[PendahuluanFraktur merupakan masalah kesehatan utama karena sering terjadi, pengobatanyang kompleks dan mahal, serta hilangnya produktivitas. Masalah diperberat bilaterjadi komplikasi berupa delayed union atau nonunions. Dalam menilai pengaruhsuatu tindakan intervensi terhadap penyembuhan fraktur, diperlukan suatu modelperlambatan penyembuhan fraktur dan suatu metode penilaian yang akurat yangmeliputi radiologi, biomekanik, dan histologi. Berbagai model perlambatanpeyembuhan fraktur telah di laporkan dengan melakukan stripping periostealdengan menggunakan cauter yang menghasilkan tidak hanya efek mekanik namunjuga efek termal. Selain itu, metode penilaian akurat radiologi, biomekani modernbergantung terhadap instrumen yang belum tersedia secara masal. Penilaianhistologi melalui histomorphometri dapat dikerjakan tanpa bergantung padainstrument modern dan mahal. Hal ini ditunjang dengan tersedianya programimage J yang merupakan program dari NIH dan dapat diperoleh secara cumacuma.MetodePenelitian dilakukan pada bulan Juli hingga September 2013 di DepartementPatologi Anatomi FKUI. Penilaian dilakukan terhadap 24 ekor tikus denganfraktur dengan dan tanpa perlakuan mekanis pada periosteum yang kemudiandievaluasi pada minggu ke-2 dan minggu ke-4. Perlakuan mekanis padaperiosteum berupa Stripping sirkular dengan bistruri sepanjang 10mm disekitarfraktur. Penilaian histomorfometri dilakukan secara semi-automated denganbantuan program image-j, meliputi penilaian parameter total area kalus, areapenulangan, area tulang rawan dan area jaringan fibrosa. Evaluasi dilakukandengan membandingkan perubahan pada kelompok 2 minggu, kelompok 4minggu serta beda kelompok 2 dan 4 minggu.HasilPemeriksaan Histomorfometri minggu ke-2 dan minggu ke-4 didapatkan areapenulangan, area tulang rawan dan area jaringan fibrosa kelompok perlakuan lebihkecil dibandingkan pada kelompok kontrol yang secara statistik bermakna. Padaevaluasi beda histomorfometri minggu ke-2 dan minggu ke-4 antara kelompokkontrol dan kelompok perlakuan didapatkan perlambatan proses penyembuhanyang juga secara statistik berbeda bermakna.KesimpulanAnalisa histomormofetri dengan image-J dapat dilakukan tanpa bergantung padainstrumentasi yang modern dan perlakuan mekanik pada periosteum berupastripping sejauh 5mm dapat menghambat penyembuhan fraktur., IntroductionFracture is a major health problem because the complexity and expensivetreatment, and also loss of productivity that accompanying. That problemworsened if there is complications such as delayed-union or nonunions. Manyintervention was done to prevent that complication. In assessing the effect ofintervention, a model and also analytic method that includes radiology,biomechanics, and histology were needed. Various models of delayed fracturehealing have been reported by stripping the periosteal with cauter which producesnot only mechanical but also thermal effect. Moreover, latest radiological andbiomechanical assessment rely on instruments that are not available in everyplaces. Histological assessment through histomorphometri can be done withoutrelying on modern and expensive instruments. This evaluation method issupported by the availability of image-J program which is a program of the NIH,and can be obtained free of charge.MethodThe study is an experimental study that was conducted in the Department ofPathology Faculty of Medicine, University of Indonesia, on July to September2013. 24 rats was divided into 2 group. 1 group was performed mechanical forceto bone only to get fracture and other was done by giving mechanical force tobone and also periosteum. Each group was evaluated at 2 weeks and 4 weeks.Histomorfometri assessment was performed semi-automatically with the aid ofimage-j software. The paramater that measure was total area of callus, newbonearea, cartilage area, and fibrotic area. Evaluation is done by comparing thedifference of 2 group in 2 weeks, 4 weeks, and also the changes of 2 and 4 weeksof each group.ResultFrom Histomorfometric examination on 2nd week and 4th week, we found thatnewbone formation area, cartilage area and fibrous tissue area of treatment groupsmaller than in the control group and statistically significant. We also found thatthere was delaying of healing process in comparring the changing in 2nd to 4thweek of treatment group and it is also statistically significantConclusionsHistomormofetri analysis with image-J can be done without relying on moderninstrumentation, mechanical force on periosteum on a fracture site by periostealstripping could inhibit healing fracture especially in histological pattern.] |