Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Fraktur distal radius merupakan salah satu fraktur yang paling sering terjadi pada berbagai kelompok usia. Terdapat berbagai faktor yang mempengaruhi luaran fraktur distal radius. Studi mengenai epidemiologi dan faktor-faktor yang mempengaruhi luaran fraktur distal radius pada populasi Asia, terutama Indonesia, masih sangat minim. Penelitian ini bertujuan untuk mengetahui faktor yang mempengaruhi luaran klinis dan radiologis fraktur distal radius.Metode: Dilakukan studi potong lintang pada 84 subjek yang mengalami fraktur distal radius dan menjalani tindakan di RSCM pada Januari 2014-Desember 2018. Dilakukan pengumpulan profil usia, jenis kelamin, tingkat pendidikan, mekanisme cedera, keterlibatan sendi, klasifikasi fernandez, jenis fiksasi, presensi fisioterapi. Hasil kemudian dihubungkan dengan luaran radiologis (radial height, radial inclination, ulnar variance, palmar tilt), luaran klinis objektif (ROM), dan subjektif (PRWE).Hasil: Dari 84 subjek (40 laki-laki dan 44 perempuan) didapat median usia 55,5 tahun (rentang 19 - 88 tahun), yang menjalani tindakan cast sebanyak 71 subjek (84,5%) dan plate and screw sebanyak 13 subjek (15,5%). Berdasarkan analisis bivariat, terdapat hubungan antara jenis kelamin dengan luaran radiologis radial height dan ulnar variance, serta mekanisme cedera dengan palmar tilt. Terdapat pula hubungan tingkat pendidikan dan keterlibatan sendi dengan luaran objektif ROM supination, jenis fiksasi dengan ROM extension, dan presensi fisioterapi dengan ROM ulnar deviation. Terdapat korelasi antara luaran radiologis ulnar variance dengan luaran objektif ROM radial deviation, serta antara radial height dengan luaran subjektif skor PRWE. Dilakukan analisis multivariat, didapatkan korelasi antara luaran objektif ROM wrist flexion dan radial deviation dengan luaran subjektif PRWE.Diskusi: Jenis kelamin dan mekanisme cedera mempengaruhi luaran radiologis, sedangkan tingkat pendidikan, keterlibatan sendi, jenis fiksasi dan presensi fisioterapi mempengaruhi luaran objektif berupa ROM. Terdapat korelasi antara luaran radiologis dengan luaran objektif dan subjektif. Terdapat pula kolerasi antara luaran objektif dan luaran subjektif (PRWE).

---

Background: Distal radius fracture is one of the most common fracture among various age groups. Several factors affect the functional outcome of distal radius fracture. Studies regarding the epidemiology and factors affecting the outcome of distal radius fracture on Asian population, especially Indonesia, are still very limited. This study aims to find out factors related with clinical and radiological outcome of distal radius fracture.

Methods: A cross sectional study was done on 86 subjects who had distal radius fracture and underwent surgical or non-surgical treatment at RSCM during January 2014-December 2018. Demographic (age, gender, and education) and clinical profiles (mechanism of trauma, joint involvement, fernandez classification, fixation type, presence of physiotherapy) was collected. The results were than compared with the radiological outcome (radial height, radial inclination, ulnar variance, palmar tilt) objective clinical outcome (ROM) and subjective outcome (PRWE).

Results: 84 subjects (40 male and 44 female) with median age 55,5 (range 19-88 years old), underwent cast about 71 subject (84,5%) and plate and screw 13 subject (15,5%). Based on bivariate analysis, there was association between gender and radial height with radiological outcome ulnar variance, also between mechanism of injury with palmar tilt. There was association between level of education and articular involvement with objective outcome (ROM) supination, fixation type with ROM extension and presence of physiotherapy with ROM ulnar deviation. There was a correlation between ulnar variance with ROM radial deviation, and radial height with PRWE. Based on multivariate analysis, there was correlation between ROM wrist flexion and radial deviation with PRWE score.

Discussion: Gender and mechanism of injury affect the radiological outcome of distal radius fracture. Level of education, articular involvement, fixation type and presence of physiotherapy affect the objective clinical outcome (ROM). There was correlation between radiological outcome, ROM and PRWE score."

