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""Clinical Orthopaedic Examination is firmly established as a standard guide to the subject. Although the basic techniques of a good clinical examination are best learned by performance under supervision, the lack of opportunities to experience an adequate range of suitable clinical cases makes this difficult to achieve in practice. As a result many students and trainees have only a sketchy knowledge of the techniques of examination which are fundamental to diagnosis and treatment. This book will be invaluable in helping fill some of these inevitable gaps until sound practice based on experience is achieved. The author's illustrations, arranged in a linear sequence, follow the traditional lines of inspection, palpation and the examination of movements and pertinent anatomical structures. The essential role of radiographic examination in the investigation of most orthopaedic cases is fully illutrated and integrated with the unique line drawings. For this Sixth Edition the text has been updated to include a number of new tests and methods of assessing overall limb function."--Publisher's description."

"Pendahuluan: Cedera yang disebabkan oleh gempa bumi seringkali memiliki pola kompleks dan bervariasi, dan maka dari itu menyebabkan krisis situasional dan serius untuk pusat layanan kesehatan. Dalam konteks terjadinya gempa, seringkali terjadi ketidakkeseimbangan antara kepadatan yang berlebihan dalam rumah sakit dan sumber daya inadekuat; hal ini menyebabkan penurunan standar pelayanan kesehatan. Sampai saat ini, di Indonesia, masih belum terdapat pedoman terkait tatalaksana cedera musculoskeletal setelah terjadinya gempa. Studi ini bertujuan untuk mengetahui analisa faktor-faktor resiko yang mempengaruhi profil luaran klinis, dan luaran radiologis pada pasien gempa Lombok 2018 dengan fraktur ekstremitas atas, ekstremitas bawah dan tulang belakang pasca tindakan orthopaedi. Metode: Penelitian ini merupakan studi potong lintang. Penelitian ini dilakukan pada bulan September 2019 di 2 Rumah Sakit dan 9 puskesmas di Lombok dan beberapa kecamatan paling terdampak di Lombok Utara. Korban bencana gempa Lombok Agustus 2018 dengan fraktur esktremitas bawah, esktremitas atas dan tulang belakang yang mendapat tindakan Orthopaedi dilibatkan dalam penelitian ini. Data diperoleh secara langsung dari pasien dan dari data kasus dan tindakan Orthoapedi tim bencana PABOI dan tim bantuan medis Orthopaedi lainnya. Hasil: Data hasil penelitian ini menunjukan bahwa mayoritas pasien berjenis kelamin perempuan 62,2% dan mayoritas berusia dewasa 75,7%. Distribusi diagnosis terbanyak adalah fraktur tertutup ekstremitas bawah 52,7%. Diagnosis jenis cedera dan tindakan ORIF memiliki hubungan yang signifikan dengan union rate (p=0,038 dan p=0,021). Faktor resiko diagnosis dan tindakan ORIF memiliki hubungan yang bermakna terhadap Infeksi (p=0,001 dan p=0,011). Faktor resiko diagnosis dan lokasi cedera memiliki hubungan yang signifikan dengan nilai SF 36 physical function (P=0,001 dan P=0,002) Diskusi: Tata laksana definitif ORID tidak realistis dilakukan sesaat setelah gempa. Damage control orthopaedic adalah tindakan pilihan penanganan kasus orthopaedi untuk patah tulang terbuka. Usia, diagnosis dan lokasi cedera dan tindakan ORIF memiliki pengaruh terhadap union rate, infeksi, dan skor fungsional SF-36 korban bencana gempa bumi. Kesimpulan: Usia, diagnosis dan lokasi cedera dan tindakan ORIF memiliki pengaruh terhadap union rate, infeksi, dan skor fungsional SF-36 korban bencana gempa bumi.

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Introduction: Injuries caused by earthquakes often have a complex and varied pattern, and therefore cause serious situational crises for health care centres. In the context of an earthquake, there is often an imbalance between overcrowding in hospitals and inadequate resources; this causes a decrease in the standard of health services. Until now, in Indonesia, there are still no guidelines regarding the management of musculoskeletal injuries after an earthquake. This study aims to determine the analysis of risk factors that affect the clinical outcome profile, and radiological outcomes in Lombok earthquake patients 2018 with fractures of the upper extremities, lower extremities and spine after orthopedic procedures.

Method: This research is a cross-sectional study. This research was conducted in September 2019 in 2 hospitals and 9 health centers in Lombok and some of the most affected sub-districts in North Lombok. Victims of the Lombok earthquake in August 2018 with fractures of the lower extremities, upper extremities and spine who received orthopedic procedures were included in this study. Data were obtained directly from patients and from data on cases and actions of the Orthopedic PABOI disaster team and other Orthopedic medical assistance teams.

