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"ABSTRAKAnalisis Penerapan Range Of Motion Untuk Mengurangi Nyeri Pada Klien Post ORIF Plate And Screw e.c Close Fraktur Tibia Fibula Dextra 1/3 Distal Di Ruang Rawat Bedah RSUPN Dr. Cipto Mangunkusumo Fraktur adalah terputusnya kontinuitas tulang dan terjadi jika tulang dikenai stress yang lebih besar dari yang dapat diabsorbsinya. Salah satu penatalaksanaan yang dilakukan adalah dengan Open Reduction Internal Fixation dimana fragmen tulang yang patah akan di stabilisasi dengan menggunakan pin dan skrup. Saat ini klien memasuki proses penyembuhan tulang dalam fase inflamasi,  dimana dalam proses inflamasi akan muncul permasalahan yang dialami oleh klien paska tindakan ORIF diantaranya yaitu nyeri. Nyeri dapat mengakibatkan masalah pada sistem muskuloskeletal seperti keram otot, berkurangnya fungsi tulang, fatigue dan keterbatasan gerak. Terapi nonfarmakologis yang dapat diberikan kepada klien untuk mengurangi nyeri paska ORIF adalah dengan melakukan Range Of Motion. Manfaat melakukan gerakan Range Of Motion adalah dapat menentukan nilai kemampuan sendi tulang dan otot, memperlancar sirkulasi darah serta dapat memperbaiki tonus otot.  Untuk itu tujuan dari penulisan karya ilmiah ini adalah untuk menganalisis terkait Range Of Motion untuk mengurangi nyeri pada klien post ORIF plate and screw. Setelah mendapatkan implementasi terapi Range Of Motion klien mengalami penurunan skala nyeri.

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ABSTRACTAnalysis of the Application  Range of Motion to Reduce Pain in Post Client ORIF Plate and Screw e.c Close Fracture Tibia Fibula Dextra 1/3 Distal in the Surgical Hospital Dr. Cipto Mangunkusumo A fracture is a break in bone continuity and occurs when the bone is subjected to a stress that is greater than it can absorb. One of the treatments performed is the Open Reduction Internal Fixation in which the broken bone fragments are stabilized using pins and couplers. Currently the client enters the bone healing process in the inflammatory phase, where in the inflammatory process the problems experienced by the client after the ORIF action will arise, including pain. Pain can lead to problems in the musculoskeletal system such as muscle cramps, reduced bone function, fatigue and limited movement. Non-pharmacological therapy that can be given to clients to reduce pain after ORIF is to do Range Of Motion. The benefits of doing Range Of Motion movement are that it can determine the value of the ability of bone and muscle joints, improve blood circulation and can improve muscle tone. For this reason, the purpose of writing this scientific paper is to analyze the related Range Of Motion to reduce pain in post ORIF plate and screw clients. After getting the implementation of Range Of Motion therapy, clients experience a decrease in the pain scale."

"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: 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"

"Fase rehabilitasi merupakan fase kemampuan fungsional berada pada tahap paling rendah dibandingkan fase lain. Pemulihan fungsi fisik menjadi prioritas dilihat dari status fungsional. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berhubungan dengan status fungsional pada paska ORIF fraktur ekstremitas bawah.Desain penelitian adalah cross-sectional dengan 35 responden dan pengumpulan data menggunakan kuesioner. Variabel independen adalah usia, lama hari rawat, jenis fraktur, nyeri, kelelahan, motivasi, fall-efficacy, dan dukungan keluarga sementara variabel dependen adalah status fungsional. Uji ANOVA digunakan untuk data kategorik serta korelasi pearson dan spearman rho untuk data numerik.Hasil penelitian menunjukan fall-efficacy (r = -0,490 dan nilai p=0,003) merupakan faktor yang berhubungan. Model multivariat memiliki nilai p=0,015 dan jenis fraktur, nyeri, dan fall-efficacy mampu menjelaskan 28,2 % status fungsional dengan nyeri sebagai faktor yang paling besar untuk memprediksi status fungsional setelah dikontrol fall-efficacy dan jenis fraktur. Penelitian ini merekomendasikan melakukan latihan meningkatkan status fungsional terintegrasi manajemen nyeri dan fall-efficacy.

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Rehabilitation phase is a phase of functional ability at the stage of the lowest compared to other phases. Recovery of physical function is a priority from functional status. Conducted research on the functional status as the basis for the restorative care. The research aimed to identify factors associated with functional status post ORIF fracture in the lower extremities.The study design was a crosssectional with 35 respondents and collecting data using questionnaires. Independent variables were age, length of day care, type of fracture, pain, fatigue, motivation, fall-efficacy, and family support; as the dependent variable was functional status. ANOVA test used for categorical data and Pearson correlation and spearman rho for numerical data.The results show the fall-efficacy (r = - 0.490 and p-value = 0.003) is related factors. Multivariat model have p value=0,015 and type of fracture, pain, and fall-efficacy explained 28,2 % functional status variable with pain as the biggest factor for predicting functional status after controlled fall-efficacy and type of fracture. This research recommended for exercises improved functional status integrated pain and fallefficacy managemen."