"Fraktur distal radius merupakan salah satu jenis fraktur yang sering ditemukan di ruangan gawat darurat, meliputi kurang lebih seperenam dari jumlah fraktur yang diterapi di ruangan gawat darurat. Fraktur distal radius ini mempunyai sejarah yang cukup panjang, sejak pertama kali dikemukakan oleh Pouteau (1783) dan Abraham Colles (1814). Yang menarik dari fraktur distal radius ini ialah sampai saat ini masih banyak para ahli yang memperdebatkan kasus ini. Masih belum ada kesepakatan dan masih merupakan kontroversi, berbagai macam klasifikasi dikemukakan dan berbagai macam pula jenis penanganan yang diusulkan.

---

Distal radius fracture is a type of fracture that is often found in the emergency room, covering approximately one-sixth of the total number of fractures treated in the emergency room. This radius distal fracture has a long history, since it was first proposed by Pouteau (1783) and Abraham Colles (1814). What is interesting about this distal radius fracture is that until now there are still many experts debating this case. There is still no agreement and it is still a controversy, various classifications have been proposed and various types of treatment have been proposed."

"ABSTRAKIntroduksi Spondilitis tuberculosis (TB) merupakan kasus infeksi tulang belakang tersering terutama di negara berkembang. Tiga hingga 5% kasus Spondilitis TB berkembang menjadi deformitas kifosis >60 derajat. Deformitas kifosis dapat mengakibatkan paraplegia dan gangguan fungsi lainnya, sehingga harus ditatalaksana dan dicegah dengan koreksi operatif. Studi ini bertujuan untuk mengetahui luaran klinis dan radiologis pada deformitas kifosis pasca koreksi operatif dan hubungannya dengan faktor-faktor yang memengaruhi deformitas kifosis.Metode Penelitian ini menggunakan desain potong lintang terhadap pasien Spondilitis TB dengan deformitas kifosis yang dilakukan tindakan koreksi operatif selama tahun 2014-2018 di RSUPN Cipto Mangunkusumo. Dilakukan penilaian luaran klinis ODI (Oswestry Disability Index) dan ASIA Impairment Scale, serta penilaian radiologis berupa persentase derajat koreksi dan loss of correction. Penilaian tersebut dilakukan pada saat pra-operasi, pasca-operasi, 6 dan 12 bulan pasca operasi, serta saat kontrol terakhir.Hasil Dari 78 pasien yang diikut sertakan dalam penelitian ini, rata-rata berusia 31,4 tahun dan mayoritas perempuan. Gejala awal tersering adalah backpain. Median jumlah keterlibatan vertebra adalah 2 dengan lokasi tersering pada level torakal. Durasi kontrol adalah 6 hingga 54 bulan. Pemilihan teknik operasi posterior lebih sering digunakan dibanding kombinasi dan tidak terdapat perbedaan yang bermakna pada pemilihan teknik operasi dengan luaran klinis maupun radiologis (p>0,05). Terdapat perbedaan yang bermakna secara statistik pada perbandingan nilai klinis, dan radiologis pre dengan pasca operasi (p<0,001). Perbaikan neurologis ASIA scale tampak mulai signifikan sejak 6 bulan pasca operasi (p<0,001). Sudut kifosis awal memberikan pengaruh yang signifikan terhadap semua kategori luaran (p<0,001). Terdapat komplikasi berupa pseudoarthrosis pada 2 pasien dan defisit neurologis yang menetap pada 1 pasien. Kesimpulan Tatalaksana operasi korektif pada pasien spondilitis TB dengan deformitas kifosis menunjukkan perbaikan luaran klinis, laboratorium dan radiologis. Sudut awal kifosis mempengaruhi luaran klinis dan radiologis.

---

ABSTRACTIntroduction Spondylitis tuberculosis (TB) is the most common case of spinal infection, especially in developing countries. Three to 5 % of Spondylitis TB cases will develop into more than 60o of kyphotic deformity. Kyphotic deformity can cause late paraplegia and other functional disturbances, therefore a kyphotic correction should be performed to prevent and treat the complications. The purpose of the study is to analyze the clinical and radiological outcome of kyphotic deformity in Spondylitis TB patients post kyphotic correction and to analyze the factors influencing the kyphotic deformity Method This study used cross-sectional design on Spondylitis TB patients who underwent corrective surgery as one of the treatment during 2014-2018 at Cipto Mangunkusumo Hospital. Evaluation of delta ODI (Oswestry Disability Index) and ASIA impairment scale were used to assess the clinical outcome. For radiological outcome, we assessed the percentage of correction and loss of correction. The data was collected from the medical record and also the patient; pre-surgery, post-surgery, 6 and 12 months post-surgery, also the current condition Result Out of the 78 patients included in this study, the average age was 31.4 years and for the majority of women. The majority of initial symptoms was complaint of backpain. The median number of vertebral involvement was 2, the majority of the location of the vertebrae involved were at the thoracic level. The choice of posterior surgery techniques is more often used than combination (posterior-anterior), however no significant differences was found when we compared the technique used with the clinical and radiological outcome (p>0,005) There were significant differences between pre and post-operative clinical and radiological value (p<0,001). Neurological improvement (ASIA scale) appears to be significant since 6 months postoperatively (p <0.001). Pre-operative kyphotic angle was found to be an influential factor in all outcome categories (p<0,001). There was pseudoarthrosis in 2 patients and refracter neurological deficit in 1 patient."

