mobilization will cause a malfunction of suture. It is caused by the occurence of
tendon connection gap gap formation caused by frequent early mobilization.
Gap connection tendon, which is too large and occurence of re rupture in the
tendon that spliced, indicating the function of sutures, it is influenced by
the technique of tendon sutures, material and size of the thread, and the ability of
biological and mechanical of the tendon in the early stages of tendon healing, as
described by Surya at the above the Kessler Modification KM technique
using two types of threads namely proline threads 4.0 and 6.0, where
proline thread 4.0 is large enough so that facilitates the tear in the fibers of tendon
that may cause the re-rupture. In addition to the size of the thread used
that influence the strength of the tendon suture technique is early mobilization
can accelerate the formation of the connection gap, so the tendon that had
been sutured have possibility could experience rupture again. However,
early mobilization is also has very techniques, that includes in category of
strong because the formed strength in this research is 1.1 kgf.
5. Diameter of Tendon Pre - Post Technique of Samu Modifikasi SM
Based on Table 5.7 can be known that of all samples that exist in the
treatment group, Samu Modification techniques SM most has different of
pre post diameter 0,2 cm.
Tendon suturing techniques, which has a slim shape tendon connection, it
will not disturb the process of the tendon gliding in the tendon sheath, while the
shape of the protruding connection will disturb the tendon gliding process
Surya, 2004.
The formation of tendon diameter caused by the formation of tendon
connection gap. The greater the gap tendon connection is formed, the larger
the diameter of the tendon is formed, this is due to the release of tissue, from
the tendon gap, thus forming a new tissue outside of the tendon. In the
sutures technique Samu Modification
important role in preventing the
SM, there are changes in the tendon of adhesion, because with early
mobilization, tendon that has been stitched or spliced avoid the occurrence
of adhesions between tissues that are not yet ripe with tissue in the surrounding of
the tendon so it will disturb the glidding process or the movement of the tendon.
In this research, the mobilization performed to the the tendon that has
spliced, in the form of the load continuously, it will provide action and
tendons are interested to form a gap, even experience rupture again. The
0.2 cm before and after sutured because in the technique of Samu Modification
SM there is a little puncture sutures so allowing the occurence of adhesion
to the tendon. The more adhesion is formed, the sutures technique is not
effective, because adhesion will affect the tendon gliding, so the tendon
function is not back to normal. In addition to the size of the thread used
that influence the strength of the tendon suture technique, the early mobilization
can accelerate the formation of the
action that fucntion as an early connection gap, so the tendon that had
mobilization, where the technique of Kessler Modification KM experienced
the gap formation at the load average of 600 grams and disconnected in the load
average of 1000 grams or 1 kg, so it can be said that the strength of Kessler
Modification KM technique on this research is include in category of quite
strong because of the strength of the technique is 1 Kgf, it is slightly different
from Samu Modification SM
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been spliced has possibility could experience hte rupture again. However,
early mobilization is also has very important role in preventing the
adhesion, because with early mobilization tof endon that has been
stitched or spliced avoid the occurrence of adhesions between tissues that are not
yet ripe with tissue in the surrounding of the tendon so it will disturb the
gliding process or the movement of the
tendon. In this research, the mobilization that provided tothe tendon that has been
spliced in the form of providing the load continuously, it will give action and
tendons are interested to form a gap, even experience rupture again. In this
research, the difference of tendon before and after sutured, is assessed in the
analysis II, the analysis is to identify the leffectiveness level of sutures
tendon
prepost test
0,2 cm so that includes in category of quite effective.
The effectiveness or success in the implementation of orthopedic surgery,
especially in the tendon grafting, depending on the sutures technique,
which is used. However, the use of the sutures technique should pay attention to
the situation, the conditions and the shape or size of the tendon itself Surya,
techniques. As we know that function is 2004.
In this research Samu as shortening the muscle tendon, the
tendon moves to point to the bottom of the foot. This is the action that allows a
Modification techniques SM includes in category of quite effe0ctive in
connecting tendons so that it can be used person to stand on ones feet, run, jump,
in surgery, especially orthopedic
walk normally, and to go up and down stairs, in addition to the function is to
bend and stretch the tendon all joints and muscles to hold the bone. Without
tendons, muscles will just be a large gathering in the field and will not be
able to move. So the greater the adhesion, the more interrupted the
process of gliding or the movement of the tendon. If that happens then the
function of the tendon will not be optimal. In this research adhesion that
formed in Samu Modification techniques SM is quite large when
compared with Kessler Modification technique SM. The good splicing of
the tendon will either be able to restore the continuity of the tendon without
causing adhesions or adhesions between the tendosn with tissue surrounding the
tendon, and form of connections that could hinder the tendon gliding. The
success of tendon grafting surgery, and rehabilitation or tendon healing process,
especially the formation of adhesions, which was instrumental is the torn of
tendon sheath, sutures techniques and mobilization. The more severe the
tendon tear, the more possibility the formation of adhesion in tendon that
has been sutured.
6. Effectiveness of Samu Modification SM suture technique
Based on Table 5.7 can be known that of all samples that exist in the
treatment group, Samu Modification techniques SM most has different in
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surgery. The effectiveness of this sutures technique is assessed from the formation
or changes in diameter. The tendon sutures technique is said to be effective
if the change in diameter before and after sutured is minimal, so as to
prevent the adhesion formation in the tendon. The formation of tendon
diameter was one caused by the formation of a connection. The bigger
the gap connection is formed, the greater the possibility of adding diameter are
formed. This is caused by the discharge of immature tissue from the tendon itself
and formed adhesions or adhesions with existing tissues around the tendon. In
this research, the suture technique of Samu Modification SM includes in
category of effective, that if we compare it with Kessler Modification technique
KM, the result is Kessler Modification technique KM is more
effective. According to researchers it happened because in this research, the
sample used was roaster with its tendon size is much smaller than the size of a
human tendon, so that the thread that used should use a smaller size.
However, Samu Modification techniques SM has a its own advantage
that an atraumatic and simple techniques making it easier for the nursing
profession or other surgeons to do so. Considering the tendon rupture cases
that including the critical cases , then requiring critical action that is fast and
precise, so that for the researchers, this Samu Modification techniques SM is
