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"External fixator adalah metode untuk mengatasi fraktur dengan cara memasukkan pin ke dalam jaringan kulit, jaringan lunak dan tulang yang dihubungkan dengan rigid external frame. Penelitian kualitatif fenomenologi deskriptif ini bertujuan untuk menggambarkan pengalaman klien yang mengalami fraktur ekstremitas bawah dengan pemasangan external fixator. Hasil penelitian mengidentifikasi 7 tema, yaitu respon psikologis, ketidaknyamanan fisik, perubahan pemenuhan kebutuhan dasar, mengalami kerugian finansial, dukungan sosial yang diterima, pelayanan keperawatan yang telah diterima, dan harapan klien terkait pemberian pelayanan keperawatan. Hasil penelitian ini menjadi acuan bahwa perawat harus memiliki kemampuan memberikan asuhan keperawatan yang komprehensif sehingga pemberian asuhan keperawatan akan lebih optimal dengan outcome yang lebih memuaskan.

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External fixator is a method to overcome the fracture by inserting pins into the skin tissue, soft tissue and bone that will be linked with external rigid frame. Descriptive phenomenology qualitative research aims to describe the experience of clients who experienced lower limb fracture with mounting external fixator.

The study identified seven themes, namely the psychological response, physical discomfort, changed in the fulfillment of basic needs, suffered financial losses, received social support, nursing services that have been received, and related client service delivery expectations of nursing.

The results of this research into a reference that nurses should have the ability to provide comprehensive nursing care so that the provision of nursing care will be optimized with a more satisfactory outcome."

"Tidur sangat diperlukan untuk proses penyembuhan, dimana gangguan tidur pasca pembedahan merupakan masalah yang penting untuk dipertimbangkan dalam program peningkatan pemulihan nyeri dan status fungsional pasca operasi. Penelitian ini bertujuan untuk mengidentifikasi faktor yang mempengaruhi kualitas tidur pasien fraktur ekstremitas bawah pasca pembedahan Open Reduction Internal Fixation (ORIF) yang menjalani rawat inap. Faktor-faktor yang diteliti dalam penelitian ini meliputi nyeri, penggunaan obat-obatan, stress dan kecemasan, fatigue, dan lingkungan ruang perawatan. Penelitian ini menggunakan desain penelitian analitik asosiatif dengan pendekatan Cross Sectional. Penelitian dilakukan pada 55 responden menggunakan metode consecutive sampling di ruang rawat inap bedah. Hasil penelitian menunjukkan faktor yang mempengaruhi kualitas tidur pasien fraktur ekstremitas bawah pasca pembedahan O RIF yang menjalani rawat inap adalah nyeri (p=0.002) dan lingkungan ruang perawatan (p=0.032), dimana nyeri merupakan faktor yang paling mempengaruhi kualitas tidur pasien (p) 0.004; Odd Ratio (OR) 28,482 (95% CI: 2,842-285,491). Penelitian ini merekomendasikan penggunaan manajemen nyeri yang efektif sehingga kualitas tidur pasien dapat terpenuhi.

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Sleep is indispensable for the healing process, where postoperative sleep disturbance are an important issue to consider in programs to improve patients postoperative pain and functional status. This study aims to identify factors that affecting sleep quality in patients with lower limb fractures post Open Reduction Internal Fixation surgery undergoing hospitalization. Those factors are pain, medications used, stress and anxiety, fatigue, and ward environment. This study using analitic assosiative design with Cross Sectional approach. 55 respondents were selected with consecutive sampling from surgical ward. The Results showed, factors that affecting sleep quality in patients with post-surgical lower limb fractures undergoing hospitalization are pain (p=0.002) and ward environment (p=0.032), where pain was considered as the most significant factor that affecting patients sleep quality with (p) 0.004; Odd Ratio (OR) 28,482 (95% CI: 2,842-285,491). This study recommends that the use of effective pain management are needed to improve patients sleep quality."

