Pengaruh Sudut Insersi Schanz Screw Terhadap Stabilitas Fiksasi Eksternal Menggunakan Metode Modifikasi Inoue Pada Uji Tarik (Pull Out Strength) Pada Fraktur Tibia Tulang Kambing Jawa (Capra Aegagrus Hircus) : Sebuah Penelitian Biomekanika

Purwadi, Bambang (2017) Pengaruh Sudut Insersi Schanz Screw Terhadap Stabilitas Fiksasi Eksternal Menggunakan Metode Modifikasi Inoue Pada Uji Tarik (Pull Out Strength) Pada Fraktur Tibia Tulang Kambing Jawa (Capra Aegagrus Hircus) : Sebuah Penelitian Biomekanika. Magister thesis, Universitas Brawijaya.

Abstract

Pendahuluan: Fiksasi eksternal menggunakan metode modifikasi Inoue semakin banyak digunakan, seiring dengan meningkatnya kasus patah tulang tibia terbuka. Ini disebabkan, biayanya yang lebih murah, mudah didapat, mudah digunakan, dan sesuai bila dikaitkan dengan era Jaminan Kesehatan Nasional di Indonesia saat ini. Namun, metode ini sering menimbulkan komplikasi berupa pin loosening, yang disebabkan oleh kurangnya stabilitas konfigurasi fiksasi eksternal. Oleh karenanya, perlu dilakukan penelitian yang bertujuan untuk meningkatkan stabilitas konfigurasi fiksasi eksternal metode ini. Metode: Tulang Tibia kambing Jawa (Capra Aegagrus hircus) dipatahkan dengan pola transversal dan dipasang fiksasi eksternal metode modifikasi Inoue. Pada group kontrol dilakukan pemasangan schanz screw dengan arah 900 perpendikular dengan tulang tibia. Perlakuan I, dilakukan pemasangan schanz screw dengan konfigurasi 100 divergen (cephalad & caudalat terhadap kontrol). Perlakuan II, dilakukan pemasangan schanz screw dengan konfigurasi 200 divergen (cephalad & caudalat terhadap kontrol). Perlakuan III, dilakukan pemasangan schanz screw dengan konfigurasi 300 divergen (cephalad & caudalat terhadap kontrol). Selanjutnya keempat kelompok tersebut dilakukan uji tarik (pull out strenght) dan dievaluasi pada 2 parameter biomekanika yaitu stiffness of construction dan static failure. Hasil dan Diskusi: Pemberian sudut insersi schanz screw dapat meningkatkan stabilitas konfigurasi fiksasi eksternal, baik pada parameter stiffness of construction dan static failure, dengan p<0,05. Seiring dengan penambahan besar sudut insersi schanz screw, juga semakin meningkatkan stabilitas konfigurasi fiksasi eksternal, dengan sudut optimal adalah 100 divergen, dengan p<0,05. Kesimpulan: Pemberian sudut pada insersi schanz screw dapat meningkatkan stabilitas konfigurasi fiksasi eksternal metode modifikasi Inoue terhadap pull out strength, dengan sudut optimal adalah 100 divergen, baik pada parameter static failure maupun stiffness of construction.

English Abstract

Introduction : Inoue Modification External fixation is more often used at present, along with the increases of open tibial bone fracture cases. Because this technique is cost effective, easy to obtained, easy to be used, and accepted by National Health Inssurance of Indonesian Government. But, this technique sometimes give a complication of pin loosening, caused by lack of stability in the external fixation configuration. Because of that matter, this study was conducted to increase the external fixation configuration stability of this technique. Method : The Java Goat (Capra Aegagrus hircus) tibial bone was broken with transversal pattern and applied for Inoue Modification External Fixation. In the Control Group, the schanz screw were inserted at the 90 degree angle, perpendicularly of the tibial bone. In the Group I, the schanz screw were inserted divergently at the 100 angle (cephalad and caudalat of the control group). In the group 2, the schanz screw were inserted divergently at the 200 angle (cephalad and caudalat of the control group). In the group 3, the schanz screw were inserted divergently at the 300 angle (cephalad and caudalat of the control group). Then, all of the group, undergo the Pull Out Strength Test and evaluated with 2 biomechanical parameter, stiffness of construction and static failure, and also observe the bone-screw interface and screw-acrylic interface. Result and Discussion : The application of angle in schanz screw insertion, divergently, can increase the stability of external fixation configuration, in the parameter of stiffness of construction and static failure, with p<0.05 . And also the increasing of the schanz screw insertion angle, lead to increasing of the stability of external fixation configuration, with optimum angle at the 100 divergently, with p<0.05. In static failure, 71% the failure site occured in bone-screw interface because the lever effect of the angle insertion of schanz screw into the metaphyseal region of the bone. Conclusion : The schanz screw insertion angle in divergent configuration increase the stability of Inoue Modification External Fixation in Pull Out Strength, with optimum angle at 100 divergent in stiffness of construction and static failure.

Item Type: Thesis (Magister)
Identification Number: TES/617.5/PUR/p/2017/041706900
Uncontrolled Keywords: STRENGTH MATERIALS, FRACTURE MECHANIES, ORTHOPEDIC SURGERY, TIBIA - FRACTURES
Subjects: 600 Technology (Applied sciences) > 617 Surgery, regional medicine, dentistry, ophthalmology, otology, audiology > 617.5 Regional medicine
Divisions: S2/S3 > Magister Ilmu Biomedis, Fakultas Kedokteran
Depositing User: Nur Cholis
Date Deposited: 15 Aug 2017 03:08
Last Modified: 29 Dec 2020 03:54
URI: http://repository.ub.ac.id/id/eprint/1321
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