TEKNIK PEMERIKSAAN RADIOGRAFI OS FEMUR PADA KASUS POST ORIF FRAKTUR FEMUR 1/3 PROKSIMAL DI INSTALASI RADIOLOGI RSUD KOTA SALATIGA

Abstract

ABSTRACT

Proximal one-third femoral fractures are bone injuries that require operative management, one of which is Open Reduction Internal Fixation (ORIF). Postoperative radiographic examination is necessary to evaluate implant position, bone alignment, and the healing process. Limited patient mobility after surgery requires adjustments to the examination technique to maintain diagnostic image quality. This study aimed to determine the examination procedure, rationale for the technique, and its advantages and disadvantages in radiographic examination of proximal one-third femur post ORIF at the Radiology Installation of Salatiga City Hospital. This qualitative study employed a case study approach and was conducted from November 2025 to April 2026. Data were obtained through observation, interviews, and documentation involving three radiographers, an orthopedic specialist, and a radiologist. Data analysis included data collection, processing, presentation, and conclusion drawing. Post-ORIF femur radiography was performed without special preparation using Anteroposterior (AP) and lateral projections with a modified horizontal central ray angled 30° caudad in the lateromedial direction according to the patient's condition. For the lateral projection, the patient's position was maintained as comfortably as possible to reduce pain and the risk of complications. The results showed that the 30° caudad horizontal central ray modification produced a sufficiently diagnostic lateral image in post-ORIF patients with limited mobility. This modification reduced anatomical superimposition and improved visualization of the fracture area and implant without truncation. Therefore, adjustments to patient positioning and exposure technique can produce optimal diagnostic images while improving patient comfort. This technique maintains image quality, allowing optimal evaluation of the femoral structure and implant.

ABSTRAK

Fraktur femur 1/3 proksimal merupakan cedera tulang yang memerlukan penanganan operatif, salah satunya Open Reduction Internal Fixation (ORIF). Pemeriksaan radiografi pascaoperasi diperlukan untuk mengevaluasi posisi implant, keselarasan tulang, dan proses penyembuhan. Keterbatasan mobilitas pasien pascaoperasi memerlukan penyesuaian teknik pemeriksaan agar tetap menghasilkan gambaran diagnostik. Penelitian ini bertujuan mengetahui prosedur pemeriksaan, alasan penggunaan teknik, serta kelebihan dan kekurangan pemeriksaan radiografi femur 1/3 proksimal post ORIF di Instalasi Radiologi RSUD Kota Salatiga. Penelitian menggunakan metode kualitatif dengan pendekatan studi kasus yang dilaksanakan pada November 2025 sampai April 2026. Data diperoleh melalui observasi, wawancara, dan dokumentasi terhadap 3 radiografer, dokter spesialis ortopedi, dan dokter spesialis radiologi. Analisis data meliputi pengumpulan, pengolahan, penyajian data, dan penarikan kesimpulan. Pemeriksaan os femur post ORIF dilakukan tanpa persiapan khusus menggunakan proyeksi Anteroposterior (AP) dan lateral dengan modifikasi central ray horizontal menyudut 30° caudad arah latero-medial sesuai kondisi pasien. Pada proyeksi lateral, posisi pasien dipertahankan senyaman mungkin untuk mengurangi nyeri dan risiko komplikasi. Hasil penelitian menunjukkan bahwa modifikasi central ray horizontal 30° caudad mampu memberikan gambaran lateral yang cukup diagnostik pada pasien post ORIF dengan keterbatasan mobilitas. Modifikasi tersebut mengurangi superposisi struktur anatomi dan memperjelas area fraktur serta implant tanpa terpotong. Dengan demikian, penyesuaian posisi dan teknik penyinaran dapat menghasilkan gambaran diagnostik yang optimal sekaligus meningkatkan kenyamanan pasien. Teknik ini mempertahankan kualitas citra sehingga evaluasi struktur femur dan implant dapat dilakukan secara optimal.