"Praktik ners spesialis keperawatan medikal bedah peminatan muskuloskeletal bertujuan untuk mengaplikasikan peran perawat sebagai pemberi asuhan, pengelola, pendidik, dan peneliti. Peran sebagai pemberi asuhan dilakukan dengan mengelola 30 pasien dengan gangguan sistem muskuloskeletal dan satu kasus kelolaan utama dengan spinal cord injury menggunakan pendekatan teori keperawatan Virginia Henderson. Penerapan intervensi keperawatan berbasis bukti ilmiah merujuk pada peran perawat sebagai peneliti, dalam hal ini adalah respiratory muscle training terhadap fungsi pernafasan pada pasien spinal cord injury. Peran perawat sebagai pengelola sekaligus pendidik teraplikasikan dalam inovasi edukasi berbasis website pada pasien yang menjalani total hip arthoplasti. Keseluruhan rangkaian tersebut bertujuan untuk mewujudkan kualitas asuhan keperawatan yang komprehensif

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The practice of medical surgical nursing specialists with musculoskeletal specialization aims to apply the role of nurses as caregivers, managers, educators, and researchers. The role as a care provider was carried out by managing 30 patients with musculoskeletal system disorders and one main managed case with spinal cord injury using Virginia Henderson's nursing theory approach. The application of scientific evidence-based nursing interventions refers to the role of nurses as researchers, in this case respiratory muscle training on respiratory function in spinal cord injury patients. The role of nurses as managers and educators is applied in website based educational innovations for patients undergoing total hip arthroplasty. The whole series aims to realize the quality of comprehensive nursing care"

"Infeksi kaki diabetik adalah faktor predisposisi utama amputasi ekstremitas bawah pada penyebab non trauma. Namun baru sedikit studi yang menyelidiki faktor - faktor risiko spesifik. Metode penelitian studi kohort retrospektif sampel besar dengan melakukan observasi data rekam medik 201 pasien dengan diagnosis infeksi kaki diabetic di RS Dr. Cipto Mangunkusumo antara tahun 2008 hingga tahun 2010. Faktor - faktor risiko kami lakukan analisis univariat, bivariat serta multivariat kemudian dilakukan model regresi logistik dan mengkonversi koefisien model ke risk score numerik. Pada hasil sebanyak 25.7% menjalani amputasi ekstremitas bawah diperoleh persamaan dengan kalibrasi Hosmer and Lemeshow Test yang baik dan nilai AUC adalah sebesar 82%. Penelitian pendahuluan ini menghasilkan sistem skoring yang sederhana dan mudah digunakan untuk mengetahui risiko amputasi ekstremitas bawah pada pasien yang menderita infeksi kaki diabetik.

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Diabetic foot infection is the primary predisposition for lower extremity amputation in non-trauma etiology. There were only few studies that has determined specific risk factors. This pilot study methods used large sample retrospective cohort study by observing 201 medical records of patients with diabetic foot infection diagnosis in Cipto Mangunkusumo Hospital for 2008 to 2010. We did univariate, bivariate, multivariate analysis continue with logistic regression model and converting coefficient model to numeric risk score. Result, there were 27.7% had lower extremity amputation, logistic regression with good equation result on Hosmer and Lemeshow test and AUC score were 82%. This pilot study produce a simple scoring system and easy to use to identify lower extremity amputation risks on diabetic foot infection patient."

"ABSTRAKPerasaan takut akan jatuh dan penurunan status fungsional sering dialami pada pasien fraktur ekstremitas bawah yang telah menjalani pembedahan. Edukasi yang tepat diikuti dengan latihan ambulasi pada pasien pascapembedahan diperlukan untuk dapat meningkatkan status fungsional dan keyakinan pasien untuk melakukan ambulasi dini. Penelitian ini bertujuan untuk mengetahui pengaruh edukasi dan latihan ambulasi terhadap fall efficacy dan status fungsional pada pasien pascapembedahan ORIF ekstremitas bawah. Desain penelitian ini adalah kuasi eksperimen dengan rancangan pre test and post test without control group. Besar sampel pada penelitian ini adalah sebanyak 33 responden dengan consecutive sampling. Hasil penelitian ini menunjukkan bahwa terdapat perbedaan fall efficacy dan status fungsional antara sebelum dan setelah dilakukan edukasi dan latihan ambulasi (p value < 0,001). Penelitian ini menyimpulkan terdapat perbedaan nilai fall efficacy dan status fungsional setelah diberikan intervensi edukasi dengan latihan ambulasi

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ABSTRACTFear of falling and decreasing functional status are often experienced in patients with lower limb fractures who have undergone surgery. Appropriate education followed by ambulation training in postsurgery patients is needed to be able to increase the functional status and confidence of patients to carry out early ambulation. This study aims to determine the effect of education and ambulation training on fall efficacy and functional status in postsurgery patients with lower extremity ORIF. The design of this study was a quassy experimental with a pre test and post test design without control group. The sample size in this study was 33 respondents with consecutive sampling. The results of this study indicate that there are differences in fall efficacy and functional status between before and after education and ambulation training (p value <0.001). This study concluded that there were differences in fall efficacy and functional status after being given educational intervention with ambulation training"

