FRAKTUR VERTEBRAE

ANATOMY OF VERTEBRAE
Vertebra consist of:
7 vertebra cervical
12 vertebra thoracal
5 vertebra lumbal
5 vertebra sacral
4 vertebra coccyx

ANATOMY OF VERTEBRA

ANATOMY OF VERTEBRA

TRAUMA CERVIKAL
FRAKTUR AVULSI :
(fraktur clay shoveller).

Mechanism of Fractures
Hyperflexion
Compression

Hyperextension

Axial

STRAIN SERVIKAL
(WHIPLASH)
The term whiplash given on a soft
tissue injury that occurs when the
neck arrived - arrived snapped into
hiperekstensi. usualy these injuries
occurred after a hit from behind ;
body was thrown forward and head
jerked back .

FRAKTUR C1 (FRAKTUR
JEFERSON)
Sudden heavy load on the head can
cause the power of " crushing " which
can cause fracture of the atlas ring
behind and in front of the lateral
masses ( Jeferson fracture ) .

FRAKTUR PEDICULUS C2
Fractures people found hanged in
daily life - the day in a car accident
where the head hit the windshield ,
forcing the neck berhiperekstensi . If
both pedicles fractured and severely
shifted , the damage will lead to
death

FRAKTUR ODONTOID

Gambar 2.15 Fraktur odontoid; anterior

dan
lateral
Odontoid fractures caused by accidents due to driving
in high speed or falling hard. Fractures that this shift is
actually a fracture - dislocation of the joints
atlantoaksial where the atlas slides forward or
backward , as well as bringing with him odontoid
processes .

CEDERA HIPEREKSTENSI C3 ke
T1

DISLOKASI DAN FRAKTUR DISLOKASI

between C3 and T1

injury flexion - rotation where the articular

surface lift to the front at the surface
underneath. Usually one or two masses
articular fractures but sometimes sometimes there is a pure dislocation
( Jumped Facets ) . Experienced posterior
ligament rupture and unstable spine . Often
there is damage to the cord . X -rays showed
vertebra shifts forward clearly above the
vertebra below it .

DISLOKASI PERMUKAAN
UNILATERAL
injury flexion rotation but only the
articular surface of the berdislokasi . In
the X-ray examination of the vertebral
body seemed to shift in part ( less than
half the width of the corpus ) and the
segment upper vertebrae rotated slightly
above the vertebra in below. Distruction
cord injury was very severe and can
occur spontaneously stabil.Reduksi neck
while being positioned for traction

Fraktur Thorakal
Thoracic vertebral fractures are
usually caused by trauma to the
longitudinal axis of the vertical
through belakang.Trauma bone
occurs because of the burden falling
over or falling from a height

The cause of fractures :

Trauma vertically along the longitudinal axis of the
spine due to trauma of the head or from below . In
these circumstances occur such as in trauma fracture
fractured cervical vertebrae .
hyperflexion trauma fracture with collapse of one or
more two vertebrae in a wedge-shaped front and that
will give kyphosis
Flexion accompanied by rotation will result in a
fracture and dislocation of the intervertebral joints
where there is a shift in the upper vertebra to
vertebra below it

injury Thorakolumbal
The most common cause of injury
was a fall from a height torakalumbal
and accidents. In an accident with On
crash with high speed and great
power often obtained assorted
combinations of styles that flexion ,
rotation and extension so that the
type of fracture is invoice dislocation

There are two types based on

stability , namely :
stable injury
unstable injury

prosessus transverse fracture

Usually occurs after a direct trauma or crushed
by heavy objects . Fractures can be on only one
prosessus tranversus or more on the same side .
Fractures can be accompanied by such a tool in
kidney damage
Compression Fractures
Compression on the front of the vertebral corpus
depressed and form a wedge fracture .
Compression fractures are the most common
fractures affecting the vertebral column

Fracture crushed ( Burst fractures )

Fractures occur when there is an emphasis vertebral corpus

and bone directly into the bone distruption.Fragmen
berpoensi into the canal spinalis.Terminologi this fracture is
spreading towards the edge of the vast corpus vrtebralis
caused more severe accidents than \ compression fractures

