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"Latar belakang: Penatalaksanaan fraktur greenstick radius sering berakibat malunion karena angulasi-ulang yang membatasi gerak sendi radio-karpal. Oleh sebab itu perlu diupayakan metoda reposisi yang aman, efektif, dan murah yang dapat dikerjakan sebagai Standar Prosedur Operasional di RSUD kabupaten Indonesia. Reposisi fraktur greenstick radius dengan melakukan over-koreksi, merupakan pilihan, karena dapat mencegah terjadinya angulasi-ulang.Tujuan: Menilai efektivitas dan keamanan reposisi dengan over-koreksi dalam penatalaksanaan fraktur greenstick radius.Rancangan dan metode: Uji klinis acak, grup paralel, dengan concealment. Penelitian melibatkan 92 anak (46 per kelompok) usia 4-14 tahun dengan fraktur greenstick radius di RSUD Kota Bekasi, Agustus 2011 sampai Mei 2012. Efektivitas prosedur diukur melalui derajat residu angulasi (minimal ditetapkan 5°), angulasi ulang, pergeseran fragmen fraktur (minimal <25%), dan risiko pengobatan (untuk mengukur keamanan pasien) mulai saat setelah reposisi 24 jam, minggu pertama sampai minggu ke-4, minggu ke-6 dan minggu ke-10.Hasil: Over-koreksi terbukti efektif dan aman digunakan dalam penatalaksanaan fraktur greenstick radius. Pada semua pengamatan, Insidens Risk untuk terjadinya residu angulasi >5° pada kelompok over koreksi lebih kecil dibandingkan kelompok tanpa over koreksi. Pada minggu kedua, IR pada kelompok over koreksi (0,04) sedangkan kelompok tanpa over koreksi (0,39) dengan Risk Difference -0,35 (95%CI: -0,50 - -0,19). Perbedaan tersebut terlihat konsisten pada seluruh pengamatan. Probabilitas kesintasan lebih besar pada kelompok over-koreksi dibanding tanpa over-koreksi untuk terjadinya angulasi ulang. Insidence Rate recurrent angulation pada kelompok over-koreksi lebih kecil dibandingkan tanpa over koreksi dengan risk difference sebesar -0,025 (95% CI: -0,02--0,03). Pada sesaat pasca reposisi hingga minggu pertama perbedaan risiko pergeseran fragmen fraktur 2:25% pada kelompok over-koreksi jauh lebih besar daripada kelompok tanpa over-koreksi namun pada minggu kedua hingga minggu kesepuluh, perbedaan risiko sudah sangat berkurang sehingga tidak didapatkan perbedaan bermakna mulai minggu kedua hingga kesepuluh. Proporsi risiko pengobatan yang terjadi pada pasien sangat sedikit sehingga penelitian ini tidak dapat membuktikan bahwa pengobatan fraktur greenstick radius dengan melakukan over-koreksi lebih baik dalam mengontrol risiko pengobatan.Kesimpulan: Over-koreksi efektif dan aman untuk digunakan dalam penatalaksanaan fraktur greenstick radius pada anak.Saran: perlu dilakukan penelitian yang sama yang dilakukan oleh ahli bedah ortopedi lain pada beberapa RSUD di kabupaten di Indonesia;

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Background: Management of greenstick radius fracture often results in malunion because re-angulations that restrictive radio-carpal joint. Therefore, needed a safer, effective, and cheaper repositioning method that can be done as a Standard Operating Procedure in district hospitals in Indonesia Reposition of greenstick radius fracture with over-correction is as choice because it can prevent re-angulations.Objective: Asses the effectiveness and safety of repositioning with over-correction in the greenstick radius fracture management.Design and method: Randomized clinical trial, parallel group, with concealment. This study involved 92 children (46 per group) aged 4-14 years with greenstick radius fracture in Bekasi City General Hospital, August 2011 until May 2012. Effectiveness of the procedure is measured by the degree of residual angulations (minimal <5<), re­ angulations, a shift in the fracture fragments (minimal <25%), and risk of treatment (to measure patient safety) started after 24 hours repositioning, first week until fourth, sixth and tenth week.Result: Over-correction proved effective and safe to use in the management of greenstick radius fracture. In All observations, Incidence Risk for the occurrence of residual angulations is >5° at the over-correction group less than non over-correction group. In the second week, IR at the over-correction group (0,04), while non over­ correction (0,39) with Risk Difference -0,35 (95%CI: -0,50 - -0,19). This difference was seen consistently in all observation. Probability of survival at the over-correction group greater than non over-correction group for the occurrence of re-angulations. Incidence Rate recurrent angulations at the over-correction group less than non over correction with risk difference -0,025 (95% CI: -0,02--0,03). After reposition until the first week, the difference of fracture fragment shift's risk 2:25% at the over­ correction group, much larger than non over-correction group. But at the second week until tenth week, the difference of risk has been significantly reduced, so that there is no significant difference started at the second week until tenth week. Proportion of treatment risk occurred in patients measly, so that this study cannot prove that the greenstick radius fracture treatment with over-correction better in control the risk of treatment.Conclusion: Over-correction is effective and safe to use in the management of greenstick radius fracture at the children.Suggestion: needs to conduct the same research done by other orthopedic surgeons at several district hospitals in Indonesia."

"Masyarakat perkotaan sebagai bagian dari ruang lingkup kerja dari keperawatan komunitas memiliki ciri khas tersendiri sehingga ia memiliki segmen yang dikenal dengan keperawatan kesehatan masyarakt perkotaan. Masyarakat perkotaan memiliki karakteristik yang khas, salah satunya ialah dalam hal masalah kesehatan yang dialaminya. Padatnya penduduk, tingginya angka pertumbuhan kendaraan bermotor, serta faktor gaya hidup menyebabkan timbulnya satu masalah kesehatan yang khas pada masyarakat perkotaan, yaitu kecelakaan lalu lintas. Kecelakaan lalu lintas menimbulkan banyak kerugian terutama pada korban kecelakaan itu. Salah satu masalah yang ditimbulkan dari kecelakaan ialah fraktur. Hasil praktik mahasiswa di ruang rawat bedah orthopedi RSUP Fatmawati menunjukkan bahwa berbagai macam fraktur dapat disebabkan oleh kecelakaan lalul lintas. Oleh karena itu penulis menuangkan salah satu kasus fraktur, yaitu fraktur radius ulna beserta asuhan keperawatan untuk kasus tersebut. Laporan ini diharapkan dapat menjadi salah satu bahan rujukan dalam menangani masalah fraktur khususnya fraktur radius ulna.

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Urban communities as part of the scope of work of the nursing community has its own characteristics so it has a segment known as urban nursing. Urban communities have distinct characteristics, one of which is in terms of health problems they experienced. Dense population, high rates of growth in motor vehicles, as well as lifestyle factors causing the health problems typical in urban communities, the traffic accidents. Traffic accidents cause a lot of damage, especially to the victims of the accident. One of the problems arising from accidents are fractures.

Result in the student practices at orthopedic surgery ward of RSUP Fatmawati indicates that a wide range of fracture can be caused by traffic accidents. Therefore, the author analyzed one case of fracture, the fracture radius ulna along with nursing care for these case. The report is expected to be one of the reference materials in dealing with particular fracture, especially radius ulna fracture."

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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