RADIOGRAPHY TECHNIQUE OF OSSA PELVIS WITH SUSPECTED FRACTURE OF RAMUS PUBIS AT EFARINA ETAHAM HOSPITAL BERASTAGI KARO DISTRICT 2021

Fracture is a broken bone, a break in bone tissue that is commonly caused by forced injuries. The cause of fracture is an accident, be it a work accident, traffic accident. Broadly speaking, fractures are divided into three types, namely closed fractures, closed fractures, and complex fractures. The examination aims to determine the results of radiographic images, if there is a fracture or dislocation and is caused by KLL factors (traffic accidents). The aim of the study was to find out how the radiographic examination technique of Ossa Pelvis with the suspicion of a Ramus Pubis Fracture at the Radiology Installation of Efarina Berastagi Hospital in 2021. This type of research is descriptive research with data collection techniques by observation, documentation study and literature (library) study. The results of the examination of the Ossa Pelvis with the suspicion of a Ramus Pubis Fracture at the Radiology Installation of Efarina Etaham Berastagi Hospital are generally using AP (Anterior Posterior) projections using conventional X-rays. The x-ray film used is a high speed type combined with a fast screen intensifying (IS) where this type of intensifying screen (IS) film can produce images with good detail and sharpness. Thus the radiation dose can also be reduced for the patient and the operator himself. The film washing process should use Automatic Processing. It is hoped that it can be used as a reference for radiographic results, especially in cases of Ramus Pubis Fractures.


INTRODUCTION A. Background
Fracture is a termfrom loss of continuity of bone, cartilage, either total or partial. In summary and in general, fractures are fractures caused by trauma or physical exertion (Helmi, 2012). According to Wahid, 2013 Fracture is a break in bone tissue which is commonly caused by force majeure. The cause of a fracture is an accident, be it a work accident, traffic accident and so on. According to Noor Zairin 2016 Pelvic ossa fracture is a disconnection of the pelvic bones, either the pubic bone or ilium bone caused by a trauma or collision. Radiological examination is a very appropriate examination to determine the anatomy and physiology of an organ so that abnormalities in pathology and trauma can help in making a diagnosis. From the research that the authors have done, there are many cases of pelvic fractures or broken bones. So the authors conducted research on "Radiographic Examination Techniques of Ossa Pelvis with Suspected Ramus Pubic Fractures at Efarina Etaham Berastagi Hospital, Karo Regency 2021". Screen (IS) can produce images with good detail and sharpness. Thus the radiation dose can also be reduced for the patient and the operator himself. The x-ray film washing process used should use Automatic Processing. B.
Formulation of the problem In making this paper, the author will formulate the problems that arise in the examinations carried out, these problems can be formulated: For Institutions a.
Educational Institution Can be used as a reference material for literature, especially on Ossa Manus Fractures and can also be used as reading material to support the teaching and learning process b.
Hospital Institution As input material in carrying out radiology services that are oriented to health problems in order to meet basic human needs to improve the quality of radiology services for patients, especially for Ossa Manus Fracture patients E.

INTRODUCTION
Filled with the background of the problem, the scope of writing, the formulation of the problem, the purpose of the examination, the writing method, and the contents of the writing.

THEORETICAL REVIEW
• Contains a description of the basic concepts which include the notion of examination, anatomy, physiology and pathology, radiological aircraft engineering, radiodiagnostic physics, radiation protection, and x-ray film processing. Meaning of Inspection Radiological examination is one of the examinations that is very necessary in establishing the diagnosis of a disease. Therefore, knowledge of radiology is an important subject in medical education (Bambang, 2014) Pelvic radiography is a radiographic examination process using x-rays. To show the pelvis and evaluate abnormalities in the form of fractures. • Anatomy According to Putri Dafriani 2019 in her book Anatomy is a science that studies the structure of the body and the relationships between them. According to Asih Puji Utami, Sudibyo Dwi Saputra and Fadli Felayani 2014 in their book Pelvis functions to connect the spine to the lower extremities, the pelvis is composed of four bones namely, two hip bones (also called coxae or innominate), one sacrum bone and one cocigeus bone. The parts are as follows: • Coxae The coxae consist of three parts: the ilium, ischium and pubis. The acetabulum is a deep cavity where the femoral head joints. The ilium is the largest part of the coxae, located superior to the acetabulum. The ischium is inferior and posterior to the acetabulum and the pubis is inferior and anterior to the acetabulum. (Asih Puji Utami, Sudibyo Dwi Saputra, Fadli Felyani, 2014) • Ilium It consists of two parts, the corpus and ala/wing. The body of the ilium lies more inferiorly close to the acebatulum and the superior two-fifths of the acetabulum is part of the corpus coxae. Ala is the thin and wide part located on the superior side. The upper edge of the ilium is called the cristae which extends from the anterior angle or is called the Anterior Superior iliac Spine The last part of the coxae is the pubic bone. The body of the pubis lies inferior and anterior to the acetabulum. One-fifth of the acetabulum. Leading anteriorly and medially from the body of each pubis are the superior rami. The two sides of the superior ramus meet in the middle which is a joint and can move called the symphysis pubis. In the coxae there is also a large hole which is located surrounded by the acebatulum, ischium and pubis which is called the Obturatorium Foramen. This foramen is the largest foramen in the human body. ( (2003) in her book Physiology is the science that studies the functions of a living body, such as anatomy and physiology which also cover special areas of function of certain organs. • Pathology Pathology is the science or study of disease. In its broadest meaning, pathology is literally abnormal biology, the study of inappropriate biological processes or the study of sick or disturbed individuals (Price, 2005) According to Farida, Abdurohman, and Yuke 2018 Pathological fractures occur due to an underlying disease so that the bones become porous or not strong, for example in osteoporosis sufferers. Farida, Abdurohman, and Yuke 2018 also stated that in general fractures can be divided into 3 types, namely: • Closed fracture or closed fracture Closed fracture or closed fracture, which is a type of fracture that is not accompanied by an injury to the lu. Understanding Examination Radiological examination is one of the examinations that is very necessary in establishing the diagnosis of a disease. Therefore, knowledge of radiology is an important subject in medical education (Bambang, 2014) Pelvic radiography is a radiographic examination process using x-rays. To show the pelvis and evaluate abnormalities in the form of fractures.