Fraktur dislokasi

Occurs when there is a segment of the vertebrae move

from its place because of the compression , rotation or
column tekanan.Ketiga damaged so very unstable , this
injury is very dangerous.Terapi depending on whether there
is or tidaknyan cord or nerve roots are damaged .
Lkerusakan will occur in the third part of the vertebral
kulomna with a combination of mechanisms accident
occurred, ie compression , pressure , rotation and peeling
process

Cedera pisau lipat (seat belt fracture)

Diagnosis
Anamnesa
physical examination
inspection support

Management
First aid and emergency treatment of
spinal trauma consists of :
assessment of consciousness ,
airway , breathing , circulation
Therapy on vertebral fracture begins
to overcome pain and stabilization to
prevent further damage again , it all
depends on the type of fracture

 Braces & Orthotics . There are three

things that do that ,
a.mempertahankan vertebral
alignment (alignment )
b.imobilisasi vertebrae convalescing .
c . overcome the pain that is felt by
limiting pergerakan.Fraktur that are
stable in need of stabilization

 This technique is a surgical technique

used for unstable fractures . Fusion is
the process of merging the two
vertebrae with bone graft assisted
with platrods tools , hooks and
pedicle bone graft is screws

 vertebroplasty & Kyphoplasty . This

action is a procedure that minimal.
invasion principle of this technique is
used in compression fractures
caused by osteoporosis and vertebral
tumors

Fracture lumbal-classification of
columna spinalis

FRACTURE LUMBAL
Classification
Based of tingkat keparahan :
Fracture minor : fraktur pada bagian belakang
vertebra yang tidak vital untuk stabilitas spinal.
Termasuk di dalamnya fraktur processus spinosus
dan facet joint
Fracture mayor : fraktur yang mengenai corpus
vertebra, pedikel, atau lamina. Fraktur corpus
vertebra dianggap mayor karena berfungsi untuk
menyangga beban tubuh. Fraktur pada pedikel atau
lamina dianggap berbahaya karena dapat terjadi
kerusakan saraf.

Based on the stability of the spine :

Fractures stable: if not cause spinal
deformity or neurological problems .
Vertebrae are still able to function
almost like normal
Fractures instabil : difficulty vertebrae
to support the load of the body and
can continue to further damage .
There deformity .

Based on the type of fracture

Fraktur kompresi : often occur in patient
with osteoporosis or patients with low
density bone.
Burst fracture : due to high energy
resulting an fracture comunitif
Flexion-distraction fracture : when body
force to the anterior. It result flexion of
vertebra
Fracture-dislocation : there is a fracture and
a dislocation in vertebra.

MECHANISM OF INJURY

fleksi dan rotasi

Trauma Fleksi

Hiperekstensi atau
retrofleksi

kompresi vertikal

Burst fracture

FRACTURE SACRUM
Definition : fracture of the sacrum is
the complete or incomplete fracture
in the sacrum

KLASIFIKASI DENIS fracture

sacrum

Transverse sacral fracture is rare , usually only 5 % of

the fractures that occur sakral.Karena fracture is
transverse , then classified in 3 Denis fracture , but
the fracture line usually includes three zones called
the transverse tersebut.Fraktur H , U , lambda and Tshaped fracture

KLASIFIKASI ROY- CAMILLE

Roy- Camille et al . And
Strange - Vognsen and
Lebech Denis zone 3
classification split into 4
subclassification . Fracture
type 1 shows the kyphosis
angulation of the fracture.
Fracture type 2 shows the
kyphosis and partial anterior
translation . 3 shows the
fracture type of kyphosis with
a complete translation .
Fracture type 4 shows the
segmental fraction of S1 with
axial compression

KLASIFIKASI ISLER
sler I do not interfere with the
stability of the lumbosacral , but
it can affect the stability of the
pelvic ring . Fractures of the
lumbosacral junction were out
past the L5 - S1 facet classified
as type II . Fractures of the
lumbosacral junction coming out
of the medial facet III.Fraktur
classified as type III type usually
associated with instability of the
lumbosacral junction.Injury type
III shows the separation sacrum
bilaterally with lumbosacral
section

Fracture Coccyx
Etio:
Mostly occurs when landing in the
seated position, but also during
childbirth

Diagnosis:
-tenderness palpated rectally or
eksternaly over coccyx

Management
Conservative :
-analgesic
-Stool softener-docusate (Dulcolax)
-Bed rest, Donut ring cushion
Discharge with orthopedi
-Surgical exission of fragment for
chronic pain