MANAJEMEN PASCA BEDAH PADA KASUS OPEN FRAKTUR SEGMENTAL CRURIS : CASE REPORT

Muhammad Zaky Ramdhani; Bambang Aditya Nugraha; Urip Rahayu

doi:10.55681/sentri.v3i6.3007

Authors

Muhammad Zaky Ramdhani Universitas Padjadjaran
Bambang Aditya Nugraha Universitas Padjadjaran
Urip Rahayu Universitas Padjadjaran

DOI:

https://doi.org/10.55681/sentri.v3i6.3007

Keywords:

Fraktur Terbuka, Manajemen Fraktur, Orif, Tibia Segmental

Abstract

Fraktur tibia segmental terbuka merupakan kejadian fraktur yang jarang terjadi dan memiliki angka komplikasi yang tinggi, umumnya fraktur ini disebabkan oleh kecelakaan bermotor. Prinsip penganan fraktur yaitu dengan reposisi tulang agar terjadinya penyatuan kembali. Salah satu tindakan operatif yang dapat dilakukan yaitu dengan Open Reduction Internal Fixation (ORIF). Tujuan dilakukannya penelitian ini untuk mengetahui manajemen perawatan pada pasien dewasa pasca ORIF open cruris tiba segmental. Metode yang digunakan yaitu dengan pendekatan laporan kasus. Hasil diamati dari respon pasien terhadap pemberian intervensi manajemen nyeri, pencegahan infeksi, perawatan luka, dan juga pembidaian yang menunjang dalam pemulihan fraktur. Manajemen yang tepat dalam menanggulangi pasien pasca ORIF menjadi kunci dalam indikasi pemulangan pasien one day care surgery, sehingga perlu mendapatkan perlakuan yang tepat yang tak luput dari peran perawat. Perawatan pasien yang diberikan sejalan dengan prinsip operasi perawatan satu hari dan mendukung indikasi pemulangan pasien pasca operasi. Namun, intervensi tertentu khususnya dalam mobilisasi dini masih belum optimal.

Downloads

Download data is not yet available.

References

Aini, L., & Reskita, R. (2018). Pengaruh Teknik Relaksasi Nafas Dalam terhadap Penurunan Nyeri pada Pasein Fraktur. Jurnal Kesehatan, 9(2), 262. https://doi.org/10.26630/jk.v9i2.905

Akinyoola, A. L., Odunsi, A., & Yusu, M. B. (2012). Use of wound drains following open reduction and internal fixation of femoral shaft fractures. Journal of Wound Care, 21(6), 279-280,282-284. https://doi.org/10.12968/jowc.2012.21.6.279

Atwan, Y., Miclau, T., Schemitsch, E. H., & Teague, D. (2020). Antibiotic utilization in open fractures. OTA International : The Open Access Journal of Orthopaedic Trauma, 3(1), e071. https://doi.org/10.1097/OI9.0000000000000071

Bhadra, A. K., Roberts, C. S., & Giannoudis, P. V. (2012). Nonunion of fibula: A systematic review. International Orthopaedics, 36(9), 1757–1765. https://doi.org/10.1007/s00264-012-1556-z

Bhakti Karthica, Y., Dyah Puspitasari, F., Studi, P. D., & Politeknik Yakpermas Banyumas, K. (2023). Treatmen of Wound in Patients With Tibia Fibula Fractures Using Nacl 0,9% in Cisumur Village, Gandrungmangu District, Cilacap Regency. Desember, 9(02), 113–117.

Corey, R. M., Park, N. K., & Cannada, L. K. (2018). Segmental Tibia Fractures: An Analysis of Complication and Healing Rates. Journal of Orthopaedic Trauma, 32(6). https://journals.lww.com/jorthotrauma/fulltext/2018/06000/segmental_tibia_fractures__an_analysis_of.6.aspx

Ewari, G. A. P., & Premana, Y. (2021). Karakteristik pasien fraktur kruris di RSUD Sanjiwani Gianyar tahun 2020. Intisari Sains Medis, 12(3), 689–693.

Fischer, V., Haffner-Luntzer, M., Amling, M., & Ignatius, A. (2018). Calcium and vitamin D in bone fracture healing and post-traumatic bone turnover. European Cells and Materials, 35, 365–385. https://doi.org/10.22203/eCM.v035a25

Greenwood, R. E. (1993). The Case Study Approach. Business Communication Quarterly, 56(4), 46–48. https://doi.org/10.1177/108056999305600409

H.M, J. A., Fendy Dwimartyono, Muliyadi, F. E., Reeny Purnamasari, Sommeng, F., Wahab, M. I., Kuswardhana, H., Arsyad, N. N., & Muhammad Imran. (2022). Pola Penggunaan Analgesik Pasien Bedah Orthopedi di Ruang Gawat Darurat Rs. Ibnu Sina Makassar. Fakumi Medical Journal: Jurnal Mahasiswa Kedokteran, 2(7), 496–503. https://doi.org/10.33096/fmj.v2i7.99