RADIOGRAPHY TECHNIQUES
Radiographic technique is the science that studies how to photograph the object being examined using x-rays to obtain radiographic images, so as to be able to establish a precise and accurate diagnosis (Clark S, 2005) According

B. RONTGEN AIRCRAFT TECHNIQUES
According to Rasad 2005 X-ray aircraft is an aircraft or equipment that can produce x-rays. Where in the medical field it is used as a tool to diagnose and treat a disease. Rasad 2005 also mentions that there are several components of an X-ray machine, namely: 1. X-ray tube X-rays are emission of electromagnetic waves similar to radio waves, heat, light and ultraviolet rays, but with very short wavelengths and X-ray tubes can be seen in Figure  2  Stator (outside insert tube) 5.
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RADIOGRAPHY Complexity fracture Complexity fractures, namely if there are two conditions, for example in the extremity there is a fracture and the joint also has a dislocation.

C. RADIOGRAPHY TECHNIQUES
Radiographic technique is the science that studies how to photograph the object being examined using x-rays to obtain radiographic images, so as to be able to establish a precise and accurate diagnosis (Clark S, 2005) According to Bontrager, 2001 radiographic techniques performed to show pelvic ossa fractures in the pubic ramus are: AP projection • Purpose of examination: Examine pelvic bone radiographs and show fractures, dislocations, degenerative disease and bone lesions. • Patient position: The patient is supine, the arms are placed at the sides and crossed over the chest, for comfort, place a pillow under the patient's head. • Object position: The cassette is arranged transversely, the edge of the cassette is set slightly above the iliac crista, so that the image of the crista is not cut off. The lower edge of the cassette conforms to or slightly below the pubic symphysis. The MSP of the patient's body is aligned in the middle of the cassette. Legs straight, feet internally rotated 15-20 degrees, neck of the femur appears in the longest position (true AP). Ensure that the pelvis is not rotated.

D. RONTGEN AIRCRAFT TECHNIQUES
According to Rasad 2005 X-ray aircraft is an aircraft or equipment that can produce x-rays. Where in the medical field it is used as a tool to diagnose and treat a disease. Rasad 2005 also mentions that there are several components of an X-ray machine, namely:

2.
X-ray tube X-rays are emission of electromagnetic waves similar to radio waves, heat, light and ultraviolet rays, but with very short wavelengths and X-ray tubes can be seen in Figure  2 Stator (outside insert tube) 5.
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Research Locations
The location of this research was carried out at the Radiology Installation of Efarina Hospital, Pangkalan Kerinci, Pelalawan Regency.

Data Checking Techniques
The data inspection technique is secondary data. The method used in writing this scientific paper uses a descriptive method, while the approach used is a case with a technique; 1. Observation and physical examination by direct observation of the client on matters relating to the client's problems.

2.
Documentation studies are carried out by seeking sources of information obtained from the patient's status and matters relating to the patient's problems. Literature study, namely by studying books, papers and other sources to obtain scientific basis related to the fracture of the human os in the 4th and 5th digit proximal phalanges so that the theory can be compared with the implementation in cases in hospitals. In this study, the study observed the implementation of Ossa Manus Radiography starting from the initial examination of the manus with cases of proximal phalangeal fractures to completion.. The patient who was a victim of a traffic accident on April 23, 2021, around 13.00 felt dizzy and had pain in the left hand. With a diagnosis of suspected fracture of the left Manus. On April 23, 2021 the patient was taken to the Radiology room to take a left manus X-ray of the patient. 3. Examination Execution 1). Photo request letter The patient brings a letter requesting a photo of the human ossa with clinical post KLL, then the patient is taken to the examination room and the cover letter is read by the officer (radiographer) and carries out an examination according to the examination procedure. 2). Tools preparation a. X-ray machine used X-ray plane Name

Evaluation of Photo Results
After carrying out a radiographic examination of the human ossa with a suspected fracture, starting from the radiography and the chemical film washing process, the resulting X-rays can be evaluated as follows: a. Evaluation of PA projection examination results 1. An anatomical picture of the human oss is visible from the Postero-Anterior position without superposition 2. Film size 24 cm x 30 cm 3. Image sharpness is sufficient 4. The radiographic image density is sufficient 5. Radiographic image details are sufficient 6. Radiographic image contrast is sufficient b.
Evaluation of the results of the lateral projection examination 1. Anatomical view of the human ossa from the lateral view. A picture of the fracture in the manus is seen 2. Film size 24 cm x 30 cm 3. Image sharpness is sufficient 4. The radiographic image density is sufficient 5. Radiographic image details are sufficient