteotomies. The results of the procedure were investigated in this study, using clinical and radiological parameters focusing on medium-term functional and structural outcomes. Discussion and conclusion Eight patients had overall good results, although performed with a different sequence of operating techniques. Ulnar lengthening with a monorail fixator is still the main choice in its implementation. Gradual ulnar lengthening improves not only the deformity but also the functionality of the associated forearm.

Introduction: Arthrogryposis multiplex congenita (AMC) is a complex abnormal condition characterized by multiple congenital contractures in the body's joints. Although this condition is not progressive, if not treated properly, it will increase the degree of disability in children. There are two types of AMC. The most common type of AMC is amyoplasia. The second type is distal arthrogryposis (DA), a genetically inherited type characterized by congenital contractures in multiple joints and no neurologic or muscular abnormalities. The incidence of AMC 1:3000 births with clubfeet and congenital hip dislocation is the most common. In this retrospective study, the authors described the profile of AMC patients who underwent surgery at our center with the approach and management. Method: The study design was a descriptive retrospective. The population of this study is all AMC patients who underwent surgery at the orthopedic hospital of Prof. Soeharso Surakarta, Indonesia. We used the total sampling technique who underwent surgery in the 2018-2021 period. Result: In this study, we got eleven AMC patients who underwent surgery. Distribution based on sex found six boys and five girls. Half of the patients underwent surgery under the age of three years, while the other half underwent surgery after the age of five. The presence of patients who are consulted at an older age indicates a lack of public literacy about the abnormal condition of AMC or a lack of concern for the condition. Almost all AMC patients who undergo surgery are in the lower extremities. Conclusion: Rehabilitation plays a very important role in improving the quality of life for AMC patients. A multidisciplinary approach is needed in the treatment of AMC patients. Surgery is performed if stretching and external support splinting/casting cannot achieve functional ROM and repair the deformity.

Total hip arthroplasty (THA) is an emerging surgery in the field of orthopedics with a successful outcome in treating various problems of the hip joint. THA in hip ankylosis is a challenging procedure. Comprehensive pre-operative planning is needed to avoid complications and obtain reasonable functional outcomes. Complete history taking is needed to determine the etiology, indications, type of ankylosis (spontaneous or surgical), age since ankylosis occurred, and previous complications. Physical examination is also important and is focused on the location of the previous incision, limb length discrepancy (LLD), femoral and sciatic nerves, vascular status, pelvic obliquity, spine problems, and range of motion of the ipsilateral knee, and also of contralateral hip and knee. In addition, surgery rehabilitation also becomes one of the important points to get a good clinical outcome. We reported the results of total hip arthroplasty to treat hip ankylosis as sequelae of childhood hip pathology.

Introduction: An aneurysmal bone cyst (ABC) is benign but has a progressive nature that can cause severe problems if it occurs close to joints such as the knee. The ultimate goal of treatment is to remove the tumor, maintain limb function, and prevent a recurrence. Local therapy is still better than tumor resection. This study aims to describe a rare case about distal femur ABC treated with two stages of surgery in the pandemic COVID-19 by excision-skeletal traction and endoprosthesis replacement. Case description: A 31-year-old woman presented with a lump on the right knee. The patient has complained of limping. Open biopsy was performed, and the patient was confirmed to have ABC on the distal of her right femur. The patient had a leg length discrepancy of 8 cm. We decided to do skeletal traction first. One week after the skeletal traction, the patient undergoes endoprosthesis replacement. Conclusion: The management of wide excision of the tumor requires special postoperative attention. This is because aggressive measures can reduce the recurrence rate of tumors, but large reconstructions are also needed to maintain joint function.

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