TACHJIAN TEXTBOOK

General Principles of Managing Orthopaedic Injuries

Nurul Indah PertiwiC111120
Andi Saputri majid C111120
Nurhafidah Mahfuz C11112058
Andi Idil saputra C111 12 059
Nur sa’adah SunusiC111 12 061
Advisor
Dr.Edwin
dr. Randy
Supevisor
dr. Icshan Kitta, Sp.OT

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 Classification of Physeal Injuries

Salter-Harris classification of physeal fractures

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 Classification of Physeal Injuries

Peterson classification of physeal fractures.

Type I injuries are frequently seen in the distal radius.
Type VI injuries are open and associated, with loss of a p
ortion of the physis.

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 Treatment of Physeal Injuries
• In general, the principles involved in the treatment ofphyseal injuries
are the same as those involved in the treatment of all fractures,
although there are a few important caveats.
• Before an injury to the physis is treated, the patient must be
thoroughly
assessed using the ABCs of trauma.
• The goal in treating physeal fractures is to achieve andmaintain an
acceptable reduction without subjecting the germinal layer of the
physis to any further damage.

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

Complications of Physeal Injuries
Assessment of Growth Disturbance
• physeal injuries may be complicated by malunion, in
fection, neurovascular problGrowth disturbance from
a physeal fracture is usually
• evident 2 to 6 months after the injuryems, or osteo
necrosis.

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 Asymmetric growth following a Salter-Harris type II distal femoral
fracture.

A: Valgus deformity 15 B: Magnetic resonance image de C: Clinical appearance 8 months

months after fracture monstrating asymmetric growth after a medial distal femoral
of the distal femoral physis. epiphysiodesis was performed.
DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017
 GUNSHOT WOUNDS

Gunshot wounds may be classified as high or low velocity.

HIGH VELOCITY
extensive soft tissue damage, gross contamination, comm
united fractures

LOW VELOCITY
have little soft tissue injuries of fracture communution

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 GUNSHOT WOUNDS

HIGH VELOCITY
should be treated as type III open fractures.
LOW VELOCITY
can be treated with local wound debridement and
short-term IV or oral antibiotic therapy.

PROGNOSIS IN CHILDREN HAVE A BETTER THAN ADULT

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 LAWNMOWER INJURIES

-ONE of unique subcategory of open fractures.

-Are bystanders rather than operators of even riders.
-Acute management of lawnmower injuries involves m
ultiple thorough debridement.
-Until there is no evidence of debris and there is a hea
lty granulation bed.
-BROAD-SPECTRUM ANTIBIOTICS.

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

 COMPARTMENT SYDROME

Compartment syndrome is a potentially devastating entity

that may develop when an injury induces increased pressure within
a closed space.
Compartment syndrome has been reported after
accidental injury, with or without a fracture, elective surgical
procedures (related to the procedure or positioning), infection,
snake bites, and IV infiltrations.

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017

DEPARTEMEN ORTHOPEDI DAN TRAUMATOLOGI FAKULTAS KEDOKTERAN UNIVERSITAS HASANUDDIN 2017