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The Journal of Indonesian Orthopaedic

HUBUNGAN EKSPRESI MYO-D OTOT BICEPS PENDERITA CEDERA PLEXUS

BRACHIALIS DENGAN PERBAIKAN MOTORIK LUAS GERAK SENDI SIKU AKTIF DAN
KEKUATAN MOTORIK OTOT BICEPS

Heri Suroto *, Andi Bahauddin Fahmi *

Departemen Orthopaedi dan Traumatologi, Fakultas Kedokteran, Universitas Airlangga,

RSUD Dr. Soetomo, Surabaya, Indonesia

Abstrak

Pendahuluan: Cedera plexus brachialis bisa menyebabkan hilangnya fungsi dan

kemampuan penderita dalam melakukan aktivitas keseharian serta kegitan dalam
pekerjaannya . Semakin tingginya angka kecelakaan kendaraan bermotor, maka jumlah kasus
cedera plexus brachialis semakin meningkat. Saraf akan mengalami berbagai tingkat
kerusakan, mulai dari neuropraxia, axonotmesis, hingga neurotmesis. Tindakan reinnervasi
dari target otot yang mengalami denervasi maka akan menghindari atrofi pada otot dan akan
mengembalikan fungsi komponen otot tersebut .Tujuan dari penelitian ini adalah mengetahui
secara klinis hubungan antara perbaikan luas gerak sendi siku terhadap jumlah ekspresi
MyoD pada otot biceps penderita cedera plexus brachialis dan hubungan antara perbaikan
kekuatan otot biceps terhadap jumlah ekspresi MyoD pada penderita cedera plexus brachialis

Metode: Penelitian ini mengikutsertakan 8 orang penderita cedera Pleksus Brachialis yang
dilakukan tindakan operasi nerve procedure selama periode Mei 2013 hingga Desember 2015
meliputi eksternal neurolisis, nerve transfer dan nerve grafting. Pengumpulan data dilakukan
secara consecutive sampling dan selanjutnya analisis data. Jumlah sel satelit yang
mengekspresikan MyoD dihitung sebagai sel satelit yang fungsional, diambil dari jumlah
sediaan sampel otot yang dievaluasi per 10 lapang pandang lalu diambil nilai rerata . Evaluasi
klinis penderita dilakukan dengan melakukan home visit dan pemeriksaan di Poliklinik
Orthopeadi RSUD Dr. Soetomo Surabaya pada setiap penderita plexus brachialis yang telah
dilakukan biopsy.

Hasil: Hubungan rentang waktu operasi dengan luas gerak sendi siku penderita brachial
plexus 12 bulan pasca Nerve Procedure mempunyai koefisien korelasi (R) sebesar -0,480.( p
= 0,229) Hubungan Rentang waktu operasi dengan kekuatan motorik otot bicep penderita
brachial plexus 12 bulan pasca Nerve Procedure mempunyai koefisien korelasi (R) sebesar -
0,256.( p = 0,541). Hubungan jumlah sel satelit yang mengekspresikan MyoD dengan luas gerak
sendi siku mempunyai koefisien korelasi (R) 0,152 (p= 0,720). Hubungan jumlah sel satelit
yang mengekspresikan MyoD dengan kekuatan motorik otot bicep 12 bulan pasca Nerve
Procedure mempunyai korelasi (R) sebesar 0,224 (p=0,594).

Kesimpulan: Tidak terdapat hubungan yang bermakna antara jumlah sel satelit yang
mengekspresikan MyoD pada sampel otot biceps penderita cedera plexus brachialis dengan
luaran klinis yang diukur dengan parameter luas gerak sendi siku dan kekuatan motoris otot
biceps.

Kata kunci: luas gerak, sendi siku, ekspresi MyoD, plexus brachialis
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The Journal of Indonesian Orthopaedic

CORRELATION BETWEEN MYO-D BICEPS MUSCLE EXPRESSION IN PATIENT

WITH PLEXUS BRACHIALIS INJURY AND THE CORRECTION OF ELBOW ACTIVE
RANGE OF MOTION AND MOTORIC POWER OF BISCEPS MUSCLE

Heri Suroto *, Andi Bahauddin Fahmi *

Departement of Orthopaedic and Traumatology, Faculty of Medicine, Airlangga University,

Dr. Soetomo General Hospital, Surabaya, Indonesia

Abstract

Introduction: Brachial plexus injury can lead to loss of function and ability of the patient in
performing daily activities and activities in the work. The higher the number of motor vehicle
accidents, the number of cases of brachial plexus injury is increasing. The nerves will
experience varying degrees of damage, ranging from neuropraxia, axonotmesis, to
neurotmesis. Reinnervasi action of denervation muscle targets will avoid atrophy of muscle
and will restore the function of muscle component. The purpose of this research is to know
clinically the relationship between the improvement of elbow joint motion to the amount of
MyoD expression in biceps muscle sufferer of brachial plexus injury and relationship
Between biceps muscle strength improvement on the amount of MyoD expression in patients
with brachial plexus injury.

Materials and methods: The study included 8 people with Brachial plexus injury who
performed nerve procedure surgery during the period of May 2013 until December 2015
covering external neurolysis, nerve transfer and nerve grafting. Data collection is done by
consecutive sampling and then data analysis. The number of satellite cells expressing MyoD
is calculated as a functional satellite cell, taken from the number of muscle sample samples
evaluated per 10 plots of view and then taken an average value. Clinical evaluation of the
patient was done by home visit and examination at Orthopeadi Polyclinic RSUD Dr.
Soetomo Surabaya on every patient brachial plexus who has done biopsy.

Results: Relationship range of operation time with elbow range of motion in Brachial Plexus
injury Patient 12 months post Nerve Procedure has correlation coefficient (R) of -0.480. (P =
0,229). Relationship time range operation with Motoric Strength Muscle in Biceps brachial
plexus injury patients 12 months post nerve procedure have the correlation coefficient (R) -
0.256 (p = 0,541). The relationship of the number of satellite cells expressing MyoD with
elbow joint motion has a correlation coefficient (R) 0.152 (p = 0.720). The Relationship of
number of satellite cells expressing MyoD with motoric strength muscles biceps 12 months
post Nerve Procedure has a correlation (R) of 0.224 (p = 0,594).

Conclusion: There was no significant association between the number of satellite cells
expressing MyoD in biceps muscle samples with brachial plexus injury with clinical outcome
measured by elbow joint motion parameters and biceps muscle motor strength.

Keyword: Active range of motion, elbow joint, MyoD expression, brachial plexus
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The Journal of Indonesian Orthopaedic