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CHAPTER I

INTRODUCTION
1.1 Background
technological developments in the medical world, especially in the increasingly sophisticated
field of radiology is helpful in making an imaging anatomy drawings are required as
enforcement melakuakan diagnosis may facilitate the diagnosis of a disease.
so many things that support for the enforcement of the diagnosis with the help of one of them
is the investigation of X-ray examination. as we know the X-ray examination plays an
important role in diagnosing a disease.
Based on her description above, the authors are interested in observing more about it by
creating a case study entitled "radiographic technique with fracture of the os pedis in the
installation falanx 1 Hospital Dr. Hi. Abdul Moeloek Bandar Lampung.

1.2 formulation of the problem


based on the background on a formulation of the problem arises is "how radiographic
technique with an indication of fracture of the os pedis falanx 1 in the installation of Abdul
Moeloek Hospital radiology Bandar Lampung ".
1.3 purpose of the study
know the os pedis radiographic techniques
know the pathology of X-ray image with an indication of fracture of the os pedis falanx 1
dextra.
1.4 benefits of research
expected in this study may increase knowledge and broaden horizons for writers and readers
of the radiographs with a case of fracture of the os pedis in falanx 1 and also help to provide
medical information that could assist in proper diagnosis.

CHAPTER II
REVIEW REFERENCES
2.1 Anatomy
Falangus (toe joint) is a short pipe bones, each consisting of 3 segments except the thumb on
the metatarsal segment number 2 of the thumb there are two small bones called the round
shape grains (sesamoid bone).
Arch. there are four arches in the feet. The medial arch is formed from behind forward
calcaneus. The lateral arch is in the form of the calcaneus kuboidea and second metatarsal
bones.
Talus bone or skip the center and highest point of the soles of the feet. This supports the tibia
and the bone on each side of the hinge with the malleolus, under the calcaneus.
Navikular, (bones form the ship) was next to the medial leg, anatartalus bone adjacent to the
rear and three front kuneiform.
Kuneiform three bones, (the bone wedge shape), jointed with the posterior and anterior
navikular with three of the medial metatarsal bone.
Cuboidal or bone dice was next to the left lateral posterior calcaneus and he is jointed with
the second metatarsal bone in front of the adjacent lateral.
Metatarsal Bones, there are five metatarsal bones. This bone-bone tramp pipe with a

rod and two ends. The proximal end or distal end jointed with the tarsal bones. Falangeal
distal end or proximal falanx jointed with the base. The first metatarsal is a dumpy second
longest metatarsal.
Falanx-falanx it with your fingers but shorter.
Arch in the foot There are four arches in the feet. Or internal medial arch is formed from
back to front by the calcaneus, which is a supporter of the posterior arch of the talus to the top
of the arch and the third metatarsal head of right anterior support in the form of the arch.
Curved lateral or outer longitudinal arch formed by the calcaneus, cuboidal and two outer
metatarsal bones.
Transverse arch there are two, namely the transverse tarsal arch formed by the tarsal bones
and the transverse metatarsal arch is usually known as the anterior transverses arch, formed
by the heads of the bone. The first and fifth bone is the long axis of the arch. In normal
circumstances this arch almost touching the ground when standing, but when it got a leg in
the rest firmer shape.
2

Leg bones held together by liagamen and supported by muscle. These arches can persist
because:
The location of the bone-wanderer who huddle in a harmonious strong ligaments in the foot.
The transverse metatarsal arch in the shape of the tarsal bones, and the anterior transverse
arch in the form of the first metatarsal head and fifth wanderer.
Anatomy is seen in the picture pedis photo are:
a. AP (anterior posterior)
1. distal phalanges
2. medial phalanges
3. proximal phalanx
4. metatarsal
5. Kunieform
6. Navikular
7. cuboidal
8. Talus
9. Calcaneus
b.

lateral
1. tibia
2. fibula
3. malleolus
4. Talus
5. Navikular
6. calcaneus
7. Kuneiform
8. cuboidal
9. Lateral longitudinal arch
10. Metatrsal
11. distal phalanges
12. proximal phalanx
13. The transverse arch
14. Medial longitudinal arch.

2.2 Pathology
Fraktur is breaking the continuity of the bone because of defects or diseases that
menyebabkan weakness in the bones. The cause of fracture because of hard knocks.
Dislocations are shifting from the original bone or shell.
2.3 Examination Techniques
To obtain optimal radiographs needed the right position to help establish the diagnosis.
The position is made for the examination technique of the os pedis, namely:
2.3.1 The position of the anterior posterior
Position the patient

: the patient put on an exam table.

Object position

: place the tape under the foot and fleksikan knee, strained his leg

about 6 inches.
Central ray

: vertical perpendicular to the tape.

