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Dr.Wahyu Eko Widiharso, Sp.OT RS.BINA HUSADA 2011.

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Presentation on theme: "Dr.Wahyu Eko Widiharso, Sp.OT RS.BINA HUSADA 2011."— Presentation transcript:

1 Dr.Wahyu Eko Widiharso, Sp.OT RS.BINA HUSADA 2011

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3 SMF Bedah FK UKI3

4 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

5 DEFINITION  DEFINITION is break of bone, epifisis and cartilage adjacent with outside. CAUSE BY: TRAFFIC ACCIDENT/TRAUMA PICTURE

6 ANKLETIBIA

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8 SMF Bedah FK UKI 8 I. Berdasarkan hub dengan dunia luar : 1.Fraktur tertutup 2. Fraktur terbuka

9  COMPLETE/ UNCOMPLETE  FRACTURE LINE FORM  FRACTURE LINE  DISPLACED /UNDISPLACED  CLOSED OR OPEN FRACTURE

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13  Anamnesa  Pemeriksaan Fisik A.GENERAL EXAMINATION. B.LOCAL EXAMINATION.  Pemeriksaan X`ray

14  TRAUMA:KLL/ non KLL  MEKANISME TRAUMA  POLYTRAUMA, MULTIPLE FRACTURE, OR LOCAL FRACTURE.  PAIN  HILANGNYA FUNGSI  LUKA

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19  ATLS  ABCD C-SPINE  EXAMINATION OF HEAD,CHEST,ABDOMEN  MULTIPLE TRAUMA/FRACTURE  SHOCK

20 OPEN FRACTUREIN THE SCENE

21  LOOK  FEEL  MOVE

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

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24 Pressure pain dan axial pain

25  Crepitation  Pain of movement  ROM and Strengt of muscle  Abnormal movement.

26  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

27  TO PROMOTE HEALING AND FUNCTION OF BONE AS SOON AS POSSIBLE.

28  1.RELEAVE PAIN  2.GOOD REPOSITION  3.PROMOTE HEALING  4.PROMOTE FUNCTION  5.REHABILITATION

29  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)

30  6.Fracture stabilisation  7.Open wound 5-7 days  8.Bone Graft  9.Rehabilitation

31  1.WOUND CLEANING MECHANICAL IRIGATION WITH Na Cl TO REMOVED STRANGE BODY

32  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

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35  4.WOUND CLOSURE Golden period 6-7 hours Leave it open Skin graft  5.antibitic Prevent infection Broad spectrum Cephalosporin Aminogcoside 3-5 days

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37  Prevent Anti Tetanus ATS/Toxoid Rural area accident give Penicilin procain

38  EARLY COMPLICATION 1.LOCAL VASKULAR: COMPARTMENT SYND TRAUMA VARKULAR NEUROLOGIS: LESI MED.SPINAL 2.SISTEMIC: FAT EMBOLISM,SHOCK BLEEDING, SEPSIS AND DEATH. Tetanus Ganggren.

39  LATE COMPLICATION JOINT STIFFNESS/CONTRACTURE DISUSE ATROFI MALUNION NONUNION DELAYED UNION GROWTH DISTURBANCE CHRONIC OSTEOMYELITIS

40  DIAGNOSA FRAKTUR : Historycal examination Physical examination Radiological examination  Open fracture Managemen  Fracture Complication

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