"Latar Belakang: Penentuan usia dental dan skeletal sangat penting dalam perawatan ortodonti. Salah satu metode yang dapat digunakan adalah metode Demirjian dan Baccetti. Penelitian sebelumnya menunjukkan bahwa kalsifikasi gigi dapat menjadi salah satu evaluasi usia skeletal. Tujuan: Mengetahui korelasi antara usia dental berdasarkan maturasi gigi dengan usia skeletal berdasarkan maturasi tulang servikal. Metode: Penelitian ini menggunakan metode potong lintang dengan 96 sampel berupa radiograf panoramik dan sefalometri lateral dari satu pasien yang memenuhi kriteria inklusi. Metode Demirjian dan metode Baccetti digunakan untuk mengevaluasi usia dental dan skeletal. Uji korelasi Spearman dilakukan untuk mengetahui korelasi antara usia dental dan skeletal. Hasil: Terdapat korelasi sangat kuat antara skor maturasi gigi dengan maturasi tulang servikal pada laki-laki (r = 0,858, p = 0,000) dan perempuan (r = 0,807, p = 0,000). Korelasi paling kuat pada laki-laki terlihat pada kalsifikasi gigi molar 2 (r = 0,850, p = 0,000), sementara pada perempuan terlihat pada kalsifikasi gigi kaninus (r = 0,805, p = 0,000). Kesimpulan: Korelasi sangat kuat antara usia dental berdasarkan maturasi gigi dan usia skeletal berdasarkan maturasi tulang servikal menunjukkan potensi penggunaan usia dental untuk memperkirakan usia skeletal. Namun, terdapat variasi kekuatan korelasi antar kalsifikasi gigi dengan usia skeletal.

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Background: Determining dental and skeletal age is critical in orthodontic treatment. The Demirjian and Baccetti method is one of various approaches to evaluate dental and skeletal age. Related research indicates that tooth calcification can serve as a primary diagnostic tool to determine skeletal age. Objective: To assess the correlation between dental age based on tooth maturation and skeletal age based on cervical vertebrae maturation. Methods: This study involved 96 panoramic and lateral cephalometric radiographs from patients who met inclusion criteria. The Demirjian method was used to assess dental age, while the Baccetti method was used for skeletal age, spearman correlation tests were conducted to evaluate the correlation. Results: A strong correlation was found between tooth maturation scores and cervical vertebrae maturation in males (r = 0,858, p = 0,000) and females (r = 0,807, p = 0,000). In males, the strongest correlation occurred in the second molar (r = 0,850, p = 0,000), while in females it occurred in the canine (r = 0,805, p = 0,000). Conclusion: Dental age based on tooth maturation strongly correlates with skeletal age based on cervical vertebral maturation, suggesting its potential use to estimate skeletal age, but variability exists among tooth types."

"Latar Belakang: Di Indonesia penelitian mengenai Korelasi Maturasi Antara VertebraServikalis Baccetti dan Molar Dua Permanen Bawah Demirjian pada Anak Usia 8-16Tahun belum banyak dipublikasikan.Tujuan: mengevaluasi Korelasi Maturasi Antara Vertebra Servikalis Baccetti denganMolar Dua Permanen Bawah Demirjian pada anak usia 8-16 tahun.Metode: Penelitian deskriptif analisis ini dilakukan dengan menggunakan studi crosssectional.Sampel diperoleh dari 90 radiograf panoramik dan sefalometri lateral dari anakyang berusia 8-16 tahun dengan kriteria tertentu. Maturasi dental diperiksa melalui tahapmineralisasi Molar Dua Permanen Bawah berdasarkan metode Demirjian (tahap A-H);Maturasi Skeletal dievaluasi dengan menggunakan metode Maturasi Vertebra Servikalisberdasarkan metode Baccetti (CS1-CS6). Uji reliabilitas penelitian menggunakan ujistatistik Kappa. Uji Kendall Tau-b digunakan untuk menentukan korelasi antara MaturasiVertebra Servikalis dan Molar Dua Permanen Bawah.Hasil: Tahap CS1 memiliki distribusi paling banyak tahap D; CS2 memiliki distribusipaling banyak tahap E; pada CS3 memiliki distribusi yang merata pada tahap F dan G,CS4 memiliki distribusi paling banyak tahap G, CS5 memiliki distribusi yang hampirmerata pada tahap G dan H; dan tahap CS6 memiliki distribusi paling banyak pada tahapH. Korelasi antara Maturasi Vertebra Servikalis dan Molar Dua Permanen Bawah sangatkuat dan signifikan (r = 0,829; p <0,05).Kesimpulan: Molar Dua Permanen Bawah dapat dipertimbangkan sebagai indikatormaturasi skeletal pada anak usia 8-16 tahun.

