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"SummaryA retrospective study of 13 Equinus feet of 10 patients ofCerebral Palsy that we were able to collect and review, betweenDecember 1985 and November 1988, has been done.Tendoachilles lengthening by the closed method for 5 feet of 3patients and open method for 8 feet of 7 cases in those patientshas been performed. The result in both methods are comparable. Although the number of cases of these· two methods were too smallfor statistical analysis the results find to inaicate that closed ·1method of Achil les Tendon Lengthening is a good procedure in childrenwith Cerebral Palsy.Achilles Tendon lengthening for Equi nus has been performed sinceAncient times using either an open or closed method.This is usually performed by an open Z or fractional lengthening ofthe tendon proper. In 1943, Whi te (5.7 ) was one of the firstproponents of · closed method. Nowadays, most of the surgeons havefound and consider the · sliding method of lengthening either by theWhite method or the Hoke method ( 1954} ··more controlled and verysatisfactory. However closed method is not a widely used method fortreatment of Equinus Contracture in Cerebral Pa1sy.This study reviews patients with C.P. who had closed or openmethod of Achi11es Tendon Lengthening in National University Hospitalbetween Cecember 1965 and November 1988."

"Asuhan keperawatan yang diberikan oleh perawat sangat mempengaruhi kualitas pelayanan kesehatan yang akan diterima oleh pasien. Upaya yang dilakukan untuk meningkatkan kualitas asuhan keperawatan tersebut salah satunya dengan menerapkan peran ners spesialis. Tujuan penulisan Karya Ilmiah Akhir (KIA) ini adalah mampu menampilkan peran ners spesialis sebagai pemberi asuhan keperawatan lanjut, pembaharu dan peneliti. Metodologi dan pendekatan yang digunakan adalah dengan menggunakan studi literature. Karya Ilmiah Akhir berisi tentang : penerapan teori Virginia Henderson pada pasien dengan Neglected Fracture Left Shaft Femur, penerapan Progressive Muscle Relaxation (PMR) sebagai Evidance Based Nursing dan proyek inovasi yaitu Aplikasi Peran Perawat dalam Program Enhanced Recovery Orthopedic Surgery (EROS) pada Pasien Operasi Total Hip Replacement (THR). Hasil : Penerapan teori Virginia Henderson efektif diterapkan pada kasus muskuloskeletal. Intervensi Progressive Muscle Relaxation (PMR) juga efektif dalam menurunkan Anxiety pasien. Kesimpulan : bahwa teori Virginia Henderson dapat digunakan pada pasien dengan Neglected Fracture Left Shaft Femur untuk meningkatkan kemandirian akibat perubahan fisik dan psikologis. Intervensi Progressive Muscle Relaxation (PMR) dapat digunakan sebagai salah satu alternatif intervensi keperawatan mandiri dalam membantu mengurangi Anxiety pasien fraktur ekstremitas yang akan di lakukan tindakan operasi elektif.

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Nursing care provided by nurses greatly influences the quality of health services patients will receive. Efforts are being made to improve the quality of nursing care, either is applying the role of specialist nurses. The purpose of this Final Scientific Writing is able to show the role of specialist ners as nurse care nurse, change agent and researcher Methodology and approach used is by using literature study. The final work contains: the application of Virginia Hendersons theory to patients with Neglected Fracture Left Shaft Femur, and the Application Progressive Muscle Relaxation as Evidance Based Nursing and innovation projects Application of the Role of Nurses in Enhanced Recovery Orthopedic Surgery (EROS) in Patient Surgery Total Hip Replacement (THR). Results: The application of Virginia Hendersons theory was effectively applied to musculoskeletal cases. The intervention of Progressive Muscle Relaxation (PMR) is also effective in reducing patient anxiety. Conclusion: that Virginia Hendersons theory is appropriately used in patients with Neglected Fracture Left Shaft Femur to improve independence due to physical and psychological changes. The intervention of Progressive Muscle Relaxation (PMR) can be used as one of the alternative independent nursing interventions to help reduce Anxiety patients in limb fracture elective surgery."

