Literature Review : Penerapan Teknik Relaksasi Nafas Dalam Untuk Menurunkan Nyeri Pada Pasien Post Operasi Fraktur

Fractures are fractures or fractures of bone generally caused by trauma, either directly or indirectly. Pain is one of the symptoms experienced by postoperative fracture patients. One of the non-pharmacological therapies to reduce pain in postoperative fracture patients is deep breathing relaxation techniques. This therapy can optimize the effect of pharmacological therapy given to the patient. The purpose of this study was to describe the application of deep breathing relaxation techniques to reduce pain in postoperative fracture patients based on a literature review. The design of this study was a literatur review of three articles from Google Scholar with keywords including fracture, pain, deep breathing relaxation techniques and full text articles published in 2013-2018. The results of the analysis of three articles with 65 respondents showed a change in pain intensity. The average value og pain raduction before the deep breathing relaxation techniques was done was 5,58 and after the deep breathing relaxation techninques it was 2,92. In conclusion, deep breathing relaxation techniques are effective for reducing pain in postoperative fracture patients. It is suggested for health services to be apply this techniques as an alternative to reduce pain in postoperative fracture patients. Keywords: Deep Breathing Relaxation Techniques; Fracture; Pain AbstrakFraktur adalah patahan atau retakan tulang umumnya disebabkan karena adanya trauma baik langsung maupun tidak langsung. Nyeri merupakan salah satu gejala yang dialami oleh pasien post operasi fraktur. Salah satu terapi non farmakologi untuk menurunkan nyeri pada pasien post operasi fraktur adalah teknik relaksasi nafas dalam. Terapi ini dapat mengoptimalkan efek dari terapi farmakologi yang diberikan pada pasien. Tujuan dari penelitian ini untuk menggambarkan penerapan teknik relaksasi nafas dalam untuk menurunkan nyeri pada pasien post operasi fraktur berdasarkan literatur review. Desain karya tulis ilmiah berupa literatur review dengan jumlah tiga artikel yang diambil dari laman jurnal google scolar dengan kata kunci fraktur, nyeri, teknik relaksasi nafas dalam berupa artikel fulltex terbit tahun 2013 – 2018. Hasil analisa karakteristik responden dari tiga artikel berjumlah 65 responden menunjukan adanya perubahan intensitas nyeri. Nilai rata-rata sebelum dilakukan teknik relaksasi nafas dalam yaitu 5,58 dan sesudah dilakukan teknik relaksasi nafas dalam menjadi 2,92. Kesimpulannya adalah teknik relaksasi nafas dalam efektif untuk menurunkan nyeri pada pasien post operasi fraktur. Saran bagi pelayanan kesehatan hendaknya dapat menerapakan teknik relaksasi nafas dalam sebagai alternatif untuk menurunkan nyeri pada pasien post operasi fraktur.Kata kunci: Fraktur; Nyeri; Teknik Relaksasi Nafas Dalam

Influence of Timing on Surgical Outcomes for Acute Humeral Shaft Fractures

Surgical treatment for humeral shaft fractures has been reported to yield satisfactory results; however, there may be complications, such as delayed bone union, nonunion, iatrogenic radial nerve injury, and infection. The risk factors for postoperative complications remain largely unknown. This study aimed to investigate the influence of timing of surgery on the incidence of postoperative complications of acute humeral shaft fractures. We retrospectively reviewed 43 patients who underwent osteosynthesis for acute humeral shaft fractures between 2006 and 2020. The patients were divided into early (21 patients) and delayed (22 patients) treatment groups based on the timing of the surgical intervention (within or after four days). Outcomes were the incidences of complications (delayed union, nonunion, iatrogenic radial nerve injury, and infection) and postoperative fracture gaps. We evaluated the outcomes using plain radiographs and clinical notes. In addition, we performed subgroup analyses on outcomes in a subgroup of patients who underwent intramedullary nailing and one who underwent plate fixation. The frequency of delayed union was significantly higher in the delayed group ( P = 0.046 ), and the postoperative fracture gap size was also significantly greater in the delayed group ( P = 0.007 ). The subgroup analyses demonstrated a significant association between the increased incidence of delayed union and delayed surgical interventions only in the intramedullary nailing subgroup ( P = 0.017 ). This study suggests that performing surgery within four days after acute humeral shaft fracture is recommended to reduce the occurrence of delayed union, particularly in cases requiring intramedullary nailing fixation.

