You are on page 1of 32

dr. Dhanan P. Sesahayu, Sp.

OT
SMF Orthopaedi & Traumatologi
RSUD RA Kartini Jepara
 Nama : dr Dhanan Prastanika Sesahayu Sp.OT
 Tempat tgl lahir : Yogyakarta 10 Desember 1982
 Status : Menikah

 Riwayat Pendidikan
 1.SD islam AL-Azhar Kebayoran Lama Jakarta , lulus 1995
 2.SMP Islam AL Azhar Bintaro Jakarta . lulus 1998
 3.SMU Muhammdiyah 1 Yogyakarta , lulus 2001
 4.Fakultas Kedokteran UII , 2001-2007
 5.PPDS Orthopedi & Traumatologi FK UNS/ RS Ortopedi Prof.
Soeharso/ RS Dr Moewardi Surakarta, Juli 2008 - Januari 2014
 Riwayat Pendidikan Tambahan
 1.AO Trauma Basic Course, Jakarta 2011
 2.Residency Training in Hip Knee Arthroplasty,
Chonnam National University Hospital, South
Korea, 2012

 Tempat Bekerja :
 1.RSUD RA KARTINI JEPARA
 2.RS Islam Kudus
 3. RS Islam Jepara
 Bones:
 Femur
 Tibia
 Fibula
 Patella ACL PCL
 Menisci
 Medial Meniscus Medial
LCL Meniscus
 Lateral Meniscus
 Ligaments: Lateral
 MCL- Medial Collateral Meniscus MCL
Ligament
 LCL- Lateral Collateral
Ligament
 ACL- Anterior Cruciate
Ligament
 PCL- Posterior Cruciate
Ligament
 ACL – anterior cruciate
ligament  Provide stability by
limiting the tibia (lower
leg bone) from moving
forward in relation to
the femur (upper leg
bone)
 Limits rotation of the
knee joint
 twisting injury to the
knee
 direct blow to the
outside of the knee
with a contact or
noncontact
mechanism
 Acute
 Marked pain and pop
 Significant knee swelling
 Difficulty bearing weight on the affected knee
 Chronic
 The knee feels loose
 Feeling of “buckling”, “giving way” or instability
 Pain and swelling
 History
 Physical exam
 X-rays
 MRI-excellent for evaluating not only the ACL
but also the meniscus, articular cartilage and
other knee ligaments
contact sport
 Pain speaks for mild sprain
 Pain & laxity speak for moderate
sprain
 No fix endpoint speaks for
complete LCL rupture
 Lachman test
 Patient supine with knee flexed
30°
 Pull on the tibia towards you

 Anterior drawer test


 Patient supine with knee flexed
90°
 pull the tibia towards you
 Posterior drawer test
 Stay in the same position as
for the anterior drawer test
 Push the tibia posteriorly
 If it moves backwards the PCL
is probably damaged
 Another way of testing
the PCL is the sag sign
Ruptured ACL Knee

Intact Knee with ACL


& PCL
 Rest
 Ice
 Elevation
 Compression
 Protected Weight
Bearing
 Brace
 No!
 Who does not need surgery?
 Patients with very advanced arthritis
 Patients who do not do activities that require an
intact ACL?
 Patients who are not interested in committing to
post-operative rehab
 Patients who perform activities requiring an
intact ACL-most active patients
 Patients with associated knee injuries
 Other ligaments, meniscus tear, gliding cartilage
injury
 Young patients with an otherwise healthy
knee
 No injury to meniscus or gliding cartilage
 Every time your knee buckles you risk injuring
other vital structures in your knee
 Meniscus, ligaments, gliding cartilage
 What happens if the vital structures are
injured?
 Rapidly accelerated arthritis
 Patients with PCL tears often do not have symptoms of
instability in their knees --> surgery is not always needed.
 Many athletes return to activity without significant
impairment after completing a prescribed rehabilitation
program.
 Knee function after this surgery is often quite good
Types of ankle injuries :

• Sprain
• Ankle Fracture
•Contusion
Ankle Sprain

BACK
What’s an Ankle Sprain?
 An injury to one or more ligaments in the ankle
 Ligaments
 Connect two bones and
hold a joint together
 3 lateral ligaments in the
ankle give you stability
 Medial ligaments also help stabilize the ankle

 In an ankle sprain, ligament(s) are either


stretched or torn
3 types of Ankle injuries:
 Inversion injury -the most common
cause of an ankle sprain. It is caused by
the foot rolling towards the inside of
your legs.

 Eversion injury- Less commonly, the


foot rolls outward and your ankle goes
towards the inside of your legs.

 High ankle sprain - the least common.


It can happen when the foot is forced to
rotate toward the outside (away from
the other foot), or when the foot is
planted so it can't move and the leg is
rotated toward the inside.

BACK
 Type I sprain- minor
 Type II sprain - incomplete
 Type III sprain - complete
 Protection. Use a protective brace along with a compression
wrap for the first 24 to 36 hours.
 Rest. Use crutches until walking is not painful without them.
 Ice. For the first 48 to 72 hours or until swelling goes down, apply
an ice pack for 10 to 20 minutes every 1 to 2 hours during the
day.
 NSAIDs. Use some sort of pain relief medicine
 Compression. An elastic compression wrap will help decrease
swelling and should be worn for the first 24 to 36 hours.
 Elevation. Raise your ankle above the level of your heart for 2 to
3 hours a day if possible to decrease swelling and bruising.
BACK