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"Penyembuhan fraktur masih merupakan masalah besar. Banyak hal dilakukanuntuk mempercepat penyembuhan fraktur dan menghindari komplikasipenyembuhan fraktur. Pemberian vitamin C salah satunya. Penelitian ini bertujuanuntuk mengetahui peran vitamin C dalam mempercepat penyembuhan frakturpada fraktur dengan periosteal stripping di femur tikus putih Spague DawleyEvaluasi percepatan penyembuhan fraktur dilakukan secara radiologis denganskor RUST dan histologis dengan histomorphometri. Penelitian ini adalahpenelitian eksperimental. Penilaian dilakukan terhadap 32 ekor tikus dengandosis vitamin C yang berbeda-beda dan dievaluasi pada minggu ke 2 dan mingguke 4. Terdapat percepatan penyembuhan fraktur pada kelompok dengan dosisbesar pada skor RUST di minggu ke-4. Secara histologis pada histomorphometrididapatkan percepatan penyembuhan fraktur,tetapi secara statistik tidak bermakna.

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Fracture Healing still became a problem. There are many things to do to enhance

and avoid the complication of fracture healing. Vitamin C is one of the way to

enhance the fracture healing.. The purpose of this study is to know the role of

vitamin C in enhancement the fracture healing in fracture with periosteal stripping

at white rats femur. The evaluation of enhancement of fracture healing used

radiograpic with RUST score and histologic with histomorphometry. This is an

experimental study. The study used 32 rats which were given vitamin C in

different dosage and was evaluated at the 2nd and 4th week. There is

enhancement of fracture healing in all dosage, especially the large dosage of

vitamin C in RUST score evaluation in the 4th week. In histomorphometry

evaluation there were enhancement of fracture healing but statistically no

significant"