Central point

: the object beam is directed at the middle

Cassette

: 24 x 30 cm

FFD

: 100 cm

Marker pairs

:R/L

Eksposi factors

: kV, depending pada ketebalan mas object.

Criteria image

: the picture will show 14 falanx toes, the distal, metatrsal.

2.3.2 Lateral Projection


Position the patient

: the patient is placed on an exam table and point it at the side of the

check to the lateral leg and foot.


Position of the object : straighten your knees to get the patella perpendicular to the
horizontal plane, fleksikan enough to put a foot on the lateral surface.
Central ray

: vertical perpendicular to the metatarsal III

Central point

: the object beam is directed at the middle

Cassette

: 24 x 30 cm

FFD

: 100 cm

Marker pairs

:R/L

Eksposi factors

: kV, depending on the thickness of the gold objects.

Criteria image

: metatarsal is almost a superposition of overlap with the posterior

tibia, distal leg look.

CHAPTER III
METHODOLOGY

3.1 Sources of data


Sources of data in this study came from the literature dealing with the case study as well as
direct observation on examination the os pedis with an indication of fracture.
3.2 time and place of study
The research was conducted at the Hospital radiology installations abdul Moeloek Bandar
Lampung on the implementation of a practice field that began on October 03 semptember 31.
3.3 tools and materials
a. plane X-ray
Type: Conventional
Brand: Acoma X-Ray
b. Tape measuring 24 x 30 cm
c. Marker left (L)
d. Proccesing automated film

CHAPTER IV
RESULTS AND DISCUSSION
4.1 the results of research
4.1.1 the identity of patients
Name

: XX

Age

: 27 years

Address

: Cape coral

Gender

: Male

Type checking : Ossa pedis


Indications

: Fracture of the left distal falanx 1

Examination number: 26 387


4.1.2 examination techniques
On radiographic examination performed routinely include a photo with the position of antero
posterior and distal.
a. Antero posterior projection
Position the patient

: the patient is asked to sit on the edge of the examining table

Object position

: place the tape under the foot and flexion of the right knee, strained

his leg about 6 inches.


Central ray

: ventrikal perpendicular to the cassette

Central point

: the object beam is directed at the middle

Eksposi factors

: use of 40 kV and 8 mas

FFD

: 100 cm

Marker pairs

:R/L

Cassette

: 24 x 30 cm

Film

: 24 x 30 cm

b. lateral projection
Position the patient

: the patient is asked to sit on the edge of the examination table

Position of the object : straighten your knees to get the patella perpendicular to the
horizontal plane, fleksikan enough to put a foot on the lateral surface.
Central ray

: vertical upright

Central point

: the object beam is directed at the middle

Eksposi factors

: use of 40 kV and 8 mas

FFD

: 100 cm

Marker pairs

:R/L

Cassette

: 24 x 30 cm

Film

: 24 x 30 cm

4.2 discussion
Shooting Ossa pedis with anteroposterior and lateral radiographic techniques in addition to
supporting the diagnosis will be obtained that optimal radiographs, which means can provide
further information for purposes of diagnosis.
An explanation of the criteria with images obtained:
a. anteroposterior position
Ossa pedis include the overall picture without overlap and superposition.
b.lateral position
Include a picture of lateral, Ossa, especially on the superposition pedis and tarsal
metatarsal.
Ossa pedis done a photo shoot produced by ekspertise radiology (Dr. Karyanto, Sp.
Rad) that fracture occurs at a dextra falanx.

CHAPTER V
CLOSING

5.1 conclusions
A. Radiographic examination indicated Ossa pedis with a fracture of the falanx dextra
can be done with two anteroposerior and lateral position.
2. Indication of the cause of trauma.
5.2 advice
Given the very berbahay radiation to the body then the radiographers must understand
how to protect themselves, patients, and the general public around the installation of
radiological exposure by limiting the area, set the shooting conditions according to the
thickness of the patient and to avoid repetition of the shooting.
In this examination of the patient should always use a radiation shield, at least for
memininalisasi radiation received at the time of the shooting. Patients are expected to
follow the implementation of a good examination in order to avoid repetition of the
shooting.

REFERENCES

Ballinger W. philip. 1949.


Merrills atlas of radiographic positions and radiologi procedure, Vol. 1 first
edition.
Pearce, evelyn C. 1998.
Anatomy and physiology to paramedic students, PT. Gramedia Pustaka Utama :
jakarta.
Suhartono and hidayat syarif putra eka. 2002.
Upper extremity radiography technique, EGC : jakarta.
Syaifuddin. 1992.
Anatomy and physiology for nurses, EGC : jakarta.
Shell S. Richard. 2006.
Clinical anatomy for medical students. Edisi 6.