Abstrak: Fraktur ekstremitas bawah memiliki prevalensi yang tinggi di antara jenis fraktur lainnya akibat kecelakaan. Pemeriksaan darah lengkap berperan penting dalam proliferasi osteoblas yang merupakan langkah awal dalam penyembuhan tulang. Penelitian ini bertujuan untuk membuktikan hubungan antara penyembuhan tulang dengan determinan darah lengkap dan hubungan determinan darah lengkap dengan jenis fraktur, lokasi fraktur, faktor-faktor demografik, dan parameter darah tepi pada pasien fraktur diafisis tulang panjang ekstremitas bawah. Penelitian ini dilaksanakan di RSUP Prof. Dr. R. D. Kandou, Manado menggunakan studi kohort (analitik observasional) dengan 10 pasien fraktur terbuka (grade I-II) dan 14 pasien fraktur tertutup. Semua pasien dilakukan pemeriksaan fisik dan pemeriksaan laboratorium darah lengkap. Hasil penelitian mendapatkan pasien laki-laki lebih banyak dibanding perempuan, median usia 30 tahun. Hasil analisis regresi mendapatkan perbedaan hasil darah lengkap pada fraktur terbuka dan fraktur tertutup (leukosit dan neutrofil batang) dan hasil bermakna pada perbedaan lokasi fraktur di femur dan tibia. Simpulan penelitian ini ialah penderita fraktur diafisis ekstremitas bawah terbuka memiliki infeksi lebih tinggi dengan ditandai peningkatan leukosit dan neutrofil batangKata kunci: kadar darah lengkap; fraktur diafisis; tulang panjang Abstract: Lower limb fracture has a high prevalence among other types of fractures due to accidents. Complete blood count has an important role in the proliferation of osteoblasts which is the first step in bone healing. This study was aimed to prove the relationship between bone healing and determinants of complete blood count and to prove the relationship between determinants of complete blood count and fracture type, fracture location, demographic factors, and peripheral blood parameters in patients with diaphysis fractures of the long bones of lower extremities. This study was conducted at Prof. Dr. R. D. Kandou Hospital, Manado using a cohort study (observational and analytical) with 10 open fracture patients (grade I-II) and 14 closed fracture patients. All patients were subjected to physical examination and complete blood count laboratory. The results showed that male subjects were predominant and the median age was 30 years. The regression analysis showed that there were differences in complete blood count between open fractures and closed fractures (leukocytes and band neutrophil) and significant differences in the location of fractures in the femur and tibia. In conclusion, leukocyte and segmented neutrophils levels are increased in patients with open lower limb diaphysis fracturesKeywords: complete blood count; long bone; diaphysis fracture
Carpal tunnel syndrome (CTS) is often reported as an occupational disease and a common problem among workers who often use their hands. The causes of CTS are considered multifactorial, involving both individual and occupational factors. Computer use is thought to be a risk factor for CTS. Using a computer keyboard is associated with wrist or hand pain, which is related with repetitive hand movements. However, the available evidence regarding the relationship between computer use or occupational risk factors and CTS is still controversial. This study aimed to determine the occupational risk factors for CTS in office workers. This was a literature review study. Data were searched from databases of Crossref and Google Scholar. The keywords were carpal tunnel syndrome, risk factor, ergonomic, occupation, computer office, workers The results obtained 10 articles reviewed according to predetermined inclusion and exclusion criteria. Work duration and work periods were referred to occupational risk factors for CTS. Awkward wrist/hand postures especially without mousepad supporting the hand or wrist, and repetitive movement were direct risk factors for CTS. In conclusion, risk factors for CTS among office workers are duration and period of working, awkward wrist/hand posture, and repetitive movement. Keywords: occupational risk factors; carpal tunnel syndrome; office workers. Abstrak: Carpal tunnel syndrome (CTS) merupakan penyakit akibat kerja dan menjadi masalah umum di antara para pekerja yang sering menggunakan tangan. Penyebab CTS dianggap multifaktorial, yang melibatkan faktor individu dan pekerjaan. Penggunaan komputer diduga menjadi faktor risiko CTS. Penggunaan keyboard komputer dihubungkan dengan nyeri pergelangan tangan atau tangan, yang berkaitan dengan gerakan tangan berulang. Walaupun demikian, bukti yang tersedia perihal keterkaitan antara penggunaan komputer atau faktor risiko pekerjaan dan CTS masih kontroversial. Penelitian ini bertujuan untuk mengetahui faktor risiko pekerjaan terjadinya CTS pada pekerja kantoran. Jenis penelitian ini ialah suatu literature review menggunakan data- base Crossref dan Google Scholar dengan kata kunci carpal tunnel syndrome, risk factor, ergonomic, occupation, computer office, workers. Hasil penelitian mendapatkan 10 artikel yang ditelaah sesuai dengan kriteria inklusi dan eksklusi yang telah ditentukan. Durasi kerja dan periode kerja disebut sebagai faktor risiko pekerjaan untuk terjadinya CTS. Postur yang janggal, khususnya dikarenakan tanpa penggunaan mousepad penyangga tangan atau pergelangan tangan serta gerakan berulang saat menggunakan mouse dan mengetik menggunakan keyboard secara langsung menjadi faktor risiko terjadinya CTS. Simpulan penelitian ini ialah durasi dan periode kerja, postur tangan/pergelangan yang janggal, dan gerakan berulang merupakan faktor risiko pekerjaan untuk terjadinya CTS. Kata kunci: faktor risiko pekerjaan; carpal tunnel syndrome; pekerja kantoran
Defects in long bones including tibia are still difficult problems in orthopaedic field for both the physician and the patient. We reported a case of a 56-year-old woman who came to the hospital with the chief complaint of being unable to walk since she was nine years old after getting a motorcycle accident. The patient complained that her leg did not grow since then. The patient was fully conscious and hemodynamically stable. Physical examination revealed that there was a deformity of the left lower leg with shortening of the lower leg and absence of the tibial bone. The patient was diagnosed with left tibia bone defect, therefore, above-the-knee amputation was performed. The amputation must be viewed as an opportunity to re-establish or enhance the patient’s functional level and facilitate a return to near normal locomotion using a prosthesis after amputation. Soft tissue and muscle quality, bone condition, neurovascular conditions and function of the limb can be considered in the selection of therapy in bone defect. The level of amputation can be determined by assessing the bone condition, neurovascular condition, and the ability of muscle and skin flaps to close the wound. In conclusion, amputation can be the treatment of choice for patient with bone defect. Improving lower limb function is proven to maximize the patient quality of life. Keywords: bone defect tibia; above-the-knee amputation; transfemoral amputation
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