"ABSTRAK Pendahuluan. Kesulitan dalam tatalaksana defek tulang yang luas merupakan salah satu tantangan dewasa ini. Selain tatalaksananya yang kompleks juga dapat memberikan dampak jangka panjang negatif yang berat. Penggunaan BMP-2 dalam tatalaksana fraktur dengan defek tulang yang luas memegang peranan penting. BMP-2 berperan pada proses osteogenesis dan chondrogenesis dan menghambat osteoclastogenesis melalui RANKL signaling. Penelitian ini bertujuan untuk mengetahui efek dari perbedaan dosis BMP-2 terhadap penyembuhan fraktur dengan defek tulang yang luas. Metode. Penelitian dilakukan di Laboratorium Animal Gizi di FKUI dan Laboratorium Patologi Anatomi FKUI-RSCM, pada bulan Juli hingga September 2015. Desain penelitian adalah randomized post test control group. Sejumlah 25 ekor tikus putih Sprague Dawley dengan usia 3-4 bulan dan berat badan antara 250 ? 350 gram, dibagi secara acak menjadi kelompok kontrol hidroksiapatit (HA) saja dan kelompok kombinasi HA + BMP-2 1 μg/ml, HA + BMP-2 5 μg/ml, HA + BMP-2 10 μg/ml, HA + BMP-2 20 µg/ml. Tiap kelompok dilakukan tindakan berupa frakturisasi dengan defek tulang 10mm pada femur kanan dan dilakukan fiksasi interna dengan menggunakan intramedullary k-wire ukuran 1,4 mm secara retrograd. Setelah 6 minggu dilakukan penilaian secara histomorfometri, radiologis dan Scanning Electron Microscope (SEM). Hasil. Berdasarkan hasil penelitian secara histomorfometri ditemukan terdapat perbedaan rerata total area kalus yang bermakna diantara kelompok penelitian (p<0,001),terdapat perbedaan bermakna rerata area penulangan antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,016, p=0,009 dan p=0,016), terdapat perbedaan bermakna rerata area kartilago antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,009, p=0,009, p=0,009 dan p=0,028), terdapat perbedaan bermakna rerata area fibrosis antara kelompok kontrol dengan kelompok 1 μg/ml dengan kelompok kontrol dan 10 μg/ml(masing-masing p=0,047 dan p=0,009).Secara radiologis dengan RUST score didapatkan perbedaan bermakna antara kelompok kontrol dengan kelompok 1 μg/ml, 5 μg/ml, 10 μg/ml, 20 μg/ml (masing-masing p=0,005, p=0,006, p=0,005 dan p=0,006). Dengan SEM didapatkan gambaran kalus yang lebih homogen dan padat pada kelompok 10μg/ml dibandingkan dengan 5 μg/ml dan 20 μg/ml. Kesimpulan: Pemberian BMP-2 dapat menstimulasi proses penyembuhan fraktur pada defek tulang luas (critical bone defect) yang bermakna secara statistik, histomorfometri, radiologis maupun secara kualitatif dengan SEM. Terdapat dosis optimal dalam pemberian BMP-2.ABSTRACT Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects. Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM). Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml. Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2.;Introduction: Difficulties in the management of extensive bone defects is one of today's challenges. It is not only complex treatment but also can provide long-term negative severe effects. The use of BMP-2 in the treatment of fractures with extensive bone defect plays an important role. BMP-2 plays a role in the process of osteogenesis and chondrogenesis and inhibits osteoclastogenesis via the RANKL signaling. This study aims to determine the effect of differences in doses of BMP-2 on the healing of the fracture with extensive bone defects. Methods: The study was conducted at the Laboratory of Animal Nutrition at the Faculty of Medicine University of Indonesia (FMUI) in July until September 2015. The study design was randomized posttest control group. A number of 25 Sprague Dawley rats aged 3-4 months and bodyweight between 250-350 grams, were randomly divided into a control group of hydroxyapatite (HA) alone and HA+BMP-2 1 µg / ml, HA+BMP -2 5 ug / ml, HA + BMP-2 10 µg / ml, HA + BMP-2 20 ug / ml. Each group carried out fracturization with 10mm bone defect in right femur and internal fixation by using intramedullary K-wire size of 1.4 mm retrograde. After 6 weeks we did histomorfometri assessment, radiological and Scanning Electron Microscope (SEM). Results: Based on the research results histomorfometrcally found there are differences in the mean total area of ​​callus significantly between the study group (p <0.001), there were significant differences in the mean area of ​​woven bone between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.016, p = 0.009 and p = 0.016), there were significant differences in the average area of ​​the cartilage between the control group with group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 ug / ml (respectively p = 0.009, p = 0.009, p = 0.009 and p = 0.028), there were significant differences in the average area of ​​fibrosis between the control group with group 1 ug / ml in the control group and 10 mg / ml (respectively -masing p = 0.047 and p = 0.009) .In radiologist assessment with RUST scores obtained significant differences between the control group and group 1 ug / ml, 5 µg / ml, 10 µg / ml, 20 µg / ml (respectively p = 0.005 , p = 0.006, p = 0.005 and p = 0.006). SEM features with callus more homogeneous and dense in the group of 10μg / mL compared with 5 ug / ml and 20 µg / ml. Conclusion: Administration of BMP-2 could stimulate the process of fracture healing in large bone defects (critical bone defect) which was statistically significant with histomorfometri assestment, radiological and qualitatively with the SEM. There is an optimal dose in the administration of BMP-2."

"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).

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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."