Hadeed, A., Werntz, R. L., & Varacallo, M. (2024). External Fixation Principles and Overview. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK547694/

Hertz, K., & Santy-Tomlinson, J. (2018). Fragility Fracture Nursing: Holistic Care and Management of the Orthogeriatric Patient. Springer. https://doi.org/10.1007/978-3-319-76681-2

Jakobsson, J. G. (2019). Recovery and discharge criteria after ambulatory anesthesia: can we improve them? Current Opinion in Anaesthesiology, 32(6), 698–702. https://doi.org/10.1097/ACO.0000000000000784

Jorge-Mora, A., Amhaz-Escanlar, S., González, I. C., López-Del Teso, C., Gómez, R., Jorge-Mora, T., Caeiro-Rey, J. R., & Pino-Mínguez, J. (2018). Management of Open Fracture. In Trauma Surgery. IntechOpen.

Karpouzos, A., Diamantis, E., Farmaki, P., Savvanis, S., & Troupis, T. (2017). Nutritional Aspects of Bone Health and Fracture Healing. Journal of Osteoporosis, 2017, 4218472. https://doi.org/10.1155/2017/4218472

Kortram, K., Bezstarosti, H., Metsemakers, W.-J., Raschke, M. J., Van Lieshout, E. M. M., & Verhofstad, M. H. J. (2017). Risk factors for infectious complications after open fractures; a systematic review and meta-analysis. International Orthopaedics, 41, 1965–1982.

Kronborg, L., Bandholm, T., Palm, H., Kehlet, H., & Kristensen, M. T. (2017). Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: a randomised controlled trial. PLoS One, 12(6), e0179867.

Latifah, S. (2023). RANGE OF MOTION (ROM) EXERCISES IN POST-OPERATIONAL PATIENT POST OPEN REDUCTION INTERNAL FIXATION (ORIF) MANAGEMENT. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 8(3).

Lee, J. H. (2017). Anesthesia for ambulatory surgery. Korean Journal of Anesthesiology, 70(4), 398.

Little, Z., Smith, T. O., McMahon, S. E., Cooper, C., Trompeter, A., Pearse, M., Britten, S., Rogers, B., Sharma, H., Narayan, B., Costa, M., Beard, D. J., & Hing, C. B. (2017). The treatment of segmental tibial fractures: does patient preference differ from surgeon choice? Injury, 48(10), 2306–2310. https://doi.org/https://doi.org/10.1016/j.injury.2017.08.014

McMahon, S. E., Little, Z. E., Smith, T. O., Trompeter, A., & Hing, C. B. (2016). The management of segmental tibial shaft fractures: A systematic review. Injury, 47(3), 568–573. https://doi.org/10.1016/j.injury.2015.11.022

mostafa, neama, & Osman, A. (2020). Effect of Applying Postoperative Nursing Instructions 0nAnkle Open Reduction Internal Fixation Surgery Patients. Assiut Scientific Nursing Journal, 8(23), 86–95. https://doi.org/10.21608/asnj.2020.47999.1065

Niedermeier, S. R., Crouser, N., Hidden, K., & Jain, S. A. (2021). Pain Management following Open Reduction and Internal Fixation of Distal Radius Fractures. Journal of Wrist Surgery, 10(1), 27–30. https://doi.org/10.1055/s-0040-1716508

Nilsson, U., Gruen, R., & Myles, P. S. (2020). Postoperative recovery: the importance of the team. Anaesthesia, 75, e158–e164.

Nopianti, W., Setyorini, D., & Pebrianti, S. (2019). Gambaran Implementasi Perawat Dalam Melakukan Mobilisasi Dini Pada Pasien Post Operasi Orif Fraktur Ekstremitas Bawah Di Ruang Orthopedi Rsud Dr. Slamet Garut. Malahayati Nursing Journal, 1(2), 196–204.

Oeding, J. F., Bockman, S., Chiu, H., Hua, C., Connor, J., & Slocum, A. (2022). A Novel Approach to Open Reduction and Internal Fixation of Distal Radius Fractures Utilizing a Multi-Degree-of-Freedom Traction and Stabilization Device. Journal of Medical Devices, 16(2), 21006. https://doi.org/10.1115/1.4052901

Pari, C., Raggini, F., Paderni, S., Bettinelli, G., Salini, V., Vicenti, G., & Belluati, A. (2021). One-stage procedure for open tibial fractures: feasible without orthoplastic surgery? Acta Bio-Medica : Atenei Parmensis, 92(S3), e2021018. https://doi.org/10.23750/abm.v92iS3.11736

Phan, T. M., Arnold, J., & Solomon, L. B. (2017). Rehabilitation for tibial plateau fractures in adults: a scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports, 15(10), 2437–2444. https://doi.org/10.11124/JBISRIR-2016-002949

Platini, H., Chaidir, R., & Rahayu, U. (2020). Karakteristik Pasien Fraktur Ekstremitas Bawah. Jurnal Keperawatan’Aisyiyah, 7(1), 49–53.

