OPTIMALISASI TEKNIK PEMERIKSAAN RADIOGRAFI FEMUR PADA PASIEN POST ORIF KASUS FRAKTUR DI INSTALASI RADIOLOGI RSUP DR. SARDJITO YOGYAKARTA
DOI:
https://doi.org/10.51878/healthy.v5i4.15177Keywords:
Fraktur Femur, Post ORIF, Radiografi Femur, Lateral Cross-Table, Cephalad 35°Abstract
ABSTRACT
Femoral fractures following Open Reduction Internal Fixation (ORIF) require radiographic examination to evaluate implant position, fracture lines, and bone alignment. Pain and limited patient mobility may hinder standard lateral projection, necessitating a modified technique. This study aimed to determine the radiographic examination procedure for post-ORIF femur cases, the rationale for using a lateral cross-table projection with a 35° cephalad beam angulation, and the anatomical information obtained. This qualitative study employed a case study approach at the Radiology Department of Dr. Sardjito General Hospital, Yogyakarta. The subjects consisted of three radiographers and one radiologist. Data were collected through observation, in-depth interviews, and documentation, followed by qualitative descriptive analysis. The examination used Anteroposterior (AP) and lateral cross-table projections with a 35° cephalad beam angulation. This modification was applied because pain and limited mobility prevented the use of the standard lateral projection. The 35° angulation provided clearer visualization of the femoral head, femoral neck, proximal femur, implant, fracture line, and bone alignment, while reducing superimposition with the pelvis and contralateral femur. However, the technique resulted in geometric distortion and magnification. A lateral cross-table projection with 35° cephalad beam angulation is an effective alternative to the standard lateral projection in post-ORIF patients, particularly when patient mobility is limited, while geometric distortion and magnification should be considered as technical limitations.
ABSTRAK
Fraktur femur pasca Open Reduction Internal Fixation (ORIF) memerlukan pemeriksaan radiografi untuk mengevaluasi posisi implan, garis fraktur, dan alignment tulang. Nyeri serta keterbatasan gerak pasien dapat menghambat pelaksanaan proyeksi lateral standar sehingga diperlukan modifikasi teknik. Penelitian ini bertujuan mengetahui prosedur pemeriksaan radiografi femur post ORIF, alasan penggunaan proyeksi lateral cross-table dengan penyudutan sinar 35° ke arah cephalad, serta informasi anatomi yang dihasilkan. Penelitian kualitatif dengan pendekatan studi kasus dilakukan di Instalasi Radiologi RSUP Dr. Sardjito Yogyakarta. Subjek terdiri atas tiga radiografer dan satu dokter spesialis radiologi. Data diperoleh melalui observasi, wawancara mendalam, dan dokumentasi, kemudian dianalisis secara deskriptif kualitatif. Pemeriksaan menggunakan proyeksi Anteroposterior (AP) dan lateral cross-table dengan penyudutan sinar 35° ke arah cephalad. Modifikasi ini diterapkan karena nyeri dan keterbatasan gerak pasien tidak memungkinkan lateral standar. Penyudutan 35° menghasilkan visualisasi head femur, femoral neck, femur proksimal, implan, garis fraktur, dan alignment yang lebih jelas serta mengurangi superposisi dengan pelvis dan femur kontralateral. Teknik ini tetap menimbulkan distorsi geometris dan magnifikasi. Proyeksi lateral cross-table dengan penyudutan 35° cephalad efektif sebagai alternatif lateral standar pada pasien post ORIF, khususnya ketika mobilisasi pasien terbatas, dengan tetap mempertimbangkan distorsi dan magnifikasi sebagai keterbatasan teknik.
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