Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Fraktur merupakan salah satu masalah perkotaan akibat cedera fisik. Penatalaksanaan fraktur patologis cukup kompleks dan mengakibatkan imobilisasi yang lama. Tingkat kemampuan mobilisasi pasien pasca total hip replacement dapat ditingkatkan melalui therapeutic exercise yang meliputi latihan range of motion, angkle pump, quads statis dan gluteal statis, serta latihan ambulasi menggunakan alat bantu yang telah diajarkan selama masa rawat. Hasil latihan menunjukkan meningkatnya kemampuan mobilisasi secara bertahap dan aman. Therapeutic exercise merupakan latihan efektif untuk meningkatkan mobilisasi dan mendukung ambulasi. Perawat perlu meningkatkan pengetahuan dan kemampuan melakukan therapeutic exercise untuk meningkatkan mobilisasi dan dibarengi peningkatan status kesehatan dengan perbaikan masalah kesehatan pasca THR. ...... The most frequent problem of urban health is fractures due to physical injuries. The management of pathological fracture is complex and leads to prolong immobilization. Patients ability level after total hip replacement surgery can be enhanced by therapeutic exercise that includes range of motion, ankle pump, quads and gluteal static exercise, and ambulatory exercises using walker in rehabilitation phase while hospital stays. The results of exercise show patients ability had increased gradually and secure to perform mobilizations. Therapeutic exercise is an effective exercise to improve mobilization and support ambulation. Nurses need to improve their knowledge and ability to perform therapeutic exercise as treatment of mobilization and be accompanied by improved patient health status from potential health problems after total hip replacement.

Abstrak :
ABSTRAK
Kecelakaan dapat menyebabkan cedera pada manusia salahsatunya terjatuh dan menyebabkan fraktur dintaranya fraktur hip. Nyeri secara terus menerus dan resiko komplikasi membuat fraktur hip harus segera diatasi, salah satunya penangan dengan pembedahan yaitu total hip replacement. Klien dengan post operasi total hip replaceman beresiko untuk mengalami dislokasi dan masalah dalam mobilisasi jika tidak dilakukan pengawasan dengan baik dan benar. Oleh karena itu diperlukan penangan pasca pembedahan berupa pemberian edukasi untuk pencegahan dislokasi pada sendi pinggul dan latihan kekuatan otot serta latihan mobilisasi untuk meningkatkan kualitas hidup klien dengan total hip replacment. Pemberian edukasi pencegahan dislokasi dan pemberian latihan mobilisasi secara dini terbukti mampu mempercepat klien dalam melakukan mobilisasi secara mandiri yang ditulis dalam karya ilmiah ini.

---

ABSTRACT
Accidents can cause injury to humans one of them dropped and caused fracture hip. Continuous pain and the risk of complications make hip fracture should be addressed, one of which is surgical treatment with total hip replacement. Clients with postoperative total hip replaceman are at risk for dislocation and problems in mobilization if not supervised properly and properly. It is therefore necessary post-surgical handling in the form of providing education for the prevention of dislocation in hip joints and muscle strength training and mobilization exercises to improve the quality of life of clients with total hip replacment. The provision of education for the prevention of dislocation and the provision of early mobilization exercises proved able to accelerate the client in performing self-mobilization written in this scientific paper.