"LATAR BELAKANG: Waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif di Indonesia masih belum diketahui. Penulis bertujuan mengetahui waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif di Departemen Bedah Saraf FKUI/RSUPNCM dan menganalisis hubungannya dengan luaran fungsional 3 bulan pascaoperasi menurut skala performa Karnofsky. METODE: Penelitian retrospektif ini didasarkan pada data rekam medis dan register pasien neuroonkologi yang menjalani operasi pengangkatan tumor intrakranial elektif pada tahun 2016. Analisis regresi logistik multivariabel dipakaiuntuk mengetahui kemaknaan statistik dari hubungan antara waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif dengan luaran fungsional dependen, ditandai oleh skor KPS 0-70 3 bulan pascaoperasi, dengan mempertimbangkan usia, jenis kelamin, skor KPS praoperasi, volume tumor pradan pascaoperasi, persentase pengangkatan tumor, patologi dan grading tumor.HASIL: Median (min-maks) waktu tunggu secara umum adalah 35 (0-529) hari. Tampak hubungan bermakna antara waktu tunggu menuju operasi pengangkatan tumor intrakranial elektif dengan luaran fungsional pada analisis univariabel (OR [95%CI]: 1,004 [1,001-1,007], tetapi tidak pada analisis multivariabel. Nilai kolinearitas volume tumor pra-operasi, pascaoperasi dan persentase pengangkatan tumor dengan waktu tunggu masing-masing adalah sebesar 5,92, 5,69, dan 3,2. SIMPULAN: Tidak terdapat hubungan bermakna secara statistik antara waktu tunggu menuju operasi pengangkatan tumor elektif dengan skor KPS 3 bulan pascaoperasi. Terdapat korelasi kuat antara waktu tunggu dengan volume tumor pra- dan pascaoperasi serta persentase pengangkatan tumor.

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BACKGROUND: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown. The author aimed to identify the waiting time to elective intracranial tumor removal surgery in the Department of Neurosurgery FMUI/RSUPNCM, and to analyze its association with functional outcome 3, defined by Karnofsky Performance Scale (KPS), in 3 months after surgery.

METHODS: This retrospective study was based on medical record and the registry of neuro-oncology patient who underwent elective intracranial tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to

investigate statistical significance of waiting time to elective intracranial tumor removal surgery and poor functional outcome, defined by 3-months follow-up KPS of 0-70, adjusting for age, sex, pre-operative KPS score, pre and post-operative

tumor volume, percentage of tumor removal, tumor histopathology and grading. RESULTS: Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant statistical association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was identified in univariable analysis (OR [95%CI]: 1,004 [1,001- 1,007]), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were,

respectively, 5,92, 5,69, and 3,2. CONCLUSION: There was no significant statistical association identified between

waiting time to elective intracranial tumor removal surgery and KPS 3 months after surgery. Strong correlations were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery"