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Background: In Indonesia, the research on Correlation Between the Maturation of

Cervical Vertebral and Lower Permanent Second Molar in Children Aged 8-16 Years has

not been widely publicized.

Objective: to evaluate the correlation between the Maturation of Cervical Vertebral of

the Baccetti method and lower permanent second Molar of the Demirjian method in

children aged 8-16 years.

Method: This research was conducted using a cross-sectional study. Samples were

obtained from 90 panoramic radiographs and lateral cephalometry obtained from children

ages 8-16 years with certain criteria. Maturation of teeth was examined through the

mineralization stage of the Lower Permanent Second Molar based on the Demirjian

method (stage A-H). Skeletal Maturation was evaluated by the use of the Cervical

Vertebral Maturation method based on Baccetti (Stage CS1-CS6). The reliability test uses

the Kappa statistical test. Kendall Tau-b Test was used to determine the correlation

between the maturation od Cervical Vertebral and Lower Permanent Second Molar.

Results: Stage CS1 has the most distribution of stage D; CS2 has the most distribution of

stage E; in CS3 has equal distribution of stage F and G; in CS4 has the most distribution

of stage G; in CS5 has equal distribution of stage G and H; and stage CS6 is has the most

distribution of stage H. The correlation between Cervical Vertebral Maturation and Lower

Permanent Second Molar Maturation was very strong and significant (r = 0.829; p <0.05).

Conclusion: The Lower Permanent Second Molar can be considered as indicator of

skeletal maturation in children aged 8-16 years."

"Umumnya pasien post operasi ORIF setelah 24 jam bedrest sehingga dapat terjadinya keterbatasan aktivitas mobilisasi dini yang dilakukan oleh perawat di ruangan dapat memperbaiki sirkulasi mengurangi komplikasi imobilisasi post operasi mempercepat pemulihan peristaltik usus mempercepat pemulihan pasien post operasi Metode penelitian ini adalah deskriftif gambaran implementasi mobilisasi dini oleh perawat pada fraktur ektermitas bawah adalah pendidikan pengalaman kerja pelatihan orthopaedi mobilisasi dini dan sumber ilmu yang didapat tentang mobilisasi dini pada pasien Pengambilan sampel dilakukan dengan cara total sampling yaitu berjumlah 31 orang perawat Dari hasil uji statistic univariat didapatkan bahwa implementasi mobilisasi dini oleh perawat pada pasien post ORIF fraktur ekstermitas bawah dominan perawat melakukan mobilisasi dini sebanyak 16 orang 51 6 dan tidak melakukan sebanyak 15 orang 48 4 dari hasil tersebut hanya selisih 1 yang berarti tingkat melakukan mobilisasi dini masih rendah Selanjutnya dapat dilakukan penelitian serupa dengan jumlah responden dari rumah sakit lainnya.

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Generally post ORIF patient should be bedrest for 24 hours It cause activity limitation Early mobilizatio ndash that is performed by nurse ndash can improve circulation reduce complication of post operative immobilization accelerate intestinal peristalsis recovery accelerate the recovery of postoperative patients This research method is descriptive Description of the implementation of early mobilization by nurse on lower extremity fracture are education work experience training of orthopedic early mobilization and source of knowledge gained about early mobilization Sampling was done by total sampling of 31 nurses

From the results of univariat estatistical tests showed that the implementation of early mobilization by nurses on lower extremity fractures post ORIF patients dominan yearly mobilization perform by 16 nurses 51 6 and did not do early mobilizaton as many as 15 nurses 48 4 of these results only difference 1 nurse which means the rate of early mobilization is low Further research can be done similar with respondents from other hospitals."