Abstrak :
Pendahuluan: Total Hip Replacement (THR) merupakan prosedur pembedahan tersering pada ekstremitas bawah. Kemajuan teknik operasi dan semakin canggihnya instrumen bedah meluaskan indikasi THR primer pada pasien yang sebelumnya tidak mungkin dilakukan dan memiliki angka komplikasi tinggi pasca operasi. Prosedur ini disebut THR primer sulit yang dilakukan pada kelompok pasien dengan kelainan panggul kompleks seperti defek tulang panggul, fusi panggul atau kontraktur jaringan lunak. Metode: 81 prosedur THR primer yang dikerjakan di RSUPN Dr. Cipto Mangunkusumo antara Januari 2012-Juni 2017. Kelompok THR primer sulit terdiri dari 29 pasien dan 52 pasien lainnya merupakan kelompok sederhana. Parameter intraoperatif seperti jumlah perdarahan, durasi operasi, ketepatan penempatan komponen, tingkat komplikasi dan luaran fungsional pasca operasi (Harris Hip Score) pada akhir follow up dicatat dan dilakukan analisis dengan membandingkan kedua kelompok tersebut. Hasil: Kelompok sulit memiliki jumlah perdarahan (p=<0.001), durasi operasi (p=<0.001) tingkat komplikasi (p=<0.012) lebih besar dibanding kelompok sederhana. Luaran radiologis berupa ketepatan penempatan orientasi komponen pada zona aman tidak memiliki perbedaan antar kedua kelompok (p=0.333). Luaran fungsional pada follow up akhir kelompok sulit (88.67) tidak memiliki perbedaan bermakna (p=0.080) dibandingkan kelompok sederhana (91.50). Pembahasan: Prosedur THR primer sulit yang dikerjakan di RSUPN Dr. Cipto Mangunkusumo walau memiliki parameter kesulitan dan tingkat komplikasi lebih besar tidak memiliki perbedaan luaran radiologis maupun fungsional dibandingkan THR primer sederhana. Perlu dilakukan identifikasi setiap prosedur THR primer apakah ada, jenis dan tingkat penyulit yang akan dihadapi saat intraoperasi untuk dilakukan perencanaan operasi yang baik sehingga didapatkan hasil luaran yang maksimal.

---

Introduction: Total hip replacement (THR) is the most common surgery in lower extremities. Improvement in surgical technique and advancement of surgical instrumentation extended the indications for primary THR in previously impossible to treat. This procedure is known as primary difficult THR which performed in patients with complex hip disorders including hip bone defect, hip fusion, or soft tissue contracture. Methods: 81 primary THR procedures were performed in Cipto Mangunkusumo National Hospital from January 2012 until June 2017. Primary difficult THR group consisted of 29 patients and 52 patients in simple group. Intraoperative parameters including bleeding volume, operation time, complication rate, radiological outcome and functional outcome (Harris Hip Score) were recorded at the end of follow up and analyzed. Result: Difficult group had bleeding volume (p=<0.001), operation time (p=<0.001), complication rate (p=<0.012), higher than simple group. Radiological outcome is measured by accuracy of component orientation placement in the safe zone resulted no significant difference between two groups (p=0,333). Functional outcome at the end of follow up in difficult group (88.67) did not have significant difference (p=0.080) with simple group (91.50). Discussion: Primary difficult THR procedure performed in Cipto Mangunkusumo National Hospital although have higher difficulty parameters and complication rates, didn't have significant difference in radiologic and functional outcome compared to simple group. It was necessary to identify each primary THR procedures whether there were any, types and levels of difficulties that would be faced intraoperatively in order to improve preoperative planning so the outcome would be optimal.

Abstrak :
ABSTRAK
Total Hip Replacement THR merupakan salah satu tindakan bedah rekonstruktif penggantian sendi panggul akibat gangguan anatomi, fungsi tubuh yang mengganggu dan berpengaruh terhadap status fungsional. Tujuan penelitian teridentifikasinya faktor-faktor yang berhubungan dengan status fungsional pasien paska operasi THR. Penelitian ini menggunakan desain case control. Penetapan jumlah sampel menggunakan nonprobability sampling dengan metoda consecutive sampling. Hasil penelitian didapatkan distribusi frekuensi status fungsional dengan menggunakan Hip Haris Score HHS proporsi responden yang mengalami gangguan status fungsional mencapai 24,4 kelompok kasus dimana diantara variabel yang mempunyai hubungan yaitu usia, program rehabilitasi dan lama rawat dengan status fungsional pasien paska operasi THR. Pada kelompok kasus usia merupakan faktor paling besar mempengaruhi status fungsional setelah dikontrol oleh program rehabilitasi dan lama rawat dengan nilai odd ratio OR usia 31,30 p value =0,031, program rehabilitasi OR 28,21, p value=0,056 dan lama rawat OR 12,99 dengan p value=0,093. Pada kelompok case penelitian ini merekomendasikan melakukan latihan meningkatkan status fungsional terintegrasi dengan memperhatikan kemampuan dan kelompok usia.