"BAB I PENDAHULUAN Pemakaian listrik yang makin meningkat dan meluas meningkatkan kecelakaan akibat listrik, baik di rumah maupun di daerah industri. Luka bakar yang ditimbulkannya mulai dari derajat ringan sampai derajat berat dan fatal. Dengan adanya listrik masuk desa, tentunya meningkatkan pula kemungkinan akan trauma listrik, lebih-lebih masyarakat belum banyak mengenal usaha pengamanannya. Tidak jarang tegangan tinggi 20.000 Volt masuk ke pemukiman penduduk yang padat Penghuninya. Dalam makalah ini akan dibahas 20 kasus trauma listrik dan ha1ilintar yang dirawat di RSCM Januari 1983 sampai dengan September 1986 dengan tujuan: - Mengingatkan kembali morbiditas dan mortalitas serta sequeale akibat trauma oleh tegangan medium (rumah tangga) dari tegangan tinggi. - Meninjau dan mengevaluasi hasil pemeriksaan dan penatalaksanaan. Untuk itu akan dibahas pathogenesa, akibat, diagnosa, penatalaksanaan dan tindakan trauma listrik sehingga penanganan selanjutnya bisa lebih terarah dan rasional. Trauma listrik dan halilintar memberikan efek spesifik yang tidak sama dengan luka bakar biasa yaitu hisa menimbulkan luka bakar dalam dan kerusakan alat-alat dalam yang sering kali diabaikan sehingga pengobatan hanya ditujukan pada jejas luar yang nampak. Dengan menemukan jejas masuk dan jejas keluar lebih mudah untuk kita memperkirakan dan menemukan kerusakan endogen tersebut. Pemeriksaan pembantu tentang adanya haemoglobine dan myoglobine urine serta kadar kuantitatifnya saat ini akan dikembangkan lebih baik oleh Bagian Pathologi Klinik RSCM/FKUI Jakarta. Adanya myoglobine dalam urine menggambarkan adanya kerusakan otot akibat luka bakar endogen (Joule burn)? "

"Pendahuluan: Trauma maksilofasial akibat kecelakaan sepeda motor sering terjadi dan meningkat setiap tahunnya. Cranial Disruption Score (CDS), Maxillofacial Injury Severity Score (MFISS), Facial Injury Severity Scale (FISS), Facial Fracture Severity Score (FFSS), Zeeshan and Simon Model (Model ZS), dan Glasgow Coma Scale (GCS) merupakan indeks keparahan trauma maksilofasial dan tingkat kesadaran yang berguna untuk memberikan perawatan dan mendapatkan prognosis bagi pasien. Akan tetapi, hubungan faktor-faktor dalam kecelakaan sepeda motor yang mempengaruhi keparahan trauma maksilofasial berdasarkan indeks-indeks tersebut belum pernah diteliti sebelumnya. Tujuan: Menganalisis hubungan faktor-faktor dalam kecelakaan, yaitu pencahayaan, kecepatan berkendara, dan penggunaan helm, terhadap keparahan trauma maksilofasial berdasarkan indeks keparahan CDS, MFISS, FISS, FFSS, Model ZS, dan GCS pasien trauma maksilofasial di Rumah Sakit Umum Daerah (RSUD) Kabupaten Tangerang periode Juni 2017 – Mei 2022. Metode: Studi dilakukan dengan menganalisis rekam medis bedah mulut di RSUD Kabupaten Tangerang periode Juni 2017 – Mei 2022. Hasil: Sebanyak 257 pasien yang memenuhi kriteria inklusi diikutkan dalam studi ini. Terdapat perbedaan bermakna (p<0,05) skor CDS, MFISS, FISS, FFSS, Model ZS, dan GCS berdasarkan pencahayaan, kecepatan berkendara, dan penggunaan helm. Analisis multivariat menunjukan terdapat pengaruh (p<0,05) kecepatan berkendara dan penggunaan helm terhadap keparahan trauma maksilofasial berdasarkan CDS, MFISS, FISS, FFSS, Model ZS, dan GCS tetapi pengaruh pencahayaan hanya terlihat pada skor MFISS dan FISS (p<0,05). Kesimpulan: Keparahan trauma maksilofasial berdasarkan CDS, FFSS, Model ZS dipengaruhi oleh kecepatan dan penggunaan helm, tetapi tidak oleh pencahayaan. Keparahan trauma maksilofasial berdasarkan MFISS dan FISS dipengaruhi oleh pencahayaan, kecepatan, dan penggunaan helm, tetapi hubungan terbalik penggunaan helm dengan FISS

