Penurunan Kekuatan Tulang dan Peningkatan Resiko Fraktur terhadap Gaya Bending dan Torsional Akibat Pencabutan Screw yang Patah dengan Hollow Reamer

Penulis Utama : Dr. Najmudin
NIM / NIP :
× Background : Broken screw can often be identified on preoperative radiograph, but it may also be encountered unexpectedly during surgery. Broken screw removal can be a time-consuming process, and no single technique is uniformly successful. Special tools are needed for removing stripped or broken screw. When the broken screw should be removed, the surgeon and patients face increasing potential risk of fracture. The aim of this study is to understand and to compare the potential risk of fracture when a broken screw is removed or leaved. Method : This biomechanics study was conducted in 120 bones, devided in 2 groups. Group A-60 tibial sheep bones, each with six 3,5 mm cortical screws. Group B-60 tibial cow bones, each with eight 4,5 mm cortical screws. All the bones are measured and compared to those of the diameter of 20-40 years-old man radius and tibial bones. The over- and undersized bones will be discarded. Then every group was divided in 3 sub-groups and receive 3 different kinds of interventions, each with 20 bones : 1 - Removal of all screw without broken screw like routine plate & screw removal 2 - Removal of all screw with one broken screw left 3 - Removal of all screw with one broken screw taken by hollow reamers and extraction bolts so that creating a large cortical bone defect. Then every sub-group (20 bones) was tested quantitatively using 2 different machines. 10 bones were tested with bending machine. Bending loads will be given until the bone fractured. The other 10 bones were tested with torsional machine. Torsional loads will be given until the bone fractured. The minimum force that makes the bone fractured was recorded and analysed for each subgroup with one-way Anova method of statistics with α=0,01. Result : Statistical analysis using software SPSS (one-way Anova), the study shows that : There is a significant difference (p<0,01) between all the bone and the intervention (divided in 12 subgroup), except for the tibial sheep bone given torsional force (subgroup 5 and 6), that no significant difference between removed and leaved broken screw. Conclussion : A broken screw, either removed or leaved, will decreased the bending or torsional force to break the bone. It also decreased the bone strength. The decreased is much higher when it was removed with hollow reamer. At the other side, the removal of broken screw increased the fracture risk compared to those of normal plate-screw removal and leaved broken screw. Keyword : Bone Strength, Broken Screw Removal, Hollow Reamer, Refracture Risk
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Penulis Utama : Dr. Najmudin
Penulis Tambahan : -
NIM / NIP :
Tahun : 2010
Judul : Penurunan Kekuatan Tulang dan Peningkatan Resiko Fraktur terhadap Gaya Bending dan Torsional Akibat Pencabutan Screw yang Patah dengan Hollow Reamer
Edisi :
Imprint : Surakarta - F. Kedokteran - 2010
Program Studi : -
Kolasi :
Sumber : UNS-F. Kedokteran Jur. Dokter Spesialis-2010
Kata Kunci :
Jenis Dokumen : Disertasi
ISSN :
ISBN :
Link DOI / Jurnal : -
Status : Public
Pembimbing : 1. Dr. Iwan Budiwan Anwar Sp.OT
Penguji :
Catatan Umum :
Fakultas :
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