Postoperative Fracture Healing Effects of Locking Compression Plate for the Treatment of Limb Fractures

Objective: To study the effects of applying locking compression plates in the treatment of patients with limb fractures on postoperative fracture healing. Methods: 115 patients with limb fractures who were treated in our hospital from November 2019 to November 2020 were selected. In order to study the effective treatment method, the random-number table method was used in this study to divide the patients into two groups, namely the experimental group and the control group, and the locking compression plate treatment method and the pure plate and screw internal fixation treatment method were administered respectively to study their clinical application effects. Results: Compared with the control group, patients in the experimental group had a lower incidence of complications, shorter hospitalizations and shorter recovery time. Meanwhile, the experimental group had a better quality of recovery, and all data were significantly different from those of the control group, P<0.05, the intervention effect of the experimental group was better. Conclusion: The application of the locking compression plate in the treatment of patients with limb fractures is more conducive to promoting the postoperative healing of the patients' fractures, reducing the incidence of postoperative complications, and promoting the rapid recovery of patients, which has positive significance for clinical development.

Educational Intervention on Self Efficacy among Postoperative Fracture: A Literature Review

Fracture is a disruption of the normal discontinuity of bone and causes the surrounding tissue to be disrupted. Management of fractures is generally divided into recognition, reduction, retention, and rehabilitation. Exercises in the postoperative fracture patient rehabilitation program require patience and take a long time to achieve maximum cure. Nurses' therapeutic action in helping patients do rehabilitation exercises is by increasing the patient's self-efficacy to be independent in carrying out activities. Efforts to increase self-efficacy can be made through nursing interventions. This literature review aimed to explore the appropriate interventions on improving self-efficacy among postoperative fracture patients. Methods: This study was obtained from 4 databases, namely EBSCO, Key clinical, Willey, and Proquest, using inclusion and exclusion criteria. Results obtained. Decreased self-efficacy can occur in cases that require long action both for the healing process and chronic disease and when taking actions to maintain health, including post-surgery fractures. In conclusion, educational media will make it easier to provide interventions in increasing self-efficacy by paying attention to the factors that affect self-efficacy, namely master experience, vicarious experience, verbal persuasion, and emotional Arousal. The recommendation is that patients need support for adjusting the use of tools in providing education, providing logistics from samples in the application of education through technology media and to parents

Efektivitas Terapi Bermain Fidget Spinner terhadap Nyeri Pasca Operasi Fraktur pada Anak

Fracture is one of the most vulnerable injuries in children. Fracture is a disconnectionin bone continuity caused by trauma or physical exertion, the management of the fracture can be done with orthopedic surgery, namely by open reduction using internal fixation. Pain is a major problem in post operative fracture care Non pharmacological techniques that can be done to ward off postoperative pain in children are by doing play therapy, one of which is by using fidget spinner therapy. This literature review aims to analyze the effect of fidget spinner therapy on postoperative fracture pain.this game can distract children and give them something soothing to release pent up energy. Methods: This research explores quantitative evidence published in electronic databases such as pubmed, garuda, and google schoolar. Using a journal search strategy, I only came up with the results of one recent and relevant journal for inclusion in the final analysis. Results: I can see a significant effect in postoperative fracture pain intensity in the child after the patient was given fidget spinner therapy. Conclusion: From the results, it can be concluded that fidget spinner therapy is a non-pharmacological therapy that can reduce the pain scale in post operative fracture patients. It is hoped that parents will use this game in the handling of fracture pain in their children

A useful intraoperative technique for transiliac-transsacral screws: a point-to-point coaxial guide apparatus