Prior, C. P., & Harris, P. C. (2018). Fractures of the distal tibial physis. Orthopaedics and Trauma, 32(5), 332–342.

Priya, A. (2020). Case Study Methodology of Qualitative Research: Key Attributes and Navigating the Conundrums in Its Application. Sociological Bulletin, 70(1), 94–110. https://doi.org/10.1177/0038022920970318

RI, K. (2018). Laporan Riskesdas 2018 Nasiona. In Lembaga Penerbit Balitbangkes (p. hal 156). https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf

Rondanelli, A. M., Gómez-Sierra, M. A., Ossa, A. A., Hernández, R. D., & Torres, M. (2021). Damage control in orthopaedical and traumatology. Colombia Medica (Cali, Colombia), 52(2), e4184802. https://doi.org/10.25100/cm.v52i2.4802

Sheen, J. R., Mabrouk, A., & Garla, V. V. (2024). Fracture Healing Overview. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551678/

Shende, K., Ratnani, G., Deodhe, N. P., & Gandhi, K. M. (2023). Promoting Flexibility and Functionality in a Surgically Managed Tibial Fracture: A Case Report on Physiotherapeutic Interventions for Postoperative Stiffness. In Cureus (Vol. 15, Issue 12, p. e50589). https://doi.org/10.7759/cureus.50589

Shetty, A., & US, R. (2015). Anesthesia For Day Care Surgery. Journal of Health and Allied Sciences NU, 05, 97–103. https://doi.org/10.1055/s-0040-1703901

Sohn, H. S., Chung, J. Y., & Song, H. K. (2019). Analysis of complications and clinical outcomes in the treatment of segmental tibial fractures according to the method of internal fixation. Asian Journal of Surgery, 42(7), 740–745. https://doi.org/https://doi.org/10.1016/j.asjsur.2018.11.001

Sop, J. L., & Sop, A. (2023). Open Fracture Management. Treasure Island (FL): StatPearls Publishing. Publishin

Touloupakis, G., Messori, M., Gilli, A., Theodorakis, E., Ghirardelli, S., & Antonini, G. (2023). Distal Tibia Fractures: is the Tibia First Technique a Rational Approach? Malaysian Orthopaedic Journal, 17(1), 172–179. https://doi.org/10.5704/MOJ.2303.020

Triana, R. N. T. N., & Puspasari, F. D. (2023). Perawatan Luka Pasien Post Orif Patella Sinistra Menggunakan Nacl 0, 9% Dan Gentamicin Sulfat. Scientific Journal of Medsains, 9(1), 31–36.

Walujo, A. M., & Satya, I. M. H. (2020). Anestesi pada Pelayanan Bedah Sehari (Outpatient Anesthesia). Cermin Dunia Kedokteran, 47(4), 247–250.

Wantoro, G., Muniroh, M., & Kusuma, H. (2020). Analisis Faktor-Faktor yang mempengaruhi Ambulasi Dini Post ORIF pada Pasien Fraktur Femur Study Retrospektif. Jurnal Akademika Baiturrahim Jambi, 9(2), 283. https://doi.org/10.36565/jab.v9i2.273

Wu, A. M., Bisignano, C., James, S. L., Abady, G. G., Abedi, A., Abu-Gharbieh, E., Alhassan, R. K., Alipour, V., Arabloo, J., Asaad, M., Asmare, W. N., Awedew, A. F., Banach, M., Banerjee, S. K., Bijani, A., Birhanu, T. T. M., Bolla, S. R., Cámera, L. A., Chang, J. C., … Vos, T. (2021). Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. The Lancet Healthy Longevity, 2(9), e580–e592. https://doi.org/10.1016/S2666-7568(21)00172-0

Yazid, B., & Sidabutar, R. R. (2024). Pengaruh Pembidaian Terhadap Penurunan Skala Nyeri Pada Pasien Fraktur Di RSU Sundari Medan. JINTAN: Jurnal Ilmu Keperawatan, 4(1), 36–45.

Young, K., Aquilina, A., Chesser, T. J. S., Costa, M. L., Hettiaratchy, S., Kelly, M. B., Moran, C. G., Pallister, I., & Woodford, M. (2019). Open tibial fractures in major trauma centres: A national prospective cohort study of current practice. Injury, 50(2), 497–502.