"Pendahuluan: Penanganan nonunion dan delayed union bukanlah penanganan yang murah dan mudah. Berbagai metode telah dilakukan untuk mengatasi masalah tersebut. Beras angkak terbukti memiliki peranan dalam penyembuhan fraktur. Beras angkak, mengandung monakolin, suatu senyawa dengan aktivitas sebanding lovastatin. Pemberian statin secara lokal dan oral terbukti meningkatkan penyembuhan tulang dengan menginduksi diferensiasi osteoblas melalui peningkatan ekspresi BMP-2. Penelitian ini dilakukan untuk membuktikan efektivitas monakolin pada beras angkak dalam meningkatkan ekspresi BMP-2 dan penyembuhan fraktur pada model delayed union tikus sprague- dawley. Material dan Metode: Studi eksperimental pada 24 hewan coba tikus putih Sprague-Dawley (SD) yang telah mengalami patah tulang femur disertasi dengan gangguan vaskularisasi (model delayed-union). Hewan coba dibagi menjadi empat kelompok (n=6) terdiri dari; kelompok pemberian ekstrak monakolin selama empat minggu (PM4), kelompok pemberian ekstrak monakolin selama dua minggu (PM2), kelompok kontrol empat minggu (KM4) dan kelompok kontrol dua minggu (KM2). Setelah dilakukan sacrifice pada minggu kedua dan keempat, dilakukan penilaian ekspresi BMP-2 secara semikuantitatif dengan pewarnaan imunohistokimia melalui skor imunoreaktif (IRS). Analisis histomorfometri untuk menilai penyembuhan fraktur dengan mengukur persentase area fibrosa, tulang rawan dan tulang imatur. Hasil: Pada evaluasi parameter IRS dan histomorfometri didapatkan ekspresi BMP-2 lebih tinggi (p=0.03), persentase area fibrosa lebih sedikit (p=0.005) dan area tulang rawan lebih besar (p=0.04) pada kelompok PM2 dibandingkan dengan kelompok KM2. Selain itu didapatkan pula secara ekspresi BMP-2 lebih tinggi (p=0.011), presentase area tulang imatur lebih besar (p=0.01), dan presentase area fibrosa lebih kecil (p=0.03) pada kelompok PM4 dibandingkan dengan kelompok KM4. Di sisi lain, didapatkan presentase area fibrosa lebih kecil (p=0.02), area tulang rawan lebih sedikit (p=0.05), dan peningkatan area tulang imatur lebih besar (p=0.04) pada kelompok PM4 dibandingkan dengan kelompok PM2. Ekspresi BMP-2 sama-sama meningkat pada kelompok PM2 dan PM4. Kesimpulan: Pemberian monakolin pada beras angkak pada model delayed-union tikus Sprague Dawley terbukti meningkatkan ekspresi BMP-2 dan meningkatkan penyembuhan fraktur.

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Introduction: Management of nonunion and delayed union could be difficult and expensive. Various methods have been studied to overcome this problem. Red-yeast-rice has a role in fracture healing. Red-yeast-rice contains monacolin, which has similar activity to lovastatin. Local application and oral administration of statins have been shown to improve bone healing by inducing osteoblast differentiation and matrix production via increasing BMP-2 expression. This study was conducted to prove the effectiveness of monacolins inside red-yeast-rice in increasing the expression of BMP-2 and fracture healing. Methods: This experimental animal study was conducted using 24 delayed union models Sprague-Dawley (SD) Rats. There were 4 groups (n=6), consist of; 4-weeks-given-monacolin group (PM4), 2-weeks-given-monacolin group (PM2), 4-weeks-control group (PM2) and 2-weeks control group (KM2). After they were sacrificed in the second and fourth weeks, immunohistochemical staining was conducted to evaluate BMP-2 expression by Immunoreactive Score (IRS). The histomorphometric evaluation was also conducted to evaluate fracture healing by measuring fibrous area, cartilage area, and woven bone area percentage. Results: There was significantly higher BMP-2 expression (p=0.03), less fibrous area (p=0.05), and larger cartilage area (p= 0.04) in the PM2 group compared to the KM2 group. There was significantly higher expression of BMP-2 (p=0.011), larger woven bone area (p=0.01), and less fibrous area (p = 0.03) in the PM4 group compared to the KM4 group. It was also presented, there was a significantly less fibrous area (p=0,02), larger cartilage area (p=0.05), and larger woven bone area (p=0.04) in the PM4 group compared to the PM2 group. The expression of BMP-2 in the PM2 group was as high as the PM4 group. Conclusion: Monacolin in red-yeast-rice effectively increased BMP-2 expression and fracture healing in the delayed union model of SD rats."

"Angka kejadian fraktur yang masih cukup tinggi, diikuti komplikasi berupa nonunion akan menimbulkan berbagai masalah selama proses penyembuhan yang berujung pada tingginya biaya kesehatan. Berbagai tindakan pencegahan perlu diberikan berdasarkan faktor-faktro yang dapat mempengaruhi penyembuhan tulang. Penelitian ini adalah studi eksperimental dengan pemberian soybean pada tikus sparaque dawley dengan patah tulang femur yang terbagi atas kelompok A/kontrol, kelompok B/25 mg, dan kelompok C/50 mg. Evaluasi dilakukan dengan radiologi dan histopatologi. Tidak didapatkan perbedaan yang bermakna pada evaluasi radiologi pada ketiga kelompok. Didapatkan perbedaan yang bermakna pada evaluasi histopatologi pada kelompok C dibandingkan kelompok lainnya"

"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."

