Platelet-Rich Fibrin Enhances Fracture Healing in Tibial Long Bone: An Experiment in Rabbit

Background: Fracture on long bone is a complicated case to manage. Bone graft procedure involving growth factors has been widely studied with promising results. Recently, platelet-rich fibrin (PRF) has been introduced as having potential in healing process. This study aimed to explore the quality of fracture healing on long bones treated with bone graft with and without PRF combination.Methods: This study was conducted between October to November 2018 on 18 rabbits that were divided into 2 groups. A 5 mm fracture was created on tibial bones and the fracture was stabilized using a 2.0 mm mini plate. The defect was then treated by an autogenic bone graft with and without  PRF. Histological analysis was conducted 3 weeks after the treatment and a scoring was performed using the Salkeld system. The quality of union; cortex development and remodeling; and bone graft incorporation and new bone formation were then analyzed.Results: There were significant differences between fractures in rabbits given PRF than those without PRF in terms of  union quality (p 0.040), cortex growth and remodeling (p 0.0001), bone graft and new bone union (p 0.0001), as well as in the total Salkeld score (p 0.0001).Conclusion: PRF given with bone graft therapy can enhance the quality of fracture healing of a long bone. Further studies on how the PRF content influences fracture healing process needs to be performed to further explore this effect.

Hubungan antara Akseptabilitas X-Ray Servikal Lateral dengan Tingkat Kesadaran dari Pasien Cedera Kepala di RS Hasan Sadikin

LATAR BELAKANG Fraktur, subluksasi dan dislokasi servikal sering luput akibat dari gambaran xray servikal yang tidak adekuat sehingga pentingnya memahami korelasi antara akseptabilitas x-ray servikal lateral dengan tingkat kesadaran dari pasien-pasien cedera kepala adalah agar dapat menghindari hasil xray servikal lateral yang tidak adekuat, terutama pada pasien cedera kepala. Tujuan penelitian ini ntuk mengetahui hubungan antara akseptabilitas x-ray servikal lateral dengan tingkat kesadaran dari pasien-pasien cedera kepala METODE Analisa retrospektif pada pasien-pasien trauma yang datang ke RS Hasan Sadikin pada periode waktu Januari 2016 – Januari 2017. Akseptabilitas dari x-ray servikal lateral berdasarkan tampaknya dari seluruh tulang servikal dan celah C7-T1. Pasien-pasien cedera kepala dibagi menjadi 3 kelompok berdasarkan skor GCS (Ringan, sedang, dan berat). Hubungan antara akseptabilitas hasil x-ray servikal dengan tingkat kesadaran pasien diukur menggunakan tes Chi-square dengan SPSS 24 untuk Windows. HASIL Terdapat 137 sampel, dengan dominasi laki-laki (78.50%) dan rerata usia 44 tahun. Pasien umumnya memiliki GCS > 13 (76 pasien). X-ray servikal lateral yang akseptabel sebanyak 39 (28% dari seluruh kasus cedera kepala; ringan (35) 90%, sedang (4) 10% dan berat (0) 0%. X-ray servikal lateral yang tidak akseptabel sebanyak (98) 72%; ringan (76) 78%, sedang (19) 19% dan berat (3) 3%. SIMPULAN Tidak terdapat korelasi yang bermakna antara akseptabilitas x-ray servikal lateral dengan tingkat kesadaran pasien cedera kepala (p=0.072) pada penelitian ini. Beberapa faktor seperti kesalahan teknis saat pemeriksaan radiografi dan keberagaman postur pasien mungkin berperan.Kata Kunci:  Xray Servikal Lateral, Akseptabilitas, Cedera Kepala, Tingkat Kesadaran BACKGROUND Cervical fractures, subluxation and cervical dislocation are often missed due to inadequate cervical xray images, thus the importance of understanding the correlation between acceptability of the lateral cervical x-ray with the level of awareness of head injury patients is to avoid the results of inadequate cervical xray, especially in patients with head injuries. The purpose of this study was to determine the relation between acceptability of lateral cervical x-ray with the level of awareness of head injury patients METHODS Retrospective analysis in trauma patients who came to Hasan Sadikin Hospital in the period of January 2016 - 2017. Acceptability of x-ray Lateral cervical based on the view of the entire cervical bone and C7-T1 space. Head injury patients were divided into 3 groups based on GCS scores (mild, moderate and severe). The relation between acceptability of lateral cervical x-ray with the level of awareness of head injury patients was measured using the Chi-square test with SPSS 24 for Windows. RESULTS There were 137 samples, with male dominance (78.50%) and average age of 44 years. Patients generally have GCS> 13 (76 patients). Acceptable lateral cervical x-rays are 39 (28% of all cases of head injury; mild (35) 90%, moderate (4) 10% and severe (0) 0%. Non-acceptable lateral cervical x-rays (98) 72%; mild (76) 78%, moderate (19) 19% and severe (3) 3% CONCLUSION There is no significant correlation between acceptability of lateral cervical x-ray with the level of awareness of head injury patients (p = 0.072) on this study: Several factors such as technical errors during radiographic examination and diversity of patient postures may play a role.Keywords: Lateral Cervical Xray, Acceptability, Head Injury, Level of Awarenes