Results: The data from this study showed that the majority of patients were female 62.2% and the majority were adults 75.7%. The most distribution of diagnoses were closed fractures of the lower extremities 52.7%. The diagnosis of the type of injury and the ORIF procedure had a significant relationship with the union rate (p=0.038 and p=0.021). Risk factors for diagnosis and ORIF treatment had a significant relationship to infection (p=0.001 and p=0.011). Risk factors for diagnosis and location of injury had a significant relationship with the SF 36 physical function value (P=0.001 and P=0.002)

Discussion: Definitive management of ORID is not realistic to be carried out immediately after the earthquake. Orthopedic damage control is the treatment of choice for orthopedic cases for open fractures. Age, diagnosis and location of injury and ORIF action have an influence on union rate, infection, and functional score of SF-36 earthquake victims.

Conclusion: Age, diagnosis and location of injury and ORIF action have an influence on union rate, infection, and functional score of SF-36 earthquake victims"

"Praktik Spesialis Keperawatan Medikal Bedah dengan kekhususan pada sistem muskuloskeletal ini bertujuan untuk mengaplikasikan peran perawat sebagai pemberi asuhan, pengelola, pendidik dan peneliti. Peran sebagai pemberi asuhan dilakukan dengan mengelola satu kasus utama; fraktur tertutup intertrokhanter femur dan 30 pasien yang mengalami masalah pada sistem muskuloskeletal dengan pendekatan teori adaptasi Roy. Peran perawat sebagai peneliti dilakukan dengan penerapan tindakan keperawatan yang berbasis bukti ilmiah (Evidence-Based Nursing Practice) yaitu dengan menerapakan foot massage untuk mengurangi nyeri dan kecemasan pada pasien paska pembedahan fraktur ekstremitas bawah. Sedangkan peran sebagai pengelola dilakukan dengan menyusun protokol pengembangan ERAS untuk pasien yang akan menjalani operasi hip. Seluruh rangkaian kegiatan tersebut bertujuan untuk mewujudkan asuhan keperawatan yang komprehensif dalam rangka meningkatkan kualitas pelayananan keperawatan.Clinical Practice of Medical-Surgical Nursing Spesialialist in specialty of orthopaedic nursing aims to apply the role of nurse as a direct patient care provider, managers, educators and researchers in the clinical setting. Role as a care provider has done by one patient (major managed cases) with closed fracture intertrochanter femur and 30 patients with musculoskeletal problems using adaptation Roy Nursing theory approach. The role of nurses as a researchers has contructed by applying the nursing action based by evidence is foot massage to reduce pain and anxiety in patients after surgery for lower limb fracture. While the role as a nursing manager is done by comliling the ERAS development protocol for patients who undergo hip surgery. All activities aim to realizing the holistic nursing care in order to improve the quality of nursing services."

"ABSTRAKRumah Sakit Ortopedi Prof Dr. R Soeharso merupakan Rumah sakit rujukan Nasional di bidang Ortopedi yang mempunyai misi memberikan Pelayanan paripurna di bidang ortopedi yang bermutu, terjangkau oleh semua lapisan masyarakat, tempat pendidikan dan pelatihan serta penelitian dan pengembangan di bidang ortopedi dalam rangka meningkatkan derajat kesehatan masyarakat.Unit analisis ialah pasien paraplegi, masalah yang diteliti ialah bahwa pasien paraplegi jumlahnya relatif sedikit (132 pasien) dibanding dengan jumlah seluruh pasien pada tahun 1995/1996 sebanyak 1539. Jumlah tersebut ternyata menurun dibanding dengan jumlah pasien paraplegi pada tahun 1994/1995 sejumlah 145 pasien. Penelitian dilakukan secara evaluatif dengan disain Cross Sectional Study.Tujuan penelitian secara umum ialah untuk mengidentifikasi persepsi pasien paraplegi terhadap pelayanan rawat inap di RSO Prof, Dr. R. Soeharso Surakarta.Banyak sampel 50 orang, penelitian dilakukan selama 3 bulan mulai 1 April 1997 sampai dengan 30 Juni 1997 dengan metode kuantitatif dan dianalisa univariat kemudian bivariat.Hasil penelitian bahwa faktor Input, faktor Proses, faktor Masyarakat berhubungan erat dengan kepuasan pasien terhadap fasilitas pelayanan RSO Prof Dr. R. Soeharso, sebanyak 66 % merasa puas terhadap fasilitas pelayanan yang ada dan sebanyak 24 % merasa sangat puas.Saran yang ditujukan kepada RSO Prof: Dr. R. Soeharso, agar mempertahankan kepuasan pasien dan menjaga mutu, serta mengaktifkan Komite Kendali Mutu yang ada agar penanganan pasien paraplegi dapat dilaksanakan secara baik dan terpadu. Sebelum memberikan tindakan medis pada pasien supaya diberikan penjelasan agar pasien mengerti manfaat dan akibat dari tindakan medis tersebut. Rumah sakit supaya menyediakan kotak saran dan leaflet. Untuk peneliti lain agar dilakukan penelitian lanjutan pada pasien yang sama sesudah pulang dari rumah sakit.