"Pendahuluan: Fraktur adalah salah satu penyakit yang menjadi permasalahan yang cukup besar dalam bidang kesehatan di dunia, terutama di negara berkembang. Secara umum fraktur dapat sembuh dengan normal. Pada beberapa kondisi, penyembuhan fraktur mengalami komplikasi seperti delayed union atau non union. Penyembuhan fraktur yang sukses merupakan suatu interaksi yang kompleks antara proses angiogenesis dan osteogenesis. Stimulus fisika berupa pajanan PEMF (pulsed electromagnetic fields) menunjukkan pengaruh proses osteogenesis baik dalam tahap perkembangan penulangan embrio dan tahap penyembuhan fraktur.Tujuan: Penelitian ini bertujuan untuk mengetahui penyembuhan fraktur tulang delayed union pada hewan coba pada pemberian ELF-PEMF dengan melihat skor radiologi RUST dan Failure Load dari Pemberian Gaya Aksial.Metode: Dilakukan uji eksperimental pada 56 hewan coba di Laboratorium Hewan Departemen Gizi, Fakultas Kedokteran Universitas Indonesia, dengan membandingkan nilai RUST Score dan Load Score pada kedua kelompok hewan coba.Hasil: Penelitian dilakukan selama Agustus-September 2018. Tidak ada perbedaan karakteristik hewan coba pada penelitian. Didapati bahwa terdapat perbedaan bermakna Rust Score pada kelompok perlakuan dan kelompok kontrol pada setiap minggu pemeriksaan dan terdapat perbedaan bermakna Load Score pada minggu keempat dan kelima.Kesimpulan: Penelitian ini menyimpulkan terdapat perbaikan penyembuhan fraktur delayed union pasca pemberian ELF-PEMF dilihat dari perbedaan nilai Rust score dan load score.

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Background: Fracture is a major health problem in the world, especially in developing countries. Usually, fractures can heal normally. In some conditions, the healing process becomes delayed union or non union. Successful healing of fractures is a complex interaction between angiogenesis and osteogenesis. Physical stimuli such as exposure of PEMF (pulsed electromagnetic fields) influences the osteogenesis process both in the development stage of embryo reinforcement and the fracture healing stage.Objective: The aim is to determine the healing of delayed union fractures in experimental animals after exposure to ELF-PEMF.Methods: The experimental study was conducted at Department of Nutrition Animal Laboratory, Faculty of Medicine, Universitas Indonesia with 56 experimental rats. The study was conducted by comparing the RUST Score and Load Score values ​​in the two experimental animal groupsResult: The study was conducted during August-September 2018 There was no difference in animal characteristics in the study. There was significant difference in Rust Score in both groups in each examination week and there were significant differences in Load Score in the fourth and fifth weeks.Conclusion: There was improvement in delayed union fracture healing after the administration of ELF-PEMF as seen from the difference in Rust score and load score."

"Background: Microtia reconstruction is a challenge for ENT Head and Neck surgeons. Varioussurgical techniques using autograft cartilage have been done to perform auricular reconstruction.Knowledge of cartilage graft concerning resorption process that affected the size, form, and aestheticsubunit of the ear is mandatory. Purpose: To evaluate the success of cartilage autograft by identifyingchondrocyte apoptosis, tissue degradation based on cell character, matrix homogeneity, fibrosis,proteoglycans, collagen and Transforming Growth Factor β (TGF β) expression in application of FibrinGlue (FG) and or Demineralized Bone Matrix (DBM) after 12 weeks in microtia reconstruction by Nagatatechnique. Methods: Quasi-experiments. FG and/or DBM were applied on the rest of the 12 ear cartilageframework which was implanted on mastoid area. Apoptosis was examined by TUNEL. Safranin Ostaining and modified Mankin’s score was used to evaluate cartilage degradation and TGF β expressionby ELISA. Results: FG or DBM on cartilage graft showed significant increase in chondrocyte viabilitycompare with control group (p=0.00). Minimal fibrosis, more homogeneous extracellular matrix, decreasedproteoglycan and minimal thickening of collagen, had significant differences compared with control orFG-DBM group. Structure differences occurred among cartilage graft after 12 week implantation whereasFG showed minimal fibrous tissue, normal cell character, proteoglycan, collagen, and tissue homogeneity(p< 0.05). Conclusion: FG is highly recommended to reduce degradation of cartilage graft in microtiareconstruction. DBM can be still used to maintain chondrocyte viability, proteoglycans, and collagen.Keywords: cartilage graft, fibrin glue, demineralized bone matrix, transforming growth factor β, Mankinscore."