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Disruption Score (CDS), Maxillofacial Injury Severity Score (MFISS), Facial Injury Severity Scale (FISS), Facial Fracture Severity Score (FFSS), Zeeshan and Simon Model (ZS Model), and Glasgow Coma Scale (GCS) are indexes of severity maxillofacial trauma and level of consciousness that are useful for providing care and obtaining a prognosis for patients. However, the relationship between factors in motorcycle accidents that influence the severity of maxillofacial trauma based on these indices has never been studied before. Objective: To analyze the relationship between the factors involved in an accident, namely lighting, driving speed, and use of a helmet, on the severity of maxillofacial trauma based on the severity index of CDS, MFISS, FISS, FFSS, Model ZS, and GCS in maxillofacial trauma patients at the Regional General Hospital (RSUD) ) Tangerang District for the period June 2017 – May 2022. Methods: The study was conducted by analyzing the medical records of oral surgery at the Tangerang District Hospital for the period June 2017 – May 2022. Results: A total of 257 patients who met the inclusion criteria were included in this study. There were significant differences (p<0.05) in the CDS, MFISS, FISS, FFSS, Model ZS, and GCS scores based on lighting, driving speed, and helmet use. Multivariate analysis showed that there was an effect (p<0.05) of driving speed and helmet use on the severity of maxillofacial trauma based on CDS, MFISS, FISS, FFSS, Model ZS, and GCS but the effect of lighting was only seen on the MFISS and FISS scores (p<0, 05). Conclusion: Severity of maxillofacial trauma based on CDS, FFSS, ZS model is affected by speed and helmet use, but not by lighting. The severity of maxillofacial trauma based on MFISS and FISS is influenced by lighting, speed, and helmet use, but there is an inverse relationship between helmet use and FISS."

"[ABSTRAKLatar belakang : Cedera ligamentum krusiatum anterior merupakan salah satu cedera olahraga yang sering terjadi. Penanganan dengan operasi rekonstruksi diharapkan dapat membantu pasien untuk kembali melakukan aktivitas fisik seperti semula. Tujuan: Mengetahui aktivitas fisik dan kemampuan fungsional pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga, serta faktor-faktor yang mempengaruhinya. Metode: Dikumpulkan 11 subyek dari daftar rumah sakit tempat praktek dokter spesialis bedah ortopedi anggota IHKS dan IOSSMA. Data demografik dan kondisi fungsional subyektif lutut dikumpulkan menggunakan kuesioner IKDC, data aktivitas fisik menggunakan kuesioner aktivitas fisik Tegner, dan data kondisi fungsional obyektif lutut menggunakan tes lompat satu kaki. Hasil: Sebagian besar subyek memiliki indeks massa tubuh di atas normal dan kebiasaan merokok. Seluruh cedera ligamentum krusiatum anterior yang dialami terjadi akibat suatu mekanisme cedera non-kontak dengan biomekanisme yang khas, yaitu: permukaan plantar kaki menempel di lantai dan berada di posisi menjauhi pusat massa tubuh, sendi lutut berada dalam keadaan hampir ekstensi dan valgus, serta batang tubuh bergeser ke lateral. Namun, sebagian besar subyek tidak menjalani program rehabilitasi sebelum operasi rekonstruksi. Hampir seluruh subyek memiliki tingkat aktivitas fisik lebih rendah dibandingkan dengan tingkat aktivitas fisiknya sebelum cedera, dan alasan utamanya adalah karena adanya rasa takut untuk kembali ke aktivitas fisiknya seperti semula. Sebagian besar subyek memiliki kondisi fungsional sendi lutut yang buruk, baik secara subyektif maupun obyektif, dan didapatkan kecenderungan adanya hubungan antara hal tersebut dengan beberapa faktor, yaitu jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum maupun sesudah operasi rekonstruksi. Kesimpulan: Pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga memiliki tingkat aktivitas fisik dan kemampuan fungsional yang rendah. Dan terdapat kecenderungan bahwa hal tersebut dipengaruhi oleh jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum dan sesudah operasi rekonstruksi yang dijalani.