---

ABSTRACT
AbstractTotal Hip Replacement THR is one of the reconstructive surgery of hip joint replacements which is done due to anatomic disorder, disturbing body function and effect on functional status. The purpose of the study is to identify the factors associated with the functional status of patients post THR surgery. This research uses case control design. Nonprobability sampling with consecutive sampling method is used to determine a number of samples. The result of this research shows that the functional status of frequency distribution using Hip Haris Score HHS proportion of respondents who have functional status disorder reached 24,4 case group where among variables possess age relationship, rehabilitation program and length of stay with functional status of patient after THR surgery. In the age group, it was the greatest factor affected functional status after controlled by rehabilitation program and length of stay with the value of odd ratio OR age 31,30 p value 0,031, rehabilitation program OR 28,21, p value 0,056 and length of treatment OR 12,99, p value 0,018. Based on the result, this case study group recommends for further research to do exercise enhancing functional status integrated with attention to ability and age group.

Abstrak :
Total Hip Replacement merupakan salah satu operasi yang dilakukan untuk memperbaiki sendi pada bagian pinggul yang terkena penyakit, kecelakaan, kelainan tulang, dan penyakin bawaan. Ukuran tulang pada setiap etnis atau koloni pada setiap negara atau suatu daerah berbeda satu dengan yang lain. Penelitian tentang setiap ukuran tulang pada setiap etnis tersebut sangat diperlukan untuk mendapatkan desain yang sesuai dengan etnis tersebut. Desain dengan ukuran tulang orang Indonesiapun dibuat dan dilakukan simulasi. Proses simulasi yang berfungsi untuk mendapatkan data dari desain hip prosthesis dengan ukuran tulang orang Indonesia yang terbilang lebih kecil dibandingkan dengan ukuran tulang orang Eropa maupun Amerika. Proses simulasi yang telah disesuaikan dengan standar American Standard Testing and Material ASTM dan International Organization for Standarization ISO tentang Finite Element Analysis. Dari hasil simulasi tersebut didapatkan desain yang sesuai dengan tulang ukuran orang Indonesia dan ketentuan yang harus diperhatikan dalam melukan desain hip prosthesis orang Indonesia. ......Total Hip Replacement is one of the surgeries performed to repair joints in hip affected by disease, accidents, bone disorder, and congenital disease. The size of the bones in each ethnic od colony in each country or region is different from one another. Research on each bone size in each ethnic group is very needed to get a design that suits to that ethnicity. Indonesian bone size design was made and simulated. Function of simulation process to get data from hip prosthesis design with Indonesian bone size that smaller than European and American bone size. The simulation process have been adjusted to American Standard Testing and Material ASTM and International Organization for Standarization ISO about Finite Element Analysis. From the simulation result, it was found that design was in accordance with the bone size of Indonesian people and the provisions that must be considered in designing hip prosthesis for Indonesian people.

