HASIL KELUARAN PENANGANAN SECARA KONSERVATIF DENGAN MENGGUNAKAN CASTING PADA FRAKTUR DISTAL RADIUS DI RS SARDJITO YOGYAKARTA

Adam Moeljono, Rahadyan Magetsari., PhD., SpOT, FICS

2012 | Tesis | S2 Ilmu Bedah

Latar Belakang : Fraktur distal radius merupakan seperenam jumlah keseluruhan kasus fraktur digawat darurat. Fraktur ini kebanyakan ditangani secara konservatif sehubungan risiko operasi, sosial ekonomi, serta demand fungsional yang rendah. Metode : Penelitian cross-sectional. Pasien memenuhi kriteria inklusi trauma single, tertutup, fraktur distal radius rentang usia 13-80 tahun(n=61) yang ditangani secara konservatif menggunakan casting dicatat hasil x ray pre dan pasca reduksi (radial inklinasi, radial length, palmar tilt, ulnar variance) dilibatkan dalam penelitian ini dilakukan kunjungan rumah untuk dilakukan penilaian outcome meliputi nilai Skor Quick DASH (subyektifitas pasien), Skor MAYO (obyektif meliputi nyeri, ROM, grip strength,return to work), Skor VAS (skala derajat nyeri). Dilakukan analisis univariate korelasi melihat faktor yang berhubungan dengan hasil keluaran. Hasil : Pasien dengan fraktur distal radius (n=61, mean usia = 49,48 th). Dilakukan imobilisasi dengan rata-rata 3,46 minggu (2-12 minggu). Dilihat dari faktor usia, derajat keparahan fraktur serta lama imobilisasi hanya derajat keparahan fraktur yang berkorelasi secara signifikan dengan skor Quick DASH (p=0,005) dan VAS (p=0,001). Hasil analisis menunjukkan aseptabilitas palmar tilt pasca reduksi mempunyai korelasi yang signifikan terhadap Skor Subyektif Quick DASH (p=0,025). Diskusi : Hasil keluaran penanganan dari suatu fraktur distal radius yang ditangani secara konservatif dengan casting berhubungan dengan derajat keparahan fraktur serta aseptabilitas palmar tilt pasca reduksi.

Introduction : Distal radius fracture is a common fracture approximately one sixth of all emergency cases in orthopaedic setting. In Indonesia generally and in Yogyakarta typically , these kinds of fracture are treated conservatively due to social economic condition, risk of operation, and also low functional demand. Method : Crossed sectional study. All patients met inclusion criteria such as single trauma, closed fracture, were recorded with range of age 13-80 years old (n=61) which were treated conservatively using Long Arm Cast. X ray pre and post reduction were noted, all were home visited (range of time post removal casting 4 – 18 months). Quick DASH as subjective perceived patients score were noted, MAYO wrist score which consist of pain, range of movement, grip strength, and return to work, also VAS (Visual Analogue Score). Univariate analysis were performed to analyze factors that correlates with the outcome. Results : Patients with distal radius fracture (n=61), mean age = 49,48 y.o. Performed closed reduction and average time of immobilization 3,46 weeks (range 2-12 weeks). From age, degree of severity and time of immobilization,criteria, only the degree of severity has stastically positive significant with subjective Quick DASH score (p=0,005) and VAS (p=0,001). Analysis study also showed that acceptability of post reduction palmar tilt correlated with Quick DASH score (p=0.025). Discussion : In this study, outcome of distal radius fracture correlated with degree of severity and also acceptability of post reduction palmar tilt. Keyword : distal radius fracture, degree of severity, palmar tilt, subjective Quick DASH score, objective MAYO wrist score, VAS

Kata Kunci : fraktur distal radius, derajat keparahan fraktur, palmar tilt, skor subyektif Quick DASH, skor obyektif MAYO, VAS.