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    ROTATOR CUFF INJURY  Hilwy Al Hanin

    REFERAT

    Pembimbing: dr. Gatot Ibrahim W, Sp.OT Fakulta !edokteran "ni#erita Triakti

    !epanitraan !linik Ilmu $edah RS"% $ekai

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    Anatomi & Fisiologi

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    Anatomi & Fisiologi

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    Anatomi & Fisiologi

    &etter F, 'anen (T. "pper )imb. &etter* +linial A&atom-. nd edition. Philadelphia: Saunder

    Ele#ier/010.p.2013

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    Defnisi

    +idera pada bagian otot atau tendon rotator u4

    %iebabkan oleh trauma, pen-akit degenerati5,

    atau karena hal lainn-a. Suprapinatu paling ering terkena $er#ariai dari mulai acute reversible tendinitis 

    hingga robekn-a tendon uprapinatu,

    in5rapinatu, dan ubapulari.

    6alanga GA. Rotator +u4 In7ur-. In: 8oung ++, editor. 019. ited 01; Feb 10?1@3o#er#ieBa;

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    Epidemiologi

     Pria C anita2   Angka ke7adian meningkat euai

    bertambahn-a uia.2

     Pada 1>21, +odman melakukan tudi autopi pada 9 kada#er dan menemukan complete rupture pada rotator u4 pada 1=2 kada#er. 2

     "ia C90 tahun ekitar 9D dan pada uia

    C0 tahun ekitar 0D. 2

    'ermann S(, Iadpanah !, Sudkamp &P, Sthrom P+. Tear o5 the rotator u4. +aue3diagnoi3treatment. A+TA +hirurgiae Orthopaediae et Traumatologiae +ehol. 01@/1:p.9;3;;

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    Etiologi

    Itoi E. Rotator u4 tear: ph-ial eamination and oner#ati#e treatment. ( Orthop Si. 012/1?.p.1>30@. %OI: 10.100=00;301302@93

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    lasif!asi

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    lasif!asi

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    lasif!asi

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    "atofsiologi

    Perubahan degenerati5 

    $erkurangn-a uplai perdarahan

    +odman men7elakan mengenai ona kritikal padatendon uprapinatu -ang uplai perdarahann-a berkurang Hdipengaruhi uia

    +hroni Impingement S-ndrome

    Proe tulang aromion bergeekan dengan tendon rotator u4. $erhubungan dengan klaiJkai bentuk aromion menurut $igliani dan 6orrion

    6alanga GA. Rotator +u4 In7ur-. In: 8oung ++, editor. 019. ited 01; Feb 10?1@3o#er#ieBa;

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    #e$ala linis

    &-eri  anterior dan lateral bahu, beri5at tumpul, progrei5, makin berat

    ketika malam=tidurSulit menggerakkan bahu terutama ketika ele#ai

    Ototn-a teraa lema

    'ermann S(, Iadpanah !, Sudkamp &P, Sthrom P+. Tear o5 the rotator u4. +aue3diagnoi3treatment. A+TA +hirurgiae

    Orthopaediae et Traumatologiae +ehol. 01@/1:p.9;3;;

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    "eme%i!saan Fisi! 

    Itoi E. Rotator u4 tear: ph-ial eamination and oner#ati#e treatment. ( Orthop Si. 012/1?.p.1>3 0@. %OI: 10.100=00;301302@93

    )ook

    • $engkak • Tanda

    inKamai • AtroJ • $entuk

    aimetri

    Feel

    • Palpai tendon   apakah teraba de5ek, n-eri tekanL

    6o#e HRO6

    • E#aluai gerak akti5 dan pai5 HRO6. Apakah terdapat

    n-eri aatgerakanL • Ele#ai >03

    10M biaan-a

    akan teraa

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    "eme%i!saan 's's

    Suprapinatu

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    "eme%i!saan 's's

     In5rapinatu

    Dropping sign or external rotation lag sign. The patient is asked to keep the arm in external

    rotation. On the intact side (a), the patient can keep the arm in external rotation position when the

    examiner lets the arm go. On the involved side (b), the patient cannot keep the arm in external

    rotation, and the arm comes back to the neutral rotation after the examiner lets the arm go

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    "eme%i!saan 's's

     Tere minor

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    "eme%i!saan 's's

    Subapulari

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    "eme%i!saan 's's

    Subapulari

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    "eme%i!saan 's's

     Impingement

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    "eme%i!saan "en'n$ang

    Rontgen houlder  2 poii HAP, outlet #ie, tranaillar- #ie tidak memperlihatkan apa3apa, han-a dapat e#aluai bentuk aromion Houtlet #ie.

    "SG  ona hipoehogenik 6RI  paling baik

    'ermann S(, Iadpanah !, Sudkamp &P, Sthrom P+. Tear o5 the rotator u4. +aue3diagnoi3treatment. A+TA +hirurgiae Orthopaediae et

     Traumatologiae +ehol. 01@/1:p.9;3;;

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    Diagnosis (anding

    Aromiola#iular 7oint in7ur- $iipital tendoniti 

    +er#ial radiulopath- 6+I=Angina petori

    6alanga GA. Rotator +u4 In7ur-. In: 8oung ++, editor. 019. ited 01; Feb 10?1@3o#er#ieBa;

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    "enatala!sanaan

    • &SAI% oral • In7eki kortikoteroid • Fiioterapi

    &on3operati5 

    •  Tendon repair •  Tendon tran5er

    Operati5 

    • Arthroopi • Open Surgial • AS%

     Teknik operai

    6oore %. Rotator +u4 Tear. 01. ited 01; Feb 10

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      U-shaped tears

    Interval Slide

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    'ermann S(, Iadpanah !, Sudkamp &P, Sthrom P+. Tear o5 the rotator u4. +aue3diagnoi3treatment. A+TA +hirurgiae Orthopaediae et Traumatologiae +ehol.

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    ompli!asi

    Rekureni paien dengan uia C;9 tahun adalah 5aktor riiko tinggi untuk mengalami kekambuhan.

    Angkan-aL Froen houlder 6enurunn-a RO6 Hter7adin-a

    kekakuan=stifness  Axillary nerve injury  Suprascapular nerve injury 

    6oore %. Rotator +u4 Tear. 01. ited 01; Feb 10

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    "%ognosis

     Tingkat keembuhan paien etelah idera bergantung pada tae -ang

    dialami dan uia paien terebut. Tingkat keberhailan dengan terapi koner#ati5 ekitar 23?0D

     Terapi operati5 ekitar >?D menghilangkan keluhan n-eri -ang dialami oleh paien.

    Itoi E. Rotator u4 tear: ph-ial eamination and oner#ati#etreatment. ( Orthop Si. 012/1?.p.1>30@. %OI: 10.100=00;3

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    TERI)A A*IH

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