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    Fraktur Terbuka

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    saraswaty710
    This document discusses the classification and management of fractures. It begins by defining fractures and their classification as closed or open based on whether the skin is intact. Gustilo classifications for open fractures are described based on the extent of soft tissue damage. Examination techniques for fractures are outlined including inspection, palpation, and radiological examination. Management principles focus on relieving pain, proper repositioning, promoting healing and function. Open fractures require emergent antibiotic treatment, debridement and irrigation, stabilization, and wound management. Early and late complications are also summarized.

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    Fraktur Terbuka

    Uploaded by

    saraswaty710
    249 views41 pages
    This document discusses the classification and management of fractures. It begins by defining fractures and their classification as closed or open based on whether the skin is intact. Gustilo classifications for open fractures are described based on the extent of soft tissue damage. Examination techniques for fractures are outlined including inspection, palpation, and radiological examination. Management principles focus on relieving pain, proper repositioning, promoting healing and function. Open fractures require emergent antibiotic treatment, debridement and irrigation, stabilization, and wound management. Early and late complications are also summarized.

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    Fraktur Terbuka

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    FRAKTUR TERBUKA

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    This document discusses the classification and management of fractures. It begins by defining fractures and their classification as closed or open based on whether the skin is intact. Gustilo classifications for open fractures are described based on the extent of soft tissue damage. Examination techniques for fractures are outlined including inspection, palpation, and radiological examination. Management principles focus on relieving pain, proper repositioning, promoting healing and function. Open fractures require emergent antibiotic treatment, debridement and irrigation, stabilization, and wound management. Early and late complications are also summarized.

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    249 views41 pages

    Fraktur Terbuka

    Uploaded by

    saraswaty710
    This document discusses the classification and management of fractures. It begins by defining fractures and their classification as closed or open based on whether the skin is intact. Gustilo classifications for open fractures are described based on the extent of soft tissue damage. Examination techniques for fractures are outlined including inspection, palpation, and radiological examination. Management principles focus on relieving pain, proper repositioning, promoting healing and function. Open fractures require emergent antibiotic treatment, debridement and irrigation, stabilization, and wound management. Early and late complications are also summarized.

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    of 41

    Dr.Wahyu Eko Widiharso, Sp.

    OT





    RS.BINA HUSADA
    2011
    SMF Bedah FK UKI 3
    SMF Bedah FK UKI
    4
    Putusnya hubungan kesinambungan/
    diskontinuitas tulang dan atau tulang rawan

    Fraktur tertutup :Bila kulit sekitar intak
    Fraktur terbuka :Bila ada luka, sehingga
    kemungkinan terjadi kontaminasi atau
    infeksi
    DEFINITION
    DEFINITION
    is break of bone, epifisis
    and cartilage
    adjacent
    with outside .

    CAUSE BY: TRAFFIC
    ACCIDENT/TRAUMA



    PICTURE
    ANKLE TIBIA

    Gustilo Classification
    I Low energy, wound less than 1 cm
    II Wound greater than 1 cm with moderate soft tissue damage
    III
    High energy wound greater than 1 cm with extensive soft tissue damage
    IIIA Adequate soft tissue cover
    IIIB Inadequate soft tissue cover
    IIIC Associated with arterial injury

    SMF Bedah FK UKI
    8
    I. Berdasarkan hub dengan dunia luar :

    1.Fraktur
    tertutup
    2. Fraktur
    terbuka
    COMPLETE/ UNCOMPLETE
    FRACTURE LINE FORM
    FRACTURE LINE
    DISPLACED /UNDISPLACED
    CLOSED OR OPEN FRACTURE



    Anamnesa

    Pemeriksaan Fisik
    A.GENERAL EXAMINATION.
    B.LOCAL EXAMINATION.

    Pemeriksaan X`ray
    TRAUMA :KLL/ non KLL

    MEKANISME TRAUMA

    POLYTRAUMA, MULTIPLE FRACTURE, OR
    LOCAL FRACTURE.
    PAIN

    HILANGNYA FUNGSI
    LUKA



    ATLS
    ABCD C-SPINE

    EXAMINATION OF HEAD,CHEST,ABDOMEN
    MULTIPLE TRAUMA/FRACTURE

    SHOCK
    OPEN FRACTURE IN THE SCENE
    LOOK

    FEEL

    MOVE
    DEFORMITY
    abnormal MOVEMENT , angulation, rotation dan
    discrepency
    FUNGSIOLAESA
    lost of function

    Pressure pain dan axial pain
    Crepitation

    Pain of movement

    ROM and Strengt of
    muscle

    Abnormal movement.
    Classical fracture easy to diagnose
    Non Classical Fractur need radiological
    examination
    Minimal 2 AP/Lateral projection
    Axial, alar and obturator.
    Chidren : need opposite side

    Include 2 joint
    TO PROMOTE HEALING AND FUNCTION OF
    BONE AS SOON AS POSSIBLE.
    1.RELEAVE PAIN
    2.GOOD REPOSITION
    3.PROMOTE HEALING
    4.PROMOTE FUNCTION
    5.REHABILITATION
    1.OPEN FRACTURE IS EMERGENCY CASE
    2.INITIAL EVALUATION (ATLS)
    3.ANTIBIOTIC FROM EMERGENCY ROOM,
    OPERATING THEATER AND POST
    OPERATION
    4.ADEQUATE DEBRIDEMENT DAN
    IRIGATION
    5.REPEAT DEBRIDEMEN (24-72 HOURS)


    6.Fracture stabilisation

    7.Open wound 5-7 days

    8.Bone Graft

    9.Rehabilitation
    1.WOUND CLEANING

    MECHANICAL
    IRIGATION WITH Na Cl
    TO REMOVED
    STRANGE BODY
    2.DEBRIDEMENT

    TISSUE NECROTIC EXC.

    NO VASC.TISSUE

    SKIN, SUB CUTAN, FAT,
    FASCIA AND MUCLE
    BONE FRAGMENT
    3.STABILIZATION

    GRADE I
    INTERNAL FIKSASI

    GRADE II/III
    EXTERNAL FIXATION

    TRACTION
    4.WOUND CLOSURE

    Golden period 6-7 hours

    Leave it open

    Skin graft
    5.antibitic

    Prevent infection

    Broad spectrum
    Cephalosporin
    Aminogcoside

    3-5 days
    Prevent Anti Tetanus

    ATS/Toxoid

    Rural area accident give
    Penicilin procain
    EARLY COMPLICATION
    1.LOCAL
    VASKULAR : COMPARTMENT SYND
    TRAUMA VARKULAR
    NEUROLOGIS : LESI MED.SPINAL

    2.SISTEMIC : FAT EMBOLISM ,SHOCK
    BLEEDING, SEPSIS AND DEATH. Tetanus
    Ganggren.
    LATE COMPLICATION

    JOINT STIFFNESS/CONTRACTURE
    DISUSE ATROFI
    MALUNION
    NONUNION
    DELAYED UNION
    GROWTH DISTURBANCE
    CHRONIC OSTEOMYELITIS
    DIAGNOSA FRAKTUR :
    Historycal examination
    Physical examination
    Radiological examination

    Open fracture Managemen

    Fracture Complication

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