"[ABSTRAKPendahuluan :Fraktur Midface merupakan fraktur yang sering terjadi dapat dapat memberikan efek baik dari segi estetik dan fungsi. Fraktur Midface yang tidak ditangani dengan baik akan merubah bentuk wajah menjadi tidak proporsional, salah satunya wajah yang menjadi lebih lebar dan panjang, terdapat depresi malar. Tata laksana dengan reposisi segmen fraktur dan fiksasi interna merupakan pilihan utama.Metode :Data yang diambil dari status estetik dengan menggunakan studi cross sectional pada pasien dengan fraktur midface sebelum operasi ORIF didapatkan di rekam medis, dan data setelah opeasi ORIF didapatkan dari follow up (4 years), kemudian dilakukan pengukuran dari proyeksi vertical, horizontal dan warm?s view .Hasil :Berdasarkan analisis fotografi dari proyeksi vertikal didapatkan 3 pasien memiliki proporsi muka yang baik, 3 pasien memiliki proporsi wajah yang baik dikarenakan perbedaan rata-rata. Berdasarkan analisis fotografi dari proyeksi horizontal didapatkan 3 pasien memiliki panjang muka yang berbeda, 2 pasien memiliki dystopia, 1 pasien memiliki enophtalmus. Berdasarkan analisi fotografi dari proyeksi worm?s eye didapatkan 4 pasien memiliki depresi malar eminensMengenai hasil estetika, didapatkan 4 pasien (66,6 %) puas dengan simetrisitas wajah setelah operasi. 2 pasien (33,3 %) mengeluhkan tidak puas dengan penampilan akhir setelah operasiKesimpulan :Untuk dapat mengevaluasi hasil operasi ORIF di Divisi Bedah Plastik Rumah Sakit Ciptomangunkusumo. Tidak hanya dibutuhkan registrasi data awal yang baik, tetapi juga dibutuhkan sarana dan fasilitas untuk mendapatkan evaluasi jangka panjang pada pasien terutama lokasi pasien yang jaraknya jauh dari lokasi rumah sakit.

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ABSTRACTBackground :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital, Background :Midface fracture is a fracture that often occurs may be able to give a good effect in terms of aesthetics and functionality. Midface fracture that is not handled properly will change the shape of the face become disproportionate, one of which face becomes wider and longer, there is a malar depression. The management of the segment repositioning fracture and internal fixation is the main option.Methods:Data taken from the status aesthetic using cross sectional study in patients with fractures midface before surgery ORIF obtained in medical records, and the data after opeasi ORIF obtained from follow-up (4 years), then the measurement of the projected vertical, horizontal and warm's view.Result:Based on the photographic analysis of the vertical projection obtained 3 patients have a good proportion of the face, 3 patients had good facial proportions due to differences in average. Based on the photographic analysis of horizontal projection obtained 3 patients had a different face long, 2 patients had a dystopia, 1 patient had enophtalmus. Based on the photographic analysis of the worm's eye projection obtained 4 patients had a malar depression eminens.Regarding the aesthetic results, obtained four patients (66.6%) are satisfied with simetrisitas face after surgery. 2 patients (33.3%) complained of is not satisfied with the final appearance after surgeryConclusions:To be able to evaluate the results of ORIF surgery in the Division of Plastic Surgery Hospital Ciptomangunkusumo. Not only the data registration needed a good start, but also the infrastructure and facilities needed to obtain a long-term evaluation of the patients, especially the location of patients that were located far from the location of the hospital]"

"[ABSTRAK Mayoritas populasi masyarakat dunia menepati daerah perkotaan. Akibat darikepadatan penduduk di daerah perkotaan timbul masalah yang berkaitan dengan lalulintassalah satunya adalah tingginya jumlah kecelakaan lalu-lintas. Frakturmerupakan salah satu akibat dari kecelakaan lalu-lintas yang memerlukanpenanganan segera untuk mempertahankan anatomi dan fungsi tubuh seperti semula.Pasien post ORIF tibia dan fibula memerlukan tindakan ambulasi untukmemperlancar sistem peredaran darah pasien. Karya ilmiah ini bertujuan untukmenganalisis intervensi keperawatan ambulasi yang diberikan pada pasien post ORIFfraktur tibia dan fibula di Ruang Angrek tengah kanan RSUP Persahabatan. Pasienyang dilakukan tindakan ambulasi secara bertahap adalah pasien dapat terhindar darikomplikasi akibat vaskularisasi yang buruk, dapat mempercepat proses penyembuhanserta memperpendek masa perawatan pasien di rumah sakit.ABSTRACT The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.;The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.;The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital., The majority of world's population lived in urban areas. As a result of population

density in urban areas, problem relating to traffic is the high number of traffic

accident. Fracture is one result of a traffic accident that requires immediate action to

preserve the anatomy and function of the body as before. The tibia and fibula

fractures post ORIF patient requires ambulation intervention to expedite the

circulatory system of the patient. This scientific work aimed to analyze ambulation of

the nursing intervention which given to tibia and fibula fractures post ORIF patient

at Angrek tengah kanan ward RSUP Persahabatan. The patient who performed the

gradually ambulation intervention can avoid the complications due to poor

vascularization, accelerate the healing process, and shorten patient care in hospital.]"