INTERNATIONAL OF MULTIDISCIPLINARY: APPLIED BUSINESS AND EDUCATION RESEARCH Radiography of Clavicula Os with Suspected Avulsion Fracture in Advent Medan General Hospital

The clavicle is an S-shaped bone that articulates laterally with the acromioma process of the scapula, medially with the manubrium of the clavicular notch to form the clavicular joint. An avulsion fracture is a disconnection of the clavicle bone caused by direct and indirect trauma in the position of the arm being cut off or pulled out (out-stretched hand) because the trauma continues from the wrist to the clavicle. Radiography is an appropriate method to show abnormalities in the os calvicula. The aim is to show the anatomy of the clavicle bone and its abnormalities. This examination uses the Antero-Pos-terior projection. The X-ray aircraft used is GE with a capacity of 500 mA. The tape used is 30 cm x 40 cm. Processing film used is Computed Radiography.


Introduction
Os clavicula is a collarbone that resembles the letter S. The medial arch is larger towards the front, the lateral arch is smaller towards the back. The medial end is related to the sternum and is called the sternal extremity, there is a protrusion small called tuberosity costalist for attaches to the costal clavicular ligament (Gupta & Gupta, 2018;Sofia et al., 2020) . The lateral part is related with acromion (extremity acrominal), there are tuberosity costalist and sulcus subclavicular (Pratistha et al., 2021;Scott et al., 2021).
The clavicle bone serves as a link to several muscles of the neck and shoulders, and thus acts as a support for the arm (Balfousias et al., 2018;Galán-Olleros et al., 2020). Avulsion fracture is a break in the continuity of bone tissue which is generally caused by a forceful, broken bone continuity caused by pressure from outside which come more big from which could absorbed from bone (Munir & Beckmann, 2021). Avulsion is a state of trauma when miss it bone from the place by intact and produce wound complex . Fracture clavicle is the bone on generally happens often _ broken to strength or collision by direct nor IJMABER 1578 Volume 3 | Number 8 | August | 2022 collision by no direct , often occur reason fracture on bone lower and shoulder arm (Kim et al., 2021). If there is an avulsion fracture in the Clavicle , it is difficult for the patient to carry out activities (Babu et al., 2022;Heyworth & Fabricant, 2021). To show abnormalities in these organs, x-rays (radiography) are needed to determine the presence or absence of fractures and their effects on surrounding organs (Palmer et al., 2020;Ferreira et al., 2021). In radiographic examination with suspected clavicle fracture, several projections were made, namely antero-posterior supine, AP erect and postero-anterior erect (Hanna et al., 2021). The aircraft used is the General X-ray Unit, with mA used of 100 mA, recording images using Computer Radiography (CR) (Szaro, 2022;ARISKA, 2019). Based on the background of the radiographic examination of the clavicle with a suspected avulsion fracture, the formulation of the problem obtained is as follows: "How to get a radiographic picture with a suspected fracture of the clavicle good?" Destination this research is for knowing how to check avulsion fracture in hospital Adventist General Medan. To find out the inspection and projection techniques used in the os examination clavicle. To get the image criteria that can match the case. To establish a proper diagnosis case.

Type study
In writing creation scientific this writer use study descriptive qualitative. Study descriptive qualitative is wrong one method group status research human, a object with destination make descriptive, with the fact that there is , without exaggeration (Ward et al., 2018).

Time and Study ▪ Time Research
: The time of the study was carried out on April 06 -May 2022 ▪ The place Research : The place where the research is carried out is in the Installation Radiology Adventist General Hospital Medan.

Collection Technique Data
At this research stage, so that valid and accountable data can be obtained, it can be obtained through: ▪ Interview As for in data collection , researcher To do Interview with radiographer , as well as identify alone as I as patient related _ with disease that natural (Doyle et al., 2020).

▪ Consultation
To obtain accurate data on the implementation of Os Clavicula radiography with suspected avulsion fractures at the Medan Adventist General Hospital. Consultation with radiographers, radiology specialists and internal medicine doctors.

Observation Results
Direct observations made by researchers can be realized by taking notes in the form of information related to patients in the radiology room at the Medan Adventist General Hospital. And also observing how to observe the procedure for examining an Os Clavicula radiograph with a suspected avulsion fracture at the Medan Adventist Hospital. For this reason, researchers can make direct observations in order to obtain evidence related to the object of this research.