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ABSTRACT

Perception Study of Paraplegic Patients on Medical Care Facilities at The Orthopaedic Hospital of Prof. Dr. R. Soeharso SurakartaThe orthopedic Hospital of Prof. Dr. R. Soeharso is National referal for orthopedic. Which service complete care in orthopedic for all people.

It is also as centers for education, training high quality research and development in orthopedic, has aim in increasing public health status.

The unit analysis is Paraplegic patients and the problem is that the number of paraplegic is very few (132 patients) compared by the number of total patient in 1995/1996 ( 1539 patients ).

The number of paraplegic in 1995/1995 is decrease compared by the number of paraplegic in 1994/1995 (145 patients).

The design of the research is evaluative description using cross sectional study. The purpose of the research is to identify the hospitalizing paraplegic perception on Hospital service's facilities in the Orthopedic Hospital of Prof.Dr R Soeharso Surakarta.

The number of the sample are 50 patients done for 3 month from April 1'1997 to June 30'1997 using quantitative method, univariat and bivariat analysis.

The patients mostly come from middle economy class to low economy class. 40% of patients is farmer, 30% of patients is laborer, 18% of patients is entrepreneur and 12% of patients is civil servant.

The percentage of the referral patients sent by their family or by themselves is 52%. The satisfaction of all Hospital services is found that satisfaction of service's facilities is 72%, satisfaction of service's process is 64%, and satisfaction of service's result is 60%. Unsatisfaction of service's process I s 20% and unsatisfaction of service's result is 20%. The contribution of all variable to satisfaction variable is 98%.

The suggestion can be given to the hospital to keep the satisfaction patient and and to keep the quality of the services is that the hospital should make guidance book of the rights and the obligation of the patient, doctors and hospital based on The Direktorat Jendral Pelayanan Medik paper. Besides that the hospital can activate the TQM activities so the paraplegic patients can be handled well and integrated.

Before giving medical treatment to the patients, it is better if the patients know the information transparently so they understand the use and the side effect of the treatment. In the other hand the hospital can provide the suggestion box and leaflets for the patients.

For other researcher, it is better if it is made further examination on post hospitalized patients of the same patients.

For the patient it is hoped to adapt the hospital environment and obey the hospital regulation."

"Keluhan utama pasien pasca bedah orthopedi adalah nyeri. Nyeri yang dialami pasien juga dapat menyebabkan kecemasan. Terapi musik religi merupakan intervensi pelengkap nonfarmakologi untuk mengurangi nyeri dan kecemasan. Penelitian ini bertujuan mengetahui pengaruh terapi musik religi terhadap nyeri dan kecemasan pada pasien fraktur pasca bedah orthopedi. Desain penelitian yang digunakan dalam penelitian ini adalah quasi experimen dengan pre and post test control group, menggunakan consecutive sampling. Jumlah sampel adalah 32 orang 16 kelompok kontrol dan 16 kelompok intervensi.Hasil penelitian menunjukan adanya pengaruh yang signifikan terhadap penurunan tingkat nyeri p value = 0,01; ? = 0,05 , tidak ada pengaruh signifikan terhadap penurunan tingkat kecemasan p value = 0,796; ? = 0,05 . Tidak ada hubungan antara usia, jenis kelamin, dan riwayat operasi sebelumnya terhadap tingkat nyeri dan kecemasan. Penelitian ini merekomendasikan terapi musik religi sebagai salah satu intervensi alternatif mandiri keperawatan untuk mengurangi nyeri pasca bedah orthopedi.

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Pain is the most common problem on orthopaedic surgery. Pain becomes one aspect that make patient feeling anxious. Religious music therapy is a nonfarmakologic intervention to decrease pain and anxiety. The purpose of this studi was examine the effect of religious music therapy to reduce pain and anxiety on fracture patient`s post orthopaedic surgery. This study used quasi experimen pre and post test control group using consecutive sampling, recuiting 32 respondents.The result shows, that there was a significant effect on reducing pain level p value 0,01 0,05 , but there was no significant effect to anxiety p value 0,796 0,05 . There was no significant correlation between age, sex and previous surgery with pain level and anxiety. Recomendation, religious music therapy becomes one of the nursing intervention in reducing post orthopaedic surgery`s pain."