Abstrak :
Osteoartritis adalah penyakit degenerasi pada sendi yang melibatkan kartilago, lapisan sendi, ligamen, dan tulang karena proses inflamasi kronis pada sendi dan tulang disekitar sendi, sehingga dapat menyebabkan fraktur dengan angka kejadian yang meningkat ketika disertai dengan obesitas. Obesitas terjadi karena gaya hidup yang kurang baik, seperti menurunnya minat dalam berolah raga. Individu dengan osteoartritis pada sendi panggul dan disertai obesitas mudah mengalami fraktur collum femur sehingga ketika sudah terjadi fraktur maka diperlukan tindakan operasi THR Total Hip Replacement . Pada post operasi Total Hip Replacement harus segera dilakukan mobilisasi dengan latihan kekuatan otot seperti ankle pump, pengesetan quadtriseps, gluteal, hip and knee flexion, short arc quad, bed mobility exercise dan latihan penggunaan alat walker. Hasil yang didapatkan, klien mendapatkan tingkat ambulasi yang diharapkan, tidak terjadi komplikasi pada berbagai sistem tubuh serta tidak memperpanjang masa rawat. ......Osteoarthritis is a degenerative disease of the joint involving the cartilage, lining of the joints, ligaments, and bones due to chronic inflammatory processes in the joints and bones around the joint, thus causing fractures with increased incidence rates when accompanied by obesity. Obesity occurs due to poor lifestyle, such as decreased interest in exercise. Individuals with osteoarthritis of the hip joint and with obesity are susceptible to fracture of the femur collum so that when a fracture occurs it is necessary to perform THR Total Hip Replacement surgery. In post operation Total Hip Replacement should be mobilized with muscle strength training such as ankle pump, quadtriseps setup, gluteal, hip and knee flexion, short arc quad, bed mobility exercise and walker tool usage exercise. The results obtained, the client gets the expected level of ambulation, no complications occur on various body systems and does not extend the length of stay.

Abstrak :
ABSTRAK
Pendahuluan: Total Hip Replacement THR disebut sebagai operasi abad ini karena menunjukan hasil yang memuaskan walaupun memiliki harga yang relatif mahal. THR telah dilakukan lebih dari 1 juta kali/tahun secara global dan diperkirakan akan meningkat dua kali pada dekade depan. Pada institusi kami, permintaan THR meningkat 313 dari tahun 2011 -2016. Kini telah banyak hadir berbagai jenis desain implant terutama tipe bearing surface dengan kelebihan dan kekurangan masing-masing. Namun pemilihannya masih menjadi kontroversial. Metode: Kami melaporkan penelitian potong lintang terhadap tiga tipe bearing surface yang sering digunakan di institusi kami; ceramic on polyethylene CoP , metal on polyethylene MoP dan ceramic on ceramic CoC . Enam puluh tiga pasien berhasil dilakukan review dengan usia rata-rata 45 tahun dan follow up rata-rata 2,5 tahun. Kami menilai luaran fungsional dengan Harris Hip Score HHS dan radiologis. Hasil dan Pembahasan: Pada follow up terakhir, rata-rata HHS pascaoperasi yaitu 87,1 10,2 p=0,79 yang menunjukan tidak ada perbedaan antar kelompok. Rata-rata perbedaan HHS pascaoperasi ndash; praoperasi yaitu 46,48 14,1 p=0,005 yang menunjukan adanya perbedaan signifikan di dalam kelompok oleh analisis one-way ANOVA. Analisa post hoc menunjukan rata-rata perbedaan HHS pascaoperasi ndash; praoperasi secara statistik lebih tinggi pada kelompok CoC 56,82 12,7 dibandingkan dengan CoP 44,29 14,1, p = 0,007 dan MoP 42,05 11,9, p = 0,015 . Tidak ada perbedaan antara kelompok MoP dan CoP p = 1,000 . Tidak ditemukan perbedaan luaran radiologis pada ketiga kelompok. dimungkinkan karena follow up yang relatif pendek sehingga dibutuhkan studi dengan follow up yang lebih lama.

---

ABSTRACT
Introduction Total Hip Replacement THR is considered to be the operation of the century with a high level of satisfactory result even though it has relatively high cost. It has been performed more than 1 million times year worldwide and its demand is estimated to double within decade. In our institution, its demand already increased by 313 from 2011 2016. Nowadays, we are faced with various implant design especially bearing surface with its benefits and weaknesses. But the ideal preference of bearing surface in THR remains a controversy. Methods We report a cross sectional study of three type of THR bearing surface which are ceramic on polyethylene CoP , metal on polyethylene MoP and ceramic on ceramic CoC , that was frequently used in our institution. Total patient of 63 were available for review with mean age of 45 years old and mean follow up of 2,5 years. We assessed their functional outcome with Harris Hip Score HHS and radiological outcome. Results and Discussion At the final follow up, mean post operative HHS was 87,1 10,2 p 0,79 that showed there were no difference between groups. Mean post operative ndash pre operative HHS differences was 46,48 14,1 p 0,005 that showed there were statically significant difference between groups as determined by one way ANOVA. A post hoc analysis revealed that postoperative ndash preoperative HHS differences were statistically significantly higher in CoC group 56,82 12,7 compared to CoP group 44,29 14,1, p 0,007 and MoP group 42,05 11,9, p 0,015 . There was no statistically significant difference between the CoP and MoP p 1,000 . Radiological outcomes reveal no loosening in all groups. This is predicted due to relatively short follow up time, thus longer follow up is needed.