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ABSTRACTBackground: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstruction surgery. It is hoped that the patient can get back to previous physical activity level after the surgery. Objective: To know the physical activity level and functional ability of patients 12-24 months post anterior cruciate ligament reconstruction surgery due to sports injury and their related factors. Methods: Eleven subjects were selected from hospitals where orthopedic surgeons of IHKS and IOSSMA having their practice. The followings data were collected: demographic and subjective functional knee evaluation using IKDC questionnaire, physical activity level using Tegner activity scale, and objective functional knee evaluation using single leg hop test. Results: Most of the subjects had high body mass index and smoking habit. All the anterior cruciate ligament injuries happened due to a non-contact mechanism with a classic biomechanics: plantar surface of the foot planted on the ground and positioned away from the center of mass of the body, valgus and almost fully extended knee, and lateral trunk motion. Unfortunately, most of the subjects did not have pre-surgical rehabilitation program. Almost all the subjects had a lower physical activity level compare to the one before injury, and the main reason was afraid to do their previous physical activity. Most of the subjects also had bad subjective and objective functional knee condition, and there was a possibility that it was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-reconstruction surgery. Conclusion: The patients 12-24 months post ACL reconstruction surgery due to sports injury had low physical activity level and functional ability. There was a propensity that this condition was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery., Background: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstructionsurgery. It is hoped that the patient can get back to previous physical activity levelafter the surgery.Objective: To know the physical activity level and functional ability of patients12-24 months post anterior cruciate ligament reconstruction surgery due to sportsinjury and their related factors.Methods: Eleven subjects were selected from hospitals where orthopedicsurgeons of IHKS and IOSSMA having their practice. The followings data werecollected: demographic and subjective functional knee evaluation using IKDCquestionnaire, physical activity level using Tegner activity scale, and objectivefunctional knee evaluation using single leg hop test.Results: Most of the subjects had high body mass index and smoking habit. Allthe anterior cruciate ligament injuries happened due to a non-contact mechanismwith a classic biomechanics: plantar surface of the foot planted on the ground andpositioned away from the center of mass of the body, valgus and almost fullyextended knee, and lateral trunk motion. Unfortunately, most of the subjects didnot have pre-surgical rehabilitation program. Almost all the subjects had a lowerphysical activity level compare to the one before injury, and the main reason wasafraid to do their previous physical activity. Most of the subjects also had badsubjective and objective functional knee condition, and there was a possibility thatit was affected by the time interval duration between the injury and reconstructionsurgery, and the rehabilitation program given pre- and post-reconstructionsurgery.Conclusion: The patients 12-24 months post ACL reconstruction surgery due tosports injury had low physical activity level and functional ability. There was apropensity that this condition was affected by the time interval duration betweenthe injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery.]"

"Tesis ini membahas analisis dan perancangan Computer Assisted Surgery (CAS) untuk robot ortopedi yang menggunakan metode Rod and Screw Correcive Manipulation (RSCM) dengan tujuan hasil analisis dan perancangan dapat dipergunakan untuk pembuatan prototipe. Penelitian ini dilakukan dengan tahapan: analisis kebutuhan, analisis sistem dan perancangan sistem. Hasil penelitian menerangkan bahwa masukan sistem ini didefinisikan sebagai nilai pengukuran yang dilakukan oleh robot ortopedi, dan keluarannya merupakan tampilan pada layar monitor yang memberikan nilai tekanan, besar sudut koreksi tulang belakang dan amplitudo keadaan syaraf. Proses untuk mendapatkan keluaran dibuat sesederhana mungkin sehingga proses berjalan cepat dan tepat.

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This thesis discusses the analysis and design of Computer Assisted Surgery (CAS) for orthopedic robot using Rod and Screw Corrective Manipulation (RSCM) methods with the purpose, that the analysis and design can be used for prototyping. This research was carried out in phases: requirements analysis, system analysis and system design.