"Pendahuluan: Malunion adalah komplikasi jangka panjang yang sering terjadi pada fraktur suprakondiler humerus yang bila tidak ditatalaksana dengan tepat dapat menimbulkan komplikasi yang dapat menurunkan kualitas hidup pasien. Osteotomi korektif dengan teknik lateral closed wedge osteotomy, merupakan teknik yang sering digunakan karena sederhana dan relatif mudah. Studi mengenai luaran klinis, fungsional dan radiologis pasca osteotomi korektif masih sedikit, khususnya di Indonesia. Metode: Penelitian ini menggunakan desain kohort retrospektif, dengan metode totalsampling pada tahun 2012-2017 di Rumah Sakit Pusat Nasional Cipto Mangunkusumo. Dilakukan penilaian luaran klinis dengan Mitchell and Adams Criteria, luaran fungsional dengan Mayo Elbow Performance Score (MEPS), dan luaran radiologis dengan Baumann Angle, Metaphyseal-diaphyseal angle, Humero-ulnar angle, Humero-capitellar angle, dan anterior humeral line pra dan pascaoperasi. Hasil: Terdapat 15 pasien yang diikut sertakan dalam penelitian dengan umur rata-rata 7,7 tahun, mayoritas laki-laki dan pada sisi sebelah kiri. Median interval waktu antara fraktur hingga osteotomi korektif adalah 11,2 bulan dengan rata-rata followup adalah 24,9 bulan. Luaran klinis berdasarkan Mitchell and adams criteria didapatkan kriteria good hingga excellent sebanyak 14 pasien (93,3%) dan hanya 1 pasien (6,7%) dengan hasil unsatisfactory. Luaran fungsional berdasarkan MEPS didapatkan kategori good hingga excellent sebanyak 14 pasien (93,3%), dan kategori fair sebanyak 1 pasien (6,7%). Terdapat perbaikan parameter radiologis yang bermakna yang diukur dengan baumann angle, metaphyseal-diaphyseal angle, humero-ulnar angle, humero-capitellar angle dan anterior humeral line. Terdapat korelasi yang kuat antara perbaikan baumann angle dengan Mitchel and Adams criteria dan terdapat korelasi yang moderat antara perbaikan metaphyseal-diaphyseal angle dengan MEPS. Kesimpulan: Tindakan osteotomi korektif dengan teknik lateral closed wedge osteotomy pada malunion fraktur suprakondiler humerus memberikan luaran klinis, fungsional dan radiologis good hingga excellent. Baumann angle dan Metaphyseal-diaphyseal angle dapat digunakan sebagai parameter untuk memprediksi luaran klinis dan fungsional pasca osteotomi korektif.

---

Introduction: Malunion is a late complication that often occurs after supracondylar humeral fractures This condition if not managed properly will cause such complications that potentially reduce the patient's quality of life. Corrective osteotomy by lateral closed wedge osteotomy is a technique that is often used due to it simplicity and relatively easy. Only few studies have reported clinical, functional and radiological outcomes in cases of malunion of supracondylar humeral fractures after corrective osteotomy, particularly in Indonesia. Methods: This study used a retrospective cohort design, with a total sampling method in period of 2012-2017 at the Cipto Mangunkusumo Central National Hospital. We assess clinical outcome by Mitchell and Adams Criteria, functional outcome by Mayo Elbow Performance Score (MEPS), and radiological outcomes by Baumann Angle, Metaphyseal-diaphyseal angle, Humero-ulnar angle, Humero-capitellar angle, and anterior humeral line, pre and postoperatively Results: There were 15 patients included in the study with an average age of 7.7 years, the majority were men and affected on the left side. The median of time interval between fracture to correction osteotomy was 11.2 months with a mean time of follow-up was 24.9 months. Clinical outcome after correction osteotomy based on Mitchell and adams criteria showed good to excellent criteria as many as 14 patients (93.3%) and only 1