Abstrak :
During the 2011 EFORT Congress in Copenhagen, many interesting topics relating to tribology in total hip arthroplasty were discussed during a special day devoted entirely to the subject. EFORT decided that, given the wide interest in these discussions, publication of the presentations would be warmly welcomed by all fellow professionals who were unable to attend. This book is the result. It provides detailed information on currently used articulating materials and their wear performance. Clinical outcomes are discussed, and important new frontiers are carefully considered.

Abstrak :
Gangguan sistem muskuloskeletal dapat terjadi pada semua usia dan mempengaruhi kualitas hidup penderitanya. Masalah sistem ini dapat mengakibatkan peningkatan angka morbiditas dan mortalitas bila tidak ditangani dengan segera dan tepat. Intervensi keperawatan berdasarkan hasil telaah bukti dalam praktik keperawatan medikal bedah diperlukan dalam memperoleh pelayanan professional dan berkualitas. Praktik Ners Residensi Spesialis dilakukan untuk mengimplementasikan peran Ners Spesialis sebagai care giver, pendidik, pengelola pelayanan keperawatan, peneliti, pembaharu dan pelaksana tugas berdasarkan pelimpahan wewenang. Peran Ners Spesialis sebagai care giver dilakukan secara langsung pada 1 klien sebagai kasus kelolaan utama dengan Osteoarthritis genu bilateral dan 30 klien sebagai kasus resume dengan variasi penyakit menggunakan pendekatan teori self-care Orem. Peran Ners Spesialis sebagai edukator selain dilakukan terhadap pasien juga dengan rekan sejawat di tatanan pelayanan rumah sakit melalui kegiatan journal reading berdasarkan fenomena lapangan. Peran Ners Spesialis sebagai peneliti dengan penerapan EBN (Evidence Based Nursing) menggunakan chewing gum sebagai pencegahan postoperative ileus pada fraktur hip. Sedangkan, peran Ners Spesialis sebagai pembaharu dengan melakukan proyek inovasi berupa pengkajian awal risiko deep vein thrombus (DVT) menggunakan “Autar Scale” sebagai pemikiran dasar dalam melakukan asuhan keperawatan terhadap klien gangguan ekstremitas bawah. ...... Musculoskeletal system disorders can occur at any age and affect the quality of life of sufferers. If not treated promptly and appropriately, this disorder can lead to increased morbidity and mortality. Nursing interventions based on the results of evidence review in medical surgical nursing practice are necessary in order to obtain professional and quality services. The Specialist Nurse Residency Practice is carried out to implement the role of Specialist Nurse as a care giver, educator, manager of nursing services, researcher, reformer, and executor of duties based on delegation of authority. The role of the Specialist Nurse as a care giver is carried out directly to 1 client as the main case managed with bilateral genu Osteoarthritis and 30 clients as resume cases with a variety of diseases. Orem's self-care theory is utilized as an approach of the research. The role of Specialist Nurses as educators is carried out not only for patients but also with colleagues in the hospital service setting through journal reading activities based on the field phenomena. The role of the Specialist Nurse as a researcher with the application of EBN (Evidence Based Nursing) is using chewing gum as a prevention of postoperative ileus in hip fractures. Meanwhile, the role of the Specialist Nurse as a reformer is carrying out an innovative project in the form of initial risk assessment of deep vein thrombus (DVT) using the "Autar Scale" as the core idea in carrying out nursing care for patients with lower limb disorders.