The results explained that the input defined as the value of measurements made by the orthopedic robot, and its output is the display on the monitor which gives the value of pressure, the angle of correction and the amplitude of spinal nerves. The process to get the output was made as simple as possible so the process goes quickly and accurately."

"Identifikasi mengenai pemilihan Cefazolin sebagai antibiotik profilaksis pasien bedah ortopedi yang diterapkan di RSUD Tarakan Jakarta penting dilakukan untuk mengetahui pemberian antibiotik profilaksis yang telah diterapkan merupakan pilihan yang tepat atau terdapat alternatif antibiotik lain yang lebih baik dibandingkan Cefazolin jika dilihat dari tatalaksana umum yang berlaku. Perbandingan antara penerapan yang telah dilakukan RSUD Tarakan Jakarta dengan tatalaksana yang berlaku dilakukan agar apoteker dapat memahami alur pemberian antibiotik profilaksis yang tepat pada pasien bedah ortopedi. Pengamatan dilakukan secara retrospektif pada salah satu pasien di Gedung A lantai 4 unit OK Sentral lalu dilanjutkan saat pasien telah pindah kembali ke ruang rawat inap di Gedung A lantai 1 unit IGD RSUD Tarakan Jakarta. Kajian ini menggunakan data sekunder berupa daftar pemakaian obat pasien. Hasil pengamatan yang diperoleh diketahui bahwa penggunaan antibiotik profilaksis Cefazolin dari hasil observasi tanggal 22 Juni 2022 di unit OK Sentral RSUD Tarakan Jakarta pada pasien Ny. Y dengan diagnosis fraktur femur merupakan pilihan yang tepat. Hal ini dilihat dari perbandingannya dengan tatalaksana yang tercantum dalam ASHP. Selanjutnya, waktu pemberian antibiotik profilaksis Cefazolin 30-60 menit sebelum operasi dan dosis pemberian antibiotik profilaksis Cefazolin sebesar 2 gram pada pasien bedah ortopedi Ny. Y yaitu di RSUD Tarakan Jakarta telah sesuai dan tidak bertentangan dengan tatalaksana ASHP dimana untuk operasi bedah ortopedi diberikan Cefazolin dosis 2-3 gram untuk pasien dewasa dan waktu pemberian <60 menit sebelum operasi.

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Identification regarding the choice of Cefazolin as a prophylactic antibiotic for orthopedic surgery patients applied at the Tarakan Hospital Jakarta, is important to determine whether the prophylactic antibiotic that has been applied is the right choice or there are other antibiotic alternatives that are better than Cefazolin if seen from the general guideline that applied. A comparison between the implementation carried out by the Tarakan District Hospital in Jakarta and the existing guideline was carried out so that apothecary could understand the appropriate way of administering prophylactic antibiotics to orthopedic surgery patients. Observations were carried out retrospectively on one of the patients in Building A, 4th floor, OK Sentral unit, then continued when the patient had moved back to the inpatient room in Building A, 1st floor, ER unit, Tarakan Hospital Jakarta. This study uses secondary data in the form of a list of patient medication use. The results of the observations obtained revealed that the use of the prophylactic antibiotic Cefazolin from the results of observations on June 22 2022 in the Central OK unit of the Tarakan Regional Hospital, Jakarta in the patient Mrs. Y with a diagnosis of femur fracture is the right choice. This can be seen from the comparison with the management listed in ASHP. Furthermore, the time for giving Cefazolin prophylactic antibiotics is 30-60 minutes before surgery and the dose of Cefazolin prophylactic antibiotics is 2 grams for orthopedic surgery patients, Mrs. Y at Tarakan Regional Hospital Jakarta is appropriate and does not conflict with ASHP guidelines where for orthopedic surgery, a dose of 2-3 grams of Cefazolin is given for adult patients and the administration time is <60 minutes before surgery"