"ABSTRAKFractures of the neck of condyle usually are the result of a blow to the mandible. A lateral blow to the body of the mandible commonly cause a contralateral condylar fracture. There are many signs and symptoms of a condylar fracture, for example crepitation, deviation of the mandible to the side of injury, and spasm of the associate group of muscles. These will result in a functional disability, which is usually seen as a limited mandibular movement. This paper reported a patient with a fracture of the right condylar neck. Patient had been treated with closed reduction and immobilization for 2 months. After that, she felt that her bite was charged, she could not occlude her teeth well, and she had clicking sound in the right joint when she opened her mouth. Besides that, patient had difficulties to move the mandible to the left side, and she could not open her mouth widely. The patient was treated with a repositioning splint and she had to do some jaw exercises.The purposes were to regain the position of condyle, to reduce the muscle spasm and finally got the normal jaw movement."

"PendahuluanFraktur kominutif dapat memberikan permasalahan berupa nonunion. Penggunaan graft untuk mengatasi masalah tersebut masih diperdebatkan. Autograft merupakan baku emas dalam penggunaan graft, namun keterbatasannya adalah persediaan yang terbatas. Untuk itu banyak beredar pengganti autograft seperti allograft, xenograft, dan graft sintetik (biomaterial scaffold). Graft harus mempunyai biokompatibilitas yang baik guna mendukung penyembuhan fraktur.MetodeDilakukan randomized post test only control group terhadap 30 tikus Sprague Dawley guna menilai biokompatibilitas scaffold secara in vivo. Scaffold yang digunakan adalah hidroksiapatit (HA)-Bongros®, nanokristalin HA-CaSO4 (Perossal®), nanokristalin HA (Ostim®), morselized bovine xenograft (BATAN), dan HA-lokal bank jaringan dr. Sutomo. Dilakukan penilaian reaksi jaringan (jumlah sel datia benda asing dan limfosit), skor radiologis dan histologis pada minggu ke-8.HasilPerbedaan bermakna ditunjukkan pada jumlah sel datia benda asing memberikan perbedaan bermakna (p=0,003), namun tidak dengan limfosit (p=0,397). Scaffold HA-lokal menunjukkan jumlah sela datia benda asing paling banyak. Skor histologis memberikan perbedaan bermakna (p=0,013) , namun skor radiologis tidak menunjukkan perbedaan bermakna (p = 0,204 untuk proyeksi antero-posterior dan p = 0,506 untuk proyeksi mediolateral). Didapatkan 2 subjek yang drop out yaitu 1 subjek pada kelompok kontrol (implant failure) dan 1 subjek pada kelompok IV (osteomielitis). Terdapat korelasi yang bermakna antara jumlah sel datia benda asing dan skor histologis (p=0,034).DiskusiBiokompatibilitas scaffold secara in vivo ditentukan oleh komponen fisik dan kimia pembentuknya. Secara fisik, scaffold yang memiliki pori-pori menunjukkan skor histologis yang lebih baik. Komponen kimia pembentuk scaffold dapat memengaruhi reaksi jaringan. Jumlah sel datia benda asing berhubungan dengan sitotoksisitas scaffold.

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Introduction

Comminuted fracture may result as nonunion. The use of bone graft is still debatable for treating comminuted fracture. Autograft is the gold standard of bone graft. However, it has a limitation in supply. Therefore, the use of other source of graft (allograft, xenograft, or synthetic) is increasing. Graft must have good biocompatibility in order to enhance fracture healing.

Method

Randomized post test only control group was conducted in 30 Sprague-Dawley rat in order to evaluate biocompatibility of the scaffold. We used hidroxyapatite (HA)-Bongros®, nanocrystalline (HA)-CaSO4 (Perossal®), nanocrystalline HA (Ostim®), morselized bovine xenograft (BATAN), dan local HA from dr. Sutomo Hospital as the scaffold. Tissue reaction (the amount of foreign body giant cell and lymphocyte), radiological and histological score was evaluated at 8th weeks.

Result

The amount of foreign body giant cell (FBGC) and histological score showed significant difference (p=0,003 and p=0,013). Local HA scaffold showed the most FBGC accumulation. There was no significant difference in the amount of lymphocyte (p=0,397) and radiological score (p=0,204 for antero-posterior projection and p=0,506 for medio-lateral projection). Two subjects were considered drop out, one due to implant failure (control group) and the other due to osteomyelitis (group IV). There was significant correlation between the amount of foreign body giant cell and histological score (p=0,034).