patient (6.7%) with unsatisfactory results. While the functional outcomes based on MEPS showed good to excellent categories of 14 patients (93.3%), and the fair category was 1 patient (6.7%). There were a significant radiological improvement measured by baumannn angle, metaphyseal-diaphyseal angle, humero-ulnar angle, humero-capitellar

angle and anterior humeral line. There was a strong correlation between baumann angle improvement with Mitchel and Adams criteria and there was a moderate correlation

between the improvement of Metaphyseal-diaphyseal angle and MEPS. Conclusion: Corrective osteotomy by lateral closed wedge osteotomy on malunion supracondylar humeral fracture showed good to excellent clinical, functional and radiological outcomes. Baumann angle and Metaphyseal-diaphyseal angle can be used as parameter to predict clinical and functional outcomes after corrective osteotomy.

"

"[ABSTRAK Keperawatan kesehatan masyarakat perkotaan merupakan bagian keperawatankomunitas yang memfokuskan pelayanan pada penyelesaian masalah kesehatan.Masyarakat perkotaan memiliki karakteristik yaitu padat penduduk, tingginya angkapertumbuhan kendaraan bermotor, dan mobilitas yang tinggi. Karakteristik inimempengaruhi pola aktivitas masyarakat, salah satunya penggunaan alat transportasiuntuk efektivitas waktu. Faktor mobilitas yang tinggi, tingginya angka pertumbuhankendaraan, dan ketidakdisiplinan pengemudi kendaraan menimbulkan risikokecelakaan yang berdampak pada masalah kesehatan salah satunya fraktur. Selamapraktik di ruang bedah RSUP Cipto Mangunkusumo penulis mengambil kasus klienfraktur radius ulna dengan ansietas tinggi selama hospitalisasi. Penulis menganalisissalah satu tindakan keperawatan untuk mengurangi ansietas klien.ABSTRACT Urban health nursing is part of the community nursing service that focuses on

addressing health problems in urban areas. Urban community is characterized by

dense population, a high rates in the growth of motor vehicles, and high mobility of

the society. These characteristics affect the pattern of community activities, one of

which is in the use of motor vehicle for transportation. High mobility factor, a high

rates of growth in motor vehicle and inappropriate behavior may increase the risk of

accidents that may impact on health, one of which is a fracture. During the practice in

the surgery department of Cipto Mangunkusumo Hospital, the author cared for the

patient with fracture of the radius ulna with high anxiety during hospitalization. The

authors analyze done of the nursing intervention provided to reduce client anxiety;Urban health nursing is part of the community nursing service that focuses on

addressing health problems in urban areas. Urban community is characterized by

dense population, a high rates in the growth of motor vehicles, and high mobility of

the society. These characteristics affect the pattern of community activities, one of

which is in the use of motor vehicle for transportation. High mobility factor, a high

rates of growth in motor vehicle and inappropriate behavior may increase the risk of

accidents that may impact on health, one of which is a fracture. During the practice in

the surgery department of Cipto Mangunkusumo Hospital, the author cared for the

patient with fracture of the radius ulna with high anxiety during hospitalization. The

authors analyze done of the nursing intervention provided to reduce client anxiety;Urban health nursing is part of the community nursing service that focuses on

addressing health problems in urban areas. Urban community is characterized by

dense population, a high rates in the growth of motor vehicles, and high mobility of

the society. These characteristics affect the pattern of community activities, one of

which is in the use of motor vehicle for transportation. High mobility factor, a high

rates of growth in motor vehicle and inappropriate behavior may increase the risk of

accidents that may impact on health, one of which is a fracture. During the practice in

the surgery department of Cipto Mangunkusumo Hospital, the author cared for the

patient with fracture of the radius ulna with high anxiety during hospitalization. The

authors analyze done of the nursing intervention provided to reduce client anxiety, Urban health nursing is part of the community nursing service that focuses on

addressing health problems in urban areas. Urban community is characterized by

dense population, a high rates in the growth of motor vehicles, and high mobility of

the society. These characteristics affect the pattern of community activities, one of

which is in the use of motor vehicle for transportation. High mobility factor, a high

rates of growth in motor vehicle and inappropriate behavior may increase the risk of

accidents that may impact on health, one of which is a fracture. During the practice in

the surgery department of Cipto Mangunkusumo Hospital, the author cared for the

patient with fracture of the radius ulna with high anxiety during hospitalization. The

authors analyze done of the nursing intervention provided to reduce client anxiety]"