Background The transiliac-transsacral screw placement is a clinical challenge for surgeons. This study explored a point-to-point coaxial guide apparatus assisting the transiliac-transsacral screw insertion and aimed to investigate the feasibility and accuracy of the guide apparatus in the treatment of posterior ring unstable pelvic fracture compared with a free-hand technique. Methods A retrospective study was performed to evaluate patients treated with transiliac-transsacral screws assisted by the point-to-point coaxial guide apparatus or free-hand technique. The intraoperative data of operative time and radiation exposure times were recorded. Postoperative radiographs and CT scans were performed to scrutinize the accuracy of screws position. The quality of the postoperative fracture reduction was assessed according to Matta radiology criteria. The pelvic function was assessed according to the Majeed scoring criteria at 6 months postoperatively. Results From July 2017 to December 2019, a total of 38 patients were included in this study, 20 from the point-to-point guide apparatus group and 18 from the free-hand group. There were no significant differences between the two groups in gender, age, injury causes, pelvic fracture type, screws level, and follow-up time (P > 0.05). The average operative time of the guide apparatus group for each screw was significantly less than that in the free-hand group (25.8 ± 4.7 min vs 40.5 ± 5.1, P < 0.001). The radiation exposure times were significantly lower in the guide apparatus group than that in the free-hand group (24.4 ± 6.0 vs 51.6 ± 8.4, P < 0.001). The intraosseous and juxtacortical rate of screw placement (100%) higher than in the free-hand group (94.4%). Conclusion The point-to-point coaxial guide apparatus is feasible for assisting the transiliac-transsacral screw in the treatment of posterior unstable pelvic fractures. It has the advantages of simple operation, reasonable design and no need for expensive equipment, and provides an additional surgical strategy for the insertion of the transiliac-transsacral screw.

Implants for trochanteric fractures in Norway: the role of the trochanteric stabilizing plate—a study on 20,902 fractures from the Norwegian hip fracture register 2011–2017

Background The trochanteric stabilizing plate (TSP) is used as an adjunct to the sliding hip screw (SHS) in unstable trochanteric and subtrochanteric fractures. We wanted to describe the choice of implant for trochanteric fractures with a focus on the TSP in Norway. Methods A total of 20,902 fractures from the Norwegian Hip Fracture Register treated surgically in 43 hospitals from 2011 to 2017 were included. Logistic regression analyses were performed to detect factors potentially influencing implant choice. Results The mean age was 83 years, and 15,137 (72%) were women. An SHS was used in 13,273 (63%) fractures, of them 4407 (33%) with a TSP. Fracture classification was the most important determinant of TSP. In cases where an SHS was used, the odds ratio (OR) for using a TSP was 14 for AO/OTA 31A2 fractures and 71 for AO/OTA 31A3 and subtrochanteric fractures, compared to AO/OTA 31A1 fractures. The probability of receiving a TSP was higher in urban, academic, and high-volume hospitals (OR 1.2 to 1.3) and lower in Central and Northern Norway (OR 0.3 to 0.7). The use of an intramedullary nail (IMN) (n = 7629 (36%)) was also to a degree decided by fracture classification (OR 1.8 to 5.3). However, hospital factors, with OR 0.1 to 0.4 for IMN in academic, urban, and high-volume hospitals and OR 1.5 to 2.6 outside South-Eastern Norway (all p < 0.001), were also important. Conclusions Fracture classification was the main determinant for TSP use. Any additional benefit from a TSP on postoperative fracture stability or clinical outcome needs to be clarified.

Efektifitas Teknik Distraksi Musik Klasik Mozart Untuk Mengurangi Nyeri Pada Pasien Post Operasi Fraktur

Most fractures are caused by traffic accidents with an estimated number of fractures in the world between 1 and 2.9 million with different age classifications. Each fracture will always undergo surgery followed by administering analgesics to reduce pain during the surgery. Non-pharmacological management to deal with pain consists of various physical treatment measures including skin stimulus, electrical nerve stimulation of the skin, acupuncture. The purpose of the study was to assess the effect of giving classical music mozart in reducing fracture pain in the Dahlia Room of Arifin Achmad Hospital Pekanbaru. Quasy Experiment Research Design, non randomized control group pretest postest design. The research sample was 30 respondents, with a sampling technique accidental sampling. The study was analyzed univariately and bivariately with the Wilcoxon and Man Whitney test. Testing the reduction in the degree of fracture pain in the control and experimental groups obtained the mean value of the experiment 6.71 post experiment 2.66 control value pre 6.35 and control post 6.48 with a value of ρ value 0.000 means that there is an influence of giving classical music mozart to fracture pain. Hopefully it can be used as a reference in providing mozart classical music distraction techniques to reduce pain in postoperative fracture patients