Discussion

Both physical and chemical factor influenced biocompatibility of scaffold. Scaffolds that have pores showed better histological score compared to that has none. Chemical compound of the scaffold play important role in tissue reaction. The amount of FBGC showed the cytotoxic level of the scaffold.

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"ABSTRAKFraktur femur dikenal sebagai fraktur yang umum terjadi di wilayah perkotaan dibandingkan wilayah pedesaan. Di perkotaan banyak dijumpai kasus fraktur femur, namun di pedesaan lebih banyak ditemukan yaitu fraktur pada ekstremitas atas. Hal ini karena perbedaan karakteristik wilayah dan penduduk dari keduanya, sehingga masyarakat kota memiliki faktor risiko yang khas wilayah perkotaan seperti contohnya fraktur yang terjadi karena trauma atau kecelakaan lalu lintas. Pada kasus ini, Ny H merupakan seorang wanita berusia 43 tahun dan bertempat tinggal di wilayah perkotaan. Ny H mengalami fraktur femur intertrochanter tertutup bukan disebabkan karena cedera tetapi karena proses infeksi. Berdasarkan pengkajian dan analisis data pada periode pre operasi maupun post operasi, ditemukan masalah keperawatan nyeri akut, hambatan mobilitas fisik, risiko infeksi, risiko trauma, dan risiko kerusakan integritas kulit. Intervensi keperawatan yang dibahas dalam karya tulis ini adalah mengenai latihan kekuatan otot isometrik untuk mencegah penurunan kekuatan otot dan mempersiapkan ambulasi serta mobilisasi dini secara optimal.

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ABSTRACT

Femoral fractures are known as common fractures in urban areas rather than rural areas. In urban areas there are many cases of femoral fracture, but in rural areas more commonly found is fracture in upper limb. This is due to the different characteristics of the region and the population of both, so that urban people have typical risk factors in urban areas such as fractures that occur because of injury or traffic accidents. In this case. Mrs H is a 43 year old female and lives in an urban area. Mrs H has a closed femoral fracture intertrochanter not caused by injury but because of infection process. Based on assessment and analysis of data in the preoperative and postoperative periods, acute pain nursing problems, impaired physical mobility, infection risk, risk for injury, and risk for impaired skin integrity were found. Nursing interventions discussed in this paper are about isometric excercise to prevent decreased muscle strength and prepare for early ambulation and early mobilization."

"ABSTRAKKeluhan utama pasien dengan fraktur adalah nyeri. Nyeri yang dialami pas1endapat menjadi salah satu penyebab ketidaknyamanan pada pasien fraktur.OJ;otherapy merupakan aplikasi zat pada tubuh yang dapat menurunkan suhujaringan dan menurunkan nyeri. Penelitian ini bertujuan mengetahui pengaruhcryotherapy terhadap nyeri dan kenyamanan pada pasien fraktur tertutup. Desainpenelitian yang digunakan dalam penelitian ini adalah quasi experiment one grouppretest-posttest design dan teknik sampling yang digunakan yaitu non probabilitysampling dengan metode concecutive sampling. Besar sampel yang digunakandalam penelitian ini adalah 25 responden. Hasil penelitian menunjukkan adanyaperbedaan yang signifikan antara tingkat nyeri sebelum dan sesudah diberikancryotherapy dengan p value= 0.0001. Nilai kenyamanan pasienjuga menunjukkanadanya perbedaan yang signifikan antara kenyamanan sebelum dan sesudahdiberikan cryotherapy dengan p value = 0.043. Penelitian ini merekomendasikanpenerapan cryotherapy untuk membantu pasien fraktur menurunkan nyeri danmeningkatkan kenyamanannya.

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ABSTRACTPain is the most common problem on patient with fracture. Pain becomes oneaspect that makes patient with fracture experience discomfmt. Cryotherapy is atreatment to decrease pain by applying substances to lowering temperature of thebody (skin) surface. The purpose of this study was to examine the influencecryotherapy to pain and level of comfmt in patient with closed fracture. This isquasi experiment one group pretest-posttest study using non probability sampling(consecutive sampling) recruiting 24 respondents. The result shows that there wasa significant difference in pain level before and after cryotherapy (p val ue=O. 00 1).There was also significant difference on level of comfm1 before and aftercryotherapy (p value=0.043). It is recommended that cryotherapy should beapplied to decrease pain and level of discomfort in patient with fracture."