Analysis Results
The data obtained in this study is qualitative, namely data related to the categorization of the characteristics or properties of variables, this data is in the form of sentences, statements, and descriptions (Hunter et al., 2019). This qualitative analysis starting with direct observation of the radiographic examination of the Os Clavicula suspected of having an avulsion fracture at the Medan Adventist General Hospital. From the results of observations, the authors found the problem behind taking the title of this Scientific Writing. To solve the problem that found, the authors conducted interviews to retrieve data relating to the subject matter.
The results of the data are then processed by collecting data first, the results are transcribed and copied in typed form. After collecting data, it is continued with data reduction to obtain more valid data information, and then researchers carry out open coding, namely data IJMABER 1579 Volume 3 | Number 8 | August | 2022 is processed by analyzing the results of observations, consultations, and interviews. The aim is to facilitate the grouping of data information so that it is easier to draw conclusions.

Results
The case taken by the author is a clavicle radiograph with a suspected avulsion fracture at the Medan Adventist General Hospital Doctor the then give letter Request inspection radiography Os Clavicle part in radiology Patient and family patient enter to room radiology with bring letter Request inspection radiography Os Clavicle then give it to officer radiology.
Officer radiology read introduction photo the then give briefing to patient and family patient for follow something procedure inspection.

Preparation Patient
On radiographic examination of the os clavicle with suspected fracture avulsion does not require special preparation, but it is informed to the family patients to undress and replace them with patient clothes that have been provided in a special room to change clothes, so as not to interfere with the examination (Goes & Pathria, 2019). After that, inform the family to hold the patient so that the patient does not move.

Preparation Tools Inspection Aircraft x-ray
Before it's done action radiography, aircraft x-ray more formerly turned on and conducted warming up in accordance with procedure on aircraft X-ray so that all component aircraft xray could work by maximum. Aircraft X -rays used on inspection radiography os clavicle with guess fracture alvulsion is aircraft that have capacity tall, have bucky.
In inspection os clavicle use aircraft x-ray i.e. general X-ray unit at Home Sick General Adventist Medan with data as following :     Conclusion: Fracture of the distal clavicle avulsion.

Discussion
Avulsion fracture is a break in the continuity of bone tissue which is generally caused by external pressure that is greater than what can be absorbed from the bone (Rosyidi, 2017).
The discussion carried out on the radiographic study of Os Clavicula.

Formulas Problem
In case this writer formulate problem namely "Effort " what to do for get description radiography Os Clavicle with guess Fracture avulsion?"

Reason Problem
As for reason problem faced _ writer is on implementation radiography Os clavicle with guess fracture avulsion for get the optimal picture is condition patients who feel pain on area her shoulder so that patient no cooperative.

Efforts made _ for get results optimal Aspect Radiographer
For get picture Os clavicle with guess fracture avulsion so Cooperation Among radiographer with patient or family patient very required so that inspection could conducted with fluent in Thing this radiographer must operate the procedure that will done. Arrangement direction ray and right cassette _ and could give results good picture _ on film.

Aspect Patient
Because the patient experience fracture avulsion on Os clavicle. Avulsion is a state of trauma when miss it bone from the place by intact and produce wound complex, so patient need comfortable position _ maybe. So use tool like stand bucky that is standing back to cassette for support and expedite the way inspection so that could avoid happening repetition photo.

Aspect radiography
Should use large field irradiation to a minimum possible with limit that will be exposed in order to get optimal picture, so that results description more sharp and could reduce radiations

Conclusion
After the author conducted and observed a radiographic examination of the Os Clavicula with suspicion of an Avulsion Fracture at the Radiology Installation of the Hospital Adventist Medan and based on the results of the discussion of the problems that have been outlined by the author, so could taken a number of conclusion, in Thing this namely: Examination of the picture of the os clavicle with guess Fracture Avulsion used Supin e AP projection with use small focus. On the picture of the os clavicle with guess Fracture Avulsion recording picture conducted with Computed Radiography (CR) for efficient and to improve photo quality. os clavicle radiography with guess Fracture Avulsion need sharpness and optimal detail, so that abnormalities on Os Clavicle capable shown with clear.