BACKGROUND: In the global pandemic of the 2019 coronavirus disease (COVID-19), many countries have reported a decrease in visits to hospitals, and health-care systems around the world are reshaping health protocols. Health service and education in orthopedics are also affected although not at the frontline in dealing COVID-19. METHODS: The data from this study collected from several official databases, including the Indonesian Ministry of Health, Central Java provincial government, general hospital, and orthopedic surgery cases. RESULTS: Pandemic COVID-19 started in March 2020 in Indonesia. Surakarta has become one of the epicenters. Health services in the orthopedic department also experienced a decrease cases on all divisions (outpatient clinics, emergency rooms, and inpatients). Mann–Whitney non-parametric comparative test showed significance result in p value operation of orthopedic cases and inpatients (p = 0.016 and p = 0.016; p < 0.05), meanwhile, outpatient visits did not show significance result with p = 0.0509 (p > 0.05). The decrease in the number of cases being treated in the orthopedic service also has an impact on education and training programs. The digital era is one of the choices in the field of education. However, digital resources cannot substitute for direct patient exposure. CONCLUSION: The average number of orthopedic patients during the pandemic period from January to December 2020 decreased compared to visits in the same period in 2019 so that orthopedic services at tertiary and academic referral hospitals experienced a significant decrease in cases. The education and services department must adapt to the policy on educational activities for residents and medical students. The education department and hospital institutions restructured and reorganized resident doctors to continue providing services. The digital era is an option that supports the education process during a pandemic.

Introduction: Pelvic fractures are responsible for skeletal injuries and soft tissue-related injuries. Pelvic fracture is a disorder of the pelvis bones' structure, including the hip bone, sacrum, and coccyx. The condition will result in stable status if the pelvis can resist weight-bearing loads without the incidence of any displacement. This study aims to determine pelvic fracture outcome, in which operative and non-operative management used the Majeed score to evaluate the functional results.Method: A retrospective case-control study was performed to retrieve data from medical records of patients with pelvic fractures at Dr. Moewardi Hospital Surakarta for the period from January 1st, 2017, until December 31st, 2019. The evaluation of reduction quality was conducted following the scores put forward by Majeed to evaluate the clinical outcomes. Data analyzing used SPSS V.24.0 (IBM Corp). P-value of <0.05 was determined as the statistical significance.Results: In this study, there were 40 samples of pelvic fracture cases; 60% were male, 55% were aged 19 – 40 y.o, motor crash caused 67%, 37.5% were cases of pubic rami fractures. Besides, operative management was 52,5%, while non-operative was 47,5%. Further, operative management's functional outcome was excellent at 66%, good at 19%, fair at 9%, and poor at 8% of the patients. Patients treated with operative management had significantly fewer severe injuries, as rated using the Majeed score than the non-operative group.Conclusion: The results suggest that operative treatment may be a viable option in treating major pelvic fracture as it provides better functional results than non-operative treatment.

Introduction: Osteoarthritis is a chronic degenerative disease characterized by pain and joint cartilage damage. Osteoarthritis is a disease that disrupts the homeostasis of cartilage metabolism so that it damages the proteoglycan structure in cartilage caused by age, excessive joint wear, anatomic defects, mechanical or chemical stress, obesity, genetics and humoral. Osteoarthritis generally occurs in the knees, feet, shoulders, hands, spine, and hips. Certain work conditions that require more strenuous physical movements such as lifting heavy weights and going up and down stairs are a risk factor for osteoarthritis. The purpose of this study was to determine the relationship between work history and the degree of osteoarthritis in women aged over 65 years. Methods: This is an analytical observational research with cross sectional study design. The Subject in this research is medical record patient RSUD DR MOEWARDI SURAKARTA Hospital who have met the criteria. Sampling was done using simple random sampling technique. Data was collected and then analyzed using Spearman correlation test. Results: The analysis result from 46 samples using Spearman correlation test obtained a p value of less than 0.05 indicating that there is a significant relationship between work history and the degree of osteoarthritis in women aged over 65 years. Conclusion: There is a significant relationship between work history and the degree of osteoarthritis in women aged over 65 years. Keywords: Osteoarthritis; Occupational History; Degree of OA

Background: Slipped capital femoral epiphysis (SCFE) is one of the most frequent hip disorders in children. SCFE is due to the displacement of the epiphysis (femoral head that keeps its location in the acetabulum) relative to the metaphysis (femoral neck) and shaft at the physic level. Treatment seeks to prevent worsening of epiphyseal slippage on the metaphysis, and percutaneous in situ fixation (ISF) using a single cannulated screw has long shown efficacy. Case Presentation: An 11 years old boy presented with diagnosed with slipped capital femoral epiphysiolysis of right hip and treated operatively with one screw pinning guiding fluoroscopy. Post operatively, from X-Ray evaluation confirmed the proper position without joint penetration. Patient is then advised to walk with crutches for gradual weight bearing to full weight bearing after 4 weeks. Then after 6 weeks, patient had already walked normally again. Conclusion:In unstable moderate-to-severe SCFE, the best reduction indications and technique remain controversial. There are many theories supporting one or two screws pinning technique. In this case we used one screw pinning fixation with excellent result.

Background As serious fracture complications, delayed union and non-union are parts of complications from fracture healing. Growth factors such as BMP-2, VEGF, proinflammatory cytokines including IL-6 and bone formation BALP, N-Mid-OC are important regulators of the fracture healing process. Red yeast rice (RYR), produced by fermenting Monascus purpureus rice, monacolin K, which is the main ingredient in RYR, was found to play a major role in the anti-inflammatory process and increasing the proliferation of osteoblast in osteoporosis cases. This study aims to examine the effect of RYR in the fracture healing process in delayed union rats through molecular studies of levels of IL-6, BMP- 2, VEGF, BALP, and N-Mid-OC. Methods This study was experimental research that used male rats (Rattus novergicus) which were divided into a control and 3 treatment groups using a random sampling method. Group 1 was given orally 25 mg/kg, Group 2 was 50 mg/kg, Group 3 was 100 mg/kg, and the control group was given a placebo. The rats were then subjected to a delayed union fracture model. Observations were made for two periods on the 14th and 28th days. Results There were no significant differences in serology examination between days 0 and 14 between groups. However, there were significant differences between groups on day 28. IL-6, BMP-2, VEGF, BALP, and N-Mid-OC on day 28 between groups (p<0.001). The group with 100 mg/kg RYR extract was found to be the most influencing serology marker level. RYR 100 mg/kg significantly decreased IL-6, and increased BMP-2, VEGF, BALP, and N-Mid-Osteocalcin, thus enhancing the fracture healing process in the delayed union rats model. Conclusion A red yeast rice dose of 100 mg/KgBW significantly reduced IL-6, increased BMP-2, VEGF, BALP, N-Mid-OC, and RUST Score so as to improve the fracture healing process in delayed union rats.