Professional Documents
Culture Documents
Perceptor:
dr. Fatah Manovito, Sp.OT
Fadel Muhammad I
Indrani Nur Winarno P
Meti Destriyana
Sayyidatun Nisa
Definition
Discontinuity of bone/cartilage or
epiphyseal plate
Type of Fractures
Fracture Location
Types of Fractures
Communication with External
Environment
Fracture Location
Open Fractures
Gustillo ;
Type I
Type II
Type III A,B and C
OPEN FRACTURES
Type I open fracture
Type II open fracture
Type III A open fracture
Type III B open fracture
Type III C open fracture
Diagnosis of Fractures
History
Fall, twisting injury, direct blow, MVA
Localized pain, aggravated by movement
Crepitus
Physical Examination
General condition associated injuries
Look : deformity, swelling, abn movement
Feel : localized tenderness, muscle spasm,
NVD
Move : ROM
Diagnostic Imaging
Exact nature & extent of fracture
X-ray : min AP & lat (ocassional : oblique)
CT / MRI : spine, pelvis
History :
Biomechanics ~ Forces
Time of injury
Possibilities or serious injuries
Decrease / lost of functions
Previous management, transportation
Physical examination
General condition :
Vital signs
ABC’s
Local condition :
Look
Feel
Move
Local Condition
Look :
Deformities : angulations, discrepancy, rotation
Bone exposed
Swelling
Feel :
Pain, crepitation, edema
Move :
Functio laesa
!
Neuro-vascular
disturbance
Supporting examinations
Laboratory
Imaging
Treatment
1. First do No harm
2. Base treatment on an Accurate Diagnosis and
Prognosis
3. Select Treatment with Specific Aims
4. Cooperate with the “Law of Nature”
5. Make Treatment Realistic and Practical
6. Select treatment for your patient as an individual
LIFE SAVING MEASURES
4 R :
Recognition diagnosis, soc ec, religion, etc
Reposition displaced /deformity to anatomic /
acceptable position
Retaining fixation of fragments : external, internal
Rehabilitation early joint ROM, muscle action, edema,
psychological consideration , previous activity
SPLINT
Advantages :
Decreasing pain
Prevent further damages
Decrease or stop the bleeding
Easy transportation
Extrication, stabilization & Transportation
INDICATION OF CONSULTATION
IMMOBILISATION/SPLINT FIRST
DO NOT DO HARM
Bone Healing
Hematoma
Granulation Tissue
Callus formation
Bone Healing
Ossification
Consolidation
Remodelling
Complications
Compartment Syndrome
Venous Thrombosis
Pulseless Pallor
Compartment Syndrome
Clinical Signs :
Classical signs : 5 P (pain,
paresthesia, pallor, paralysis,
pulselessnes).
Bulae
Significant sign : strecth pain and
paresthesia, decompresion
fasciotomy
Measurement of the intra
compartment pressure
fasciotomy
Management
Remove extrinsic compression
Elevate to at least level of heart
Compartment pressure measurement?
Fasciotomy
Thank you
“to cure sometimes, to relieve often, to comfort
always.”
